挑治法联合中药对精索静脉曲张性不育症患者精子质量和精浆活性氧/miR-210的影响  

Effect of needle-pricking and traditional Chinese medicine combination therapy on sperm quality and seminal plasma reactive oxygen species/miR-210 in varicocele infertility patients

作　　者：何超拔 袁少英[1] 覃湛[1] 金明昱[1] 耿立果[1] 王友炼 张兆磊[1] 王伟光[1] HE Chaoba;YUAN Shaoying;QIN Zhan;JIN Mingyu;GENG Liguo;WANG Youlian;ZHANG Zhaolei;WANG Weiguang(Department of Andrology,Guangzhou University of Chinese Medicine Affiliated Guangdong Provincial Hospital of Chinese Medicine,Zhuhai,Zhuhai 519015,Guangdong,China)

机构地区：[1]广州中医药大学附属广东省中医院珠海医院男科,广东珠海519015

出　　处：《中国性科学》2024年第1期135-140,共6页Chinese Journal of Human Sexuality

基　　金：珠海市医学科研基金项目(ZH3310200007PJL);广东省中医药科研项目(20202169)。

摘　　要：目的探讨挑治法联合中药对精索静脉曲张(VC)性不育症患者的临床疗效及作用机制。方法选取2020年10月至2022年6月在广东省中医院珠海医院诊治的120例气虚血瘀型VC性不育症患者作为研究对象。按照随机数字表法分为挑治组、联合组、对照组,各40例。挑治组予挑治法治疗,联合组在挑治组的基础上联合丹红通精方治疗,对照组采用显微精索静脉结扎术。观察并比较各组临床疗效、中医证候积分、精浆活性氧和微小RNA-210(miR-210)、精子浓度和总数、前向运动精子百分率、正常形态精子百分率等指标的变化。结果联合组与对照组总有效率高于挑治组(P<0.05)。各组治疗后精子浓度和总数、前向运动精子百分率、正常形态精子百分率均有明显提高(P<0.01),中医证候积分、精浆活性氧和miR-210水平均明显下降(P<0.01)。治疗后组间比较,除正常形态精子百分率差异无统计学意义(P>0.05)外,其余指标差异均具有统计学意义(P<0.05或P<0.01)。其中,精子浓度和总数、前向运动精子百分率、活性氧和miR-210水平方面,联合组与对照组改善均优于单纯挑治组(P<0.01或P<0.05),联合组及对照组之间差异则无统计学意义(P>0.05)。联合组中医证候积分改善优于挑治组和对照组(P<0.01)、挑治组优于对照组(P<0.01)。结论挑治对VC性不育患者精子质量有改善作用,挑治联合中药治疗可进一步提高疗效,短期内可以达到与显微手术相当的疗效,且对中医证候积分改善优于手术,无明显不良反应,其作用机制可能与调节miR-210、下调活性氧表达有关。Objective To explore the clinical effect and mechanism of the combination of needlepricking and traditional Chinese medicine(TCM)on varicocele(VC)infertility patients.Methods A total of 120 infertile patients with varicocele of qi deficiency and blood stasis type admitted to Guangdong Provincial Hospital of Chinese Medicine,Zhuhai from October 2020 to June 2022 were selected as study subjects.According to the random number table method,the patients were divided into the needle-pricking group,the combined group and the control group,with 40 subjects in each group.The needle-pricking group was treated with acupoint-pricking,while the combined group was treated with Danhong Tongjing Formula on the basis of the needle-pricking group.The control group was treated with varicocele ligation under the microscope.The clinical efficacy,TCM syndrome score,seminal plasma reactive oxygen species(ROS),and micro RNA-210(miR210),sperm concentration and total sperm count,the percentages of progressive motility sperm(PMS),morphologically normal sperm(MNS)were observed and compared among all groups.Results The total effective rate of the combined group and the control group were higher than that of the needle-pricking group(P<0.05).After treatment,sperm concentration,total sperm count,PMS and MNS in all groups were significantly increased(P<0.01),while TCM syndrome score,seminal plasma ROS and miR-210 levels were significantly decreased((P<0.01).All of index after treatment showed statistical differences in group comparison(P<0.05 or 0.01)except MNS(P>0.05).In terms of sperm concentration,total number count and PMS,ROS and miR-210 level,the improvement of the combined group and the control group were better than those of the needle-pricking group(P<0.01 or 0.05),while the difference between the combined group and the control group was not statistically significant(P>0.05).The improvement of TCM syndrome score in the combined group were better than that in the needle-pricking group and the control group(P<0.01),and the needle-prickin

关 键 词：精索静脉曲张 不育症 挑治法 微小RNA-210 活性氧 

分 类 号：R277.5[医药卫生—中医学]