中医补肾法治疗无症状弱精子症疗效及安全性的Meta分析  

Meta-analysis of efficacy and safety of kidney-tonifying method of traditional Chinese medicine in the treatment of asymptomatic asthenozoospermia

作　　者：姜子祥 赵子寅 郑维玺 史孟华 徐磊 鲁佳建 林煦垚 傅伟 张春和 秦国政 JIANG Zixiang;ZHAO Ziyin;ZHENG Weixi;SHI Menghua;XU Lei;LU Jiajian;LIN Xuyao;FU Wei;ZHANG Chunhe;QIN Guozheng(Master Degree Candidate of Surgery Enrolled in 2023,the First School of Clinical Medicine,Yunnan Uniersity of Chinese Medicine,Kunming 650500,Yunnan,China;Doctoral Candidate of Surgery Enrolled in 2022,the First School of Clinical Medicine,Yunnan Uniersity of Chinese Medicine,Kunming 650500,Yunnan,China;Doctoral Candidate of Surgery Enrolled in 2023,the First School of Clinical Medicine,Yunnan Uniersity of Chinese Medicine,Kunming 650500,Yunnan,China;Department of Andrology,Yunnan Provincial Hospital of Traditional Chinese Medicine(the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine),Kunming 650021,Yunnan,China;Department of Andrology,Shenzhen Bao′an Hospital of Traditional Chinese Medicine,Shenzhen 518100,Guangdong,China)

机构地区：[1]云南中医药大学第一临床医学院,昆明650500 [2]云南省中医医院(云南中医药大学第一附属医院)男科,昆明650021 [3]深圳市宝安中医院男科,广东深圳518100

出　　处：《中国性科学》2025年第2期101-106,共6页Chinese Journal of Human Sexuality

基　　金：2023年中医药循证能力提升项目-男性不育循证研究(云财社[2024]12号)。

摘　　要：目的系统评价中医补肾法治疗无症状性弱精子症的疗效与安全性,为中医补肾法治疗无症状弱精子症提供循证依据。方法检索中国知网、维普、万方、the Cochrane Library、PubMed等数据库建库至2024年6月30日收录的中医补肾法治疗无症状弱精子症的随机对照试验(RCT)文献。使用Jadad评分量表进行文献质量评价,采用Revman5.4软件进行Meta分析。结果本研究共纳入6篇RCT文献。Meta分析结果显示,治疗组总有效率(OR=2.85,P<0.0001)、前向运动精子百分率(PR)(MD=7.47,P<0.00001)、PR+非前向运动精子百分率(NP)(MD=8.77,P<0.00001)、妊娠率(OR=3.20,P=0.0006)均优于对照组;两组不良反应比较,差异无统计学意义(OR=1.37,P=0.70)。结论中医补肾法治疗无症状弱精子症的疗效优于单纯西医治疗,且两者安全性相当,提示在临证辨治无症状性弱精子症时应从肾论治,采用中医补肾法改善精子活力,提高妊娠率。Objective To systematically evaluate the efficacy and safety of kidney-tonifying method of traditional Chinese medicine(TCM)in the treatment of asymptomatic asthenozoospermia and provide evidence-based support for the application of kidney-tonifying method of TCM in treating asymptomatic asthenozoospermia.Methods Randomized controlled trial(RCT)literature on the kidney-tonifying method of TCM for asymptomatic asthenozoospermia was retrieved from CNKI,VIP,Wanfang,the Cochrane Library,and PubMed databases from the establishment of the databases to June 30,2024.The quality of the literature was evaluated using the Jadad scoring system,and a Meta-analysis was conducted using RevMan 5.4 software Results A total of 6 RCT literatures were included in this study.The Meta-analysis indicated that treatment group was superior to the control group in terms of the total effective rate(OR=2.85,P<0.000,1),progressive motility of sperm rate(PR)(MD=7.47,P<0.000,01),PR+non-progressive motility sperm rate(NP)(MD=8.77,P<0.000,01),and the pregnancy rate(OR=3.20,P=0.000,6).However,there was no statistically significant difference in adverse reactions(OR=1.37,P=0.70)between the two groups.Conclusions The kidney-tonifying method of TCM has advantages over simple western medicine treatment in the management of asymptomatic asthenozoospermia,and the safety of both is comparable.It is suggested that the treatment of asymptomatic asthenozoospermia in clinical practice should be based on kidney theory,using kidney-tonifying method of TCM to improve sperm motility and increase pregnancy rates.

关 键 词：中医补肾法 无症状弱精子症 不育 META分析 

分 类 号：R275[医药卫生—中医皮科]