精索静脉曲张性不育与中医体质的相关性研究
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摘要
目的探讨精索静脉曲张性不育患者中医体质辨识的分布规律并分析其精液参数与中医体质之间的相关性。方法选取2016年9月1日—2017年11月30日期间在宁波市中医院男科门诊就诊并符合纳入标准的患者146例,年龄20～45岁。通过回收患者所填写的《精索静脉曲张性不育临床症状调查表》、《中医体质观察表》,记录患者一般信息、精液常规以及中医体质情况等结果,再经过相关统计学处理,分析患者基本信息、中医体质及精液常规相关结果之间的统计学关系。结果 (1)146例精索静脉曲张性不育患者中,各体质类型所占比例分别为气郁质17.59%、气虚质16.67%、血瘀质11.58%、阴虚质11.34%、阳虚质10.88%、痰湿质9.72%、湿热质9.49%、平和质7.87%、特禀质4.86%。(2)在相关精液参数与主要中医体质类型的关系中,采用非参数秩和检验或者独立样本t检验分析后可知,气郁质与非气郁质、阴虚质与非阴虚质患者的精子浓度差异均有统计学意义(均P<0.05),气虚质与非气虚质患者的精子总活力差异有统计学意义(P<0.05)。而前向运动精子及正常形态精子比例与主要中医体质类型之间不相关(均P>0.05)。结论精索静脉曲张性不育与中医体质类型相关;其精子浓度分别与气郁质、阴虚质有相关性,精子总活力与气虚质有相关性。
Objective To explore the distribution rule of TCM constitution identification in patients with varicocele infertility,and analyze the correlation between the parameters of related semen and TCM constitution.Methods Total 146 patients meeting the inclusion criteria of male infertility caused by varicocele,aged 20 to 45 years,from the andrology clinic in Ningbo Hospital of TCM from September 2016 until November 2017 were enrolled into study.The general information,semen analysis and body constitution in TCM were collected by " Questionnaire of Clinical Symptoms of Male Infertility Caused by Varicocele" and " Scale for Body Constitution in TCM",and their relationships were analyzed by using statistical methods.Results(1)Among the 146 cases,qi-stagnation constitution accounted for 17.59%,qi-deficiency constitution for 16.67%,blood-stasis constitution for 11.57%,yin-deficiency constitution for 11.34%,yang-deficiency constitution for 10.88%,phlegm-dampness constitution for 9.72%,damp-heat constitution for 9.49%,gentleness constitution for 7.87%,and special-innateness constitution for 4.86%.(2) There was statistically difference in the sperm concentration between qi-deficiency constitution and non qi-deficiency constitution patients and between yin-deficiency constitution and non yin-deficiency constitution patients by using the nonparametric rank sum test or t-test for independent samples(all P < 0.05).However,there is no statistical significance between the main TCM constitution and the rate of forward moving sperm and normal morphological sperm(all P > 0.05).Conclusion Varicocele infertility is related to TCM constitution.The sperm concentration is respectively correlated with qi-stagnation constitution and yin-deficiency constitution,and the total sperm motility is correlated with qi-deficiency constitution.
Objective To explore the distribution rule of TCM constitution identification in patients with varicocele infertility,and analyze the correlation between the parameters of related semen and TCM constitution.Methods Total 146 patients meeting the inclusion criteria of male infertility caused by varicocele,aged 20 to 45 years,from the andrology clinic in Ningbo Hospital of TCM from September 2016 until November 2017 were enrolled into study.The general information,semen analysis and body constitution in TCM were collected by " Questionnaire of Clinical Symptoms of Male Infertility Caused by Varicocele" and " Scale for Body Constitution in TCM",and their relationships were analyzed by using statistical methods.Results(1)Among the 146 cases,qi-stagnation constitution accounted for 17.59%,qi-deficiency constitution for 16.67%,blood-stasis constitution for 11.57%,yin-deficiency constitution for 11.34%,yang-deficiency constitution for 10.88%,phlegm-dampness constitution for 9.72%,damp-heat constitution for 9.49%,gentleness constitution for 7.87%,and special-innateness constitution for 4.86%.(2) There was statistically difference in the sperm concentration between qi-deficiency constitution and non qi-deficiency constitution patients and between yin-deficiency constitution and non yin-deficiency constitution patients by using the nonparametric rank sum test or t-test for independent samples(all P < 0.05).However,there is no statistical significance between the main TCM constitution and the rate of forward moving sperm and normal morphological sperm(all P > 0.05).Conclusion Varicocele infertility is related to TCM constitution.The sperm concentration is respectively correlated with qi-stagnation constitution and yin-deficiency constitution,and the total sperm motility is correlated with qi-deficiency constitution.
