益肾通络方治疗肾虚络阻型特发性弱畸精子症不育患者的临床疗效及对精浆氧化应激的影响  

Yishen Tongluo Prescription Treats Idiopathic Asthenospermia and Teratozoospermia in Patients with Syndrome of Kidney Deficiency and Collateral Obstruction by Alleviating Seminal Plasma Oxidative Stress

作　　者：李鹏超 何瑞宣 孙自学 LI Pengchao;HE Ruixuan;SUN Zixue(Henan Province Hospital of Chinese Medicine/Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450002,China;The Second Clinical Medical School of Henan University of Chinese Medicine,Zhengzhou 450008,China)

机构地区：[1]河南省中医院/河南中医药大学第二附属医院,郑州450002 [2]河南中医药大学第二临床医学院,郑州450008

出　　处：《中国实验方剂学杂志》2025年第9期157-164,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省中医药科学研究专项(2023ZY3010);河南省中原英才计划-中原名医项目(ZYMY201809);国家中医药管理局高水平中医药重点学科建设项目-中医男科学(国中医药人教函[2023]85号)。

摘　　要：目的:观察益肾通络方治疗肾虚络阻型特发性弱畸精子症患者的临床疗效及对精浆生化、精浆氧化应激相关指标的影响。方法:将符合纳入标准的患者按随机数字表法分为观察组61例(脱落2例,完成59例)、对照组61例(脱落2例,剔除1例,完成58例)。观察组口服益肾通络方,1剂/d;对照组口服左卡尼汀口服溶液,10 mL/次,3次/d,两组疗程均为12周,随访6周,记录两组患者治疗前后前向运动精子比例(PR)、正常形态精子率、氧化应激指标[精浆超氧化物歧化酶(SOD)、精浆丙二醛(MDA)]、精浆生化指标[精浆酸性磷酸酶(ACP)、精浆锌(Zn)、精浆果糖(Fru)、精浆α-葡萄糖苷酶(α-Glu)]及中医证候积分等情况。结果:观察组总有效率为76.3%(45/59),对照组总有效率为44.8%(26/58),观察组高于对照组(χ^(2)=12.120,P<0.05)。与本组治疗前比较,两组患者PR、正常形态精子率、精浆SOD水平均升高(P<0.05),且与对照组治疗后比较,观察组患者PR、正常形态精子率、精浆SOD水平升高更明显(P<0.05);两组患者MDA水平、中医证候积分均明显下降(P<0.05),且与对照组治疗后比较,观察组患者精浆MDA水平、中医证候积分下降更明显(P<0.05)。与本组治疗前比较,治疗后观察组患者精浆ACP、Zn、Fru、α-Glu水平均升高(P<0.05),对照组患者精浆α-Glu水平升高(P<0.05)。与对照组治疗后比较,观察组患者精浆ACP、Zn、Fru、α-Glu水平均明显升高(P<0.05),两组均未发生明显的不良反应。结论:益肾通络方能改善肾虚络阻型特发性弱畸精子症不育患者精子活力与畸形率,其作用机制可能通过对附睾、前列腺、精囊腺微环境产生影响,改善精浆生化水平,以及提高精浆抗氧化能力,清除过多活性氧,缓解氧化应激反应有关。Objective:To evaluate the clinical effects of Yishen Tongluo Prescription in treating patients with idiopathic asthenozoospermia and teratozoospermia due to kidney deficiency and collateral obstruction,as well as the effects of this formula on biochemical indices and oxidative stress of seminal plasma.Methods:Patients who fulfilled the inclusion criteria were randomly allocated by the random number table method into an observation group(61 patients,including 2 dropped out and 59 completed)and a control group(61 patients,including 2 dropped out,1 excluded,and 58 completed).The observation group took Yishen Tongluo Prescription orally,1 dose/day,and the control group took levocarnitine oral solution,10 mL/time,3 times/day.Both groups received a treatment course of 12 weeks and were followed up for 6 weeks.The percentage of progressive motile sperms(PR),percentage of sperms with normal morphology,seminal plasma oxidative stress indicators[malondialdehyde(MDA)and superoxide dismutase(SOD)],seminal plasma biochemical indicators[acid phosphatase(ACP),zinc(Zn),fructose(Fru),and alpha-glucosidase(α-Glu)],and traditional Chinese medicine(TCM)symptom scores were recorded for both groups before and after treatment.Results:The total response rate in the observation group was 76.3%(45/59),which was higher than that(44.8%,26/58)in the control group(χ^(2)=12.120,P<0.05).After treatment,both groups of patients showed increases in PR,percentage of sperms with normal morphology,and seminal plasma SOD level(P<0.05),which were higher in the observation group than in the control group(P<0.05).The MDA level and TCM symptom scores decreased in both groups after treatment(P<0.05),and the decreases were more obvious in the observation group than in the control group(P<0.05).After treatment,the seminal plasma levels of ACP,Zn,Fru,andα-Glu in the observation group(P<0.05)and that ofα-Glu in the control group(P<0.05)rose.Moreover,the observation group had higher seminal plasma levels of ACP,Zn,Fru,andα-Glu than the control group(P<0.05

关 键 词：特发性弱畸精子症 益肾通络方 肾虚络阻证 疗效评价 

分 类 号：R259[医药卫生—中西医结合] R698.2[医药卫生—中医内科学] R256.56[医药卫生—中医学]