1.上海中医药大学,上海 201203
2.上海中医药大学 附属第七人民医院,上海 200137
王俊博,硕士,从事泌尿及生殖疾病的研究,E-mail:wangjunboflying@163.com
孙建明,博士生导师,主任医师,从事泌尿及生殖疾病的研究,E-mail:sunjm67@126.com
收稿:2024-07-15,
录用:2024-08-28,
网络出版:2024-10-21,
纸质出版:2025-03-20
移动端阅览
王俊博,梁世佳,毛剑敏等.九子回春方联合健脾灸治疗脾肾两虚型弱精子不育症的临床疗效[J].中国实验方剂学杂志,2025,31(06):171-179.
WANG Junbo,LIANG Shijia,MAO Jianmin,et al.Clinical Efficacy of Jiuzi Huichun Decoction Combined with Spleen-strengthening Moxibustion on Asthenospermia Infertility with Spleen-kidney Deficiency Pattern[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(06):171-179.
王俊博,梁世佳,毛剑敏等.九子回春方联合健脾灸治疗脾肾两虚型弱精子不育症的临床疗效[J].中国实验方剂学杂志,2025,31(06):171-179. DOI: 10.13422/j.cnki.syfjx.20250492.
WANG Junbo,LIANG Shijia,MAO Jianmin,et al.Clinical Efficacy of Jiuzi Huichun Decoction Combined with Spleen-strengthening Moxibustion on Asthenospermia Infertility with Spleen-kidney Deficiency Pattern[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(06):171-179. DOI: 10.13422/j.cnki.syfjx.20250492.
目的
2
观察九子回春方联合健脾灸对脾肾两虚型弱精子不育症患者的有效性和安全性。
方法
2
纳入上海市第七人民医院脾肾两虚型弱精子症患者82例,随机分为观察组和对照组,每组各41例。对照组口服五子衍宗丸联合健脾灸,五子衍宗丸每日1剂,2次/d,每次1袋,健脾灸每周1次;观察组口服九子回春方联合健脾灸,九子回春方每日2次,早、晚各服用1次,每次200 mL,健脾灸每周1次。两组患者疗程均为12周,并随访12周。治疗期间脱失及剔除12例,最终可供评估病例70例,对照组35例,观察组35例。记录6个月内患者配偶受孕情况;进行治疗前后脾肾两虚型中医证候评分;检测两组患者治疗前与治疗后精液量、精液常规参数、精子正常形态、精子DNA碎片指数、精浆果糖、精浆酸性磷酸酶与精浆
α-
葡糖苷酶水平;检测两组患者治疗前后肝、肾功能相关安全性指标。
结果
2
在6个月的观察期间,与本组治疗前比较,观察组与对照组患者治疗后精液量有所升高,但差异无统计学意义,精子浓度、精子活率、a+b级精子比例、精子正常形态、精浆果糖、精浆酸性磷酸酶、精浆
α
-葡糖苷酶、a级精子比例、直线精子活率、直线精子浓度、直线精子数均明显升高(
P
<
0.05),精子DNA碎片指数、脾肾两虚型中医证候评分均明显降低(
P
<
0.05)。与对照组治疗后比较,观察组临床疗效优于对照组(
Z
=-2.276,
P
<
0.05),观察组配偶受孕率为14.3%,高于对照组的2.9%,但差异无统计学意义,观察组精子活率、a+b级精子比例、精浆果糖、a级精子比例、正常精子形态、
α
-葡糖苷酶、直线精子活率均高于对照组(
P
<
0.05),观察组精子DNA碎
片指数、脾肾两虚型中医证候评分均低于对照组(
P
<
0.01)。二组治疗中未见严重不良反应,治疗后安全性指标未见异常。
结论
2
九子回春方联合健脾灸用于脾肾两虚型男性弱精不育症患者可提升精子活率与精子浓度、改善脾肾两虚型弱精子症中医相关证候及精子形态、降低精子DNA碎片指数、并可调节精浆生物酶水平,值得在临床实践中进一步推广及应用。
Objective
2
To observe the effectiveness and safety of Jiuzihuichun decoction combined with spleen- strengthening moxibustion in patients with asthenospermia infertility with spleen-kidney deficiency pattern.
Methods
2
A total of 82 patients with asthenospermia of spleen-kidney deficiency pattern in Shanghai Seventh People's Hospital were included. The patients were randomly divided into an observation group and a control group, with 41 patients in each group. The control group received oral administration of WuziYanzong pills combined with spleen-strengthening moxibustion. The dosage of Wuzi Yanzong pills was 1 bag each time, and it was taken twice a day. The spleen-strengthening moxibustion was carried out once a week. The observation group, on the other hand, took Jiuzi Huichun decoction orally combined with spleen-strengthening moxibustion. The Jiuzi Huichun Decoction was taken 200 mL each time, twice a day, with one dose in the morning and one in the evening. The spleen-strengthening moxibustion for the observation group was also performed once a week. The treatment course for both groups was 12 weeks, and they were followed up for an additional 12 weeks. During the treatment process,12 cases were either lost to follow-up or excluded. Eventually, 70 cases were available for evaluation,with 35 cases in the control group and 35 cases in the observation group. The pregnancy status of the patients' spouse within 6 months was recorded. The traditional Chinese medicine (TCM) syndrome scores of spleen-kidney deficiency pattern before and after treatment were evaluated. The semen volume,semen routine parameters,normal sperm morphology,sperm DNA fragmentation index,seminal plasma f
ructose,seminal plasma acid phosphatase, and seminal plasma
α
-glucosidase levels of the two groups were detected before and after treatment. In addition, the safety indicators related to liver and kidney functions of the two groups were detected before and after treatment.
Results
2
During the 6-month observation period, when compared with the situation before treatment in their respective groups,the semen volume of the observation group and the control group increased. In contrast, the sperm concentration,sperm motility,proportion of a+b-grade sperm,normal sperm morphology,seminal plasma fructose,seminal plasma acid phosphatase,seminal plasma
α
-Glucosidase,the proportion of a-grade sperm,linear sperm motility,linear sperm concentration, and linear sperm count all increased significantly(
P
<
0.05). At the same time, the sperm DNA fragmentation index and the TCM syndrome scores of the spleen-kidney deficiency pattern decreased significantly(
P
<
0.05). When the observation group was compared with the control group after treatment, the clinical efficacy of the observation group was better(
Z
=-2.276,
P
<
0.05). The pregnancy rate of the observation group's spouses was 14.3%,which was higher than the 2.9% of the control group. The sperm motility, the proportion of a+b-grade sperm,seminal plasma fructose,the proportion of a-grade sperm,normal sperm morphology,
α
-glucosidase, and linear sperm motility in the observation group were higher than those in the control group (
P
<
0.05). Moreover, the sperm DNA fragmentation index and the TCM syndrome scores of spleen-kidney deficiency pattern in the observation group were lower than those in the control group (
P<
0.01). No serious adverse reactions occurred in the two groups,and no abnormalities were found in the safety indicators after treatment.
Conclusion
2
Jiuzi Huichun decoction combined with spleen-strengthening moxibustion can enhance sperm viability and sperm concentration. It can also improve the TCM-related symptoms of asthenospermia of spleen-kidney deficiency pattern and sperm morphology. Additionally, it can reduce the sperm DNA fragmentation index and regulate the level of seminal plasma bioenzyme in patients with male asthenospermia infertility of spleen-kidney deficiency pattern. Therefore, it is worthy of further promotion and application in clinical practice.
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