引文
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[14]刘易.铁皮石斛多糖对肾阴虚大鼠抗氧化活性和免疫调节影响的研究[D].广州:广州中医药大学,2015.
[15]尹西拳.地黄丸类方对肾阳虚大鼠HPAT轴的影响及配伍理论研究[D].广州:广州中医药大学,2014.
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[18]陆杰.中药保留灌肠联合红黄仙子饮治疗Ⅲ型前列腺炎并不育症临床观察[D].南宁:广西中医药大学,2016.
[19]王永.弱精子症中医体质与中医证型分布规律及其相关性分析[J].现代中西医结合杂志,2017,26(33):3692-3694.
[20]杨世坚.102例特发性弱畸形精子症患者与中医体质辨识的相关研究[D].广州:广州中医药大学,2016.
[2]王权胜,王悦良,唐振宇.精索静脉曲张性不育的中医治疗研究概况[J].广西中医药大学学报,2016,19(2):107-109.
[3]顾硕,傅广波,牛晓兵,等.显微外科技术治疗复发性精索静脉曲张的临床分析[J].微创泌尿外科杂志,2018,7(2):119-121.
[4]王琦.中医体质学[M].北京:人民卫生出版社,2005:2.
[5]姜辉,邓春华.中国男科疾病诊断治疗指南与专家共识(2016版)[M].北京:人民卫生出版社,2016:39-102.
[6]许鹏.胃癌化疗毒性与中医体质之间关系[J].吉林中医药,2018,38(6):648-651.
[7]柴琦琦.聚精颗粒治疗畸形精子症的临床和实验研究[D].南京:南京中医药大学,2018.
[8]崔云,郑军状,江大为.从经络、气血论肝肾同源主男性不育症理论构建[J].辽宁中医药大学学报,2016,18(1):5-7.
[9]方跃坤,崔云,郑军状,等.崔云运用疏肝通络强精法治疗精索静脉曲张不育症经验撷菁[J].上海中医药杂志,2017,51(1):29-31.
[10]林兆丰,唐运革,石汉振,等.气郁体质对男性不育症患者性激素水平的影响[J].中国中医基础医学杂志,2014,20(8):1077-1078.
[11]刘祺,曹继刚.浅议气郁体质与男科疾病[J].光明中医,2014,29(3):467-468.
[12]谈望晶,朱向东,安耀荣,等.基于《黄帝内经》养生思想的溃疡性结肠炎缓解期的调治与保养[J].时珍国医国药,2018,29(5):1178-1180.
[13]郭军华,何清湖.滋阴补肾法防治男性不育症的实验研究进展[J].湖南中医药大学学报,2014,34(6):57-60.
[14]刘易.铁皮石斛多糖对肾阴虚大鼠抗氧化活性和免疫调节影响的研究[D].广州:广州中医药大学,2015.
[15]尹西拳.地黄丸类方对肾阳虚大鼠HPAT轴的影响及配伍理论研究[D].广州:广州中医药大学,2014.
[16]黄卫强,彭红华.皮肤衰老从肾论治[J].中华中医药杂志,2014,29(1):299-300.
[17]罗玉雪,李晓荣,杨锦亮,等.六味地黄丸对自然衰老SD大鼠卵巢功能的影响[J].宁夏医科大学学报,2018,40(5):512-516.
[18]陆杰.中药保留灌肠联合红黄仙子饮治疗Ⅲ型前列腺炎并不育症临床观察[D].南宁:广西中医药大学,2016.
[19]王永.弱精子症中医体质与中医证型分布规律及其相关性分析[J].现代中西医结合杂志,2017,26(33):3692-3694.
[20]杨世坚.102例特发性弱畸形精子症患者与中医体质辨识的相关研究[D].广州:广州中医药大学,2016.