摘要
世界卫生组织的研究结果表明，发达国家约有5％～8％的夫妇受到不育症的影响，发展中国家一些地区不育症的患病率高达30％，全世界的不育症人数约5000万～8000万，且每年约有200万新增的不育不孕夫妇，其中因男性原因而引起的不育约占50％。而特发性少精子症是男性不育的重要原因，且发病率有上升趋势。
特发性少精子症发病机理至今尚未完全明了。近年来现代医学对该病的治疗主要从激素、抗激素、抗炎、手术、辅助生殖技术的治疗着手，不良反应大，价格不菲。因受孕率低，疗效也欠满意，而且也由于人们的文化差异难以被国内不育患者接受。因此寻找一种行之有效、无副作用、无依赖性、经济、易行的治疗方法是非常需要的。
导师陈德宁教授在古方聚精丸的基础上，结合多年临床经验得出的验方一加味聚精食疗汤，融药疗与食疗于一体，滋肾填精，健脾益气，不仅口感良好，且安全无毒。该方对脾肾两虚型少精子症有效率高，治疗后患者精子密度、活力较治疗前均有明显上升，且简便易行，便于临床推广应用。本研究通过比较口服加味聚精食疗汤和五子衍宗片对少精子症患者精子质量的影响，探讨加味聚精食疗汤改善精子质量的机理，为少精子症患者提供更方便有效的中医治疗方法。
研究目的：本课题遵循循证医学、临床流行病学／DME的原则，观察加味聚精食疗汤对少精子症患者精子质量的影响。
研究方法：选取广州中医药大学附属深圳市中医院男科的少精子症患者80例为研究对象，利用简单随机化方法，把患者随机分为加味聚精食疗汤组(治疗组)和五子衍宗片组(对照组)，各40例。实验组：观察40例患者口服加味聚精食疗汤3个月后精子质量的变化；对照组：观察40例患者口服五子衍宗片3个月精子质量的变化。比较两组治疗前后精子质量变化。
研究结果：
1、实验组与对照组治疗前精子密度、液化时间、pH值差异无统计学意义，治疗后实验组和对照组精子密度均有明显改善，两组分别与治疗前比较差异有统计学意义(P＜0.05)，但实验组改善更加明显，两组治疗后进行比较(P＜0.05)，差异有统计学意义，两组治疗前后液化时间及pH值无明显改变，差异无统计学意义。
2、治疗前后两组患者症状均有明显改善，与治疗前相比差异有统计学意义(P＜0.05)，但治疗后治疗组与对照组相比改善更加明显，差异有统计学意义(P＜0.05)。
3、治疗前后CASA检测的精子的3种速度参数直线速度、曲线速度、平均路径速度两组都有改善，P＜0.05，差异有统计学意义，但两组治疗后比较差异无统计学意义(P＞0.05)。
研究结论：
1、加味聚精食疗汤和五子衍宗片治疗少精子症导致的不育症均有确切疗效，两者均能提高怀孕率、改善精子质量(精子密度、精子活力)，加味聚精食疗汤疗效较五子衍宗片明显。
2、加味聚精食疗汤和五子衍宗片治疗少精子症患者脾肾两虚症状均有改善，加味聚精食疗汤较对照组改善更加明显。
3、加味聚精食疗汤口服无副作用、无不良反应。
Research of the World Health Organization (WHO) indicates that 5%~8% of married couples in the developed countries are suffering from infertility, while in some area of the developing countries, it might reach 30%. In total, the global infertility rate is about 50~80 million with an increase of 2 million new cases each year. Among them, 50% are from males which are mainly caused by an unexpected Oligospermia. What' s more, incidence is on the rise.
Pathogenesis of the unexpected Oligospermia is still not quite clear. In the recent years, treatment of modern medicine is based on the use of hormone, antihormone, anti-inflammation, surgery and technological aided- reproduction. All these treatments are not only costly and highly adverse in effects, but also low in pregnancy rate and unsatisfactory to the curative effects, which are difficult to be accepted by our domestic patients in this cultural differences. Therefore, it is promptly required to find a treatment which is effective, economical, practical, with no side effects and with no medicine dependence.
The recipe of Jiaweijujing Decoction prescripted by Professor Chen Dening is based on the combination of Ancient-recipe Jujing pills and long times of his clinical experience. This recipe combines the medicine and diet therapy with a good tasting, safety and non-toxic materials, which is good for nourishing the kidney and replenishing the essence as well as strengthening the spleen and supplementing the vital energy. This recipe has great efficiency on Oligospermia. The density and vitality of the patients' sperms increase obviously comparing with those before therapy. It is simple and easy for clinical popularization and application. This research discusses how the Jiaweijujing decoction improves the mechanism of sperm quality by comparing the sperm quality of the patients with Oligospermia treated by the therapy of Jiaweijujing decoction with those by Wuziyanzong tablets in order to offer a more convenient and effective traditional Chinese medicine therapy to these patients.
Objective:
To study the effects of Jiaweijujing decoction on sperm quality in patients with oligospermia.
Method:
80 outpatients suffering oligospermia were recruited from out-patient department of andrology of Shenzhen Hospital of TCM. Subjects were randomly allocated two groups. 40 cases of trial group took the Jiaweijujing decoction for 3 months, while 40 cases of control group took the Wuziyanzong tablet the same. Observe the changes of their sperm quality.
Result:
1. The difference of density of sperm, liquefying time, pHbetween trial and control group before treatment has no statistic meaning. Meanwhile the density of sperm of the two groups has improved obviously after therapy and shows statistic meaning by comparing those before therapy (p＜0.05). But the trial group has improved more obviously than control group and the difference (p＜0.05) shows statistic meaning. The liquefying time and pH have no obvious changes before and after treatment and have no statistic meaning.
2. The symptoms of these patients of the two groups have obviously improved after therapy and the difference comparing by those before therapy indicates statistic meaning (p＜0.05).
3. Comparing treatments before and after therapy, three types of sperm speed parameter: straight line velocity, curve line velocity and average pathway velocity which are tested by CASh have improved and the difference (p＜0.05) shows statistic meaning. Meanwhile after therapy, the difference between the two groups has no statistic meaning (p＞0.05).
Conclusions:
1. Both the Jiaweijujing decoction and Wuziyanzong tablets have correct curative effects on infertility which is caused by Oligospermia. Both of the two therapies can improve the pregnancy rate and sperm quality (sperm density and vitality) and the Jiaweijujing decoction has more significant curative effect than the Wuziyanzong tablets.
2. Both the Jiaweijujing decoction and Wuziyanzong tablets have correct curative effects on Asthenia of both spleen and kidney, while the Jiaweijujing decoction has more significant curative effect than the control group.
3. Jiaweijujing decoction do not have any side effect or adverse reaction.
引文
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