首页|五子玉液汤治疗气阴两虚型2型糖尿病合并弱精子症的随机对照研究

五子玉液汤治疗气阴两虚型2型糖尿病合并弱精子症的随机对照研究

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目的:观察五子玉液汤治疗气阴两虚型2型糖尿病合并弱精子症患者的临床有效性与安全性.方法:选取2023年1月至2024年3月于宁波大学附属第一医院生殖医学中心、中医科就诊的气阴两虚型糖尿病合并弱精子症患者100例,按照随机数字表法将其随机分为试验组(50例)和对照组(50例).两组均给予西药控制空腹血糖至正常水平.试验组给予五子玉液汤治疗,对照组给予左卡尼汀口服溶液治疗,疗程均为12周,随访24周.观察两组患者治疗前后的精液参数、中医证候评分、生殖激素、配偶临床妊娠情况.结果:与治疗前相比,治疗12周后试验组患者前向运动精子百分率[(18.0±4.2)% vs(35.5±6.1)%]、精子浓度[(40.0±36.1)× 106/ml vs(54.0±33.4)× 106/ml]和中医证候评分[(18.5±5.2)分vs(4.5±2.3)分]均明显改善,差异具有统计学意义(P<0.05);精液量[(2.85±0.36)ml vs(2.84±0.59)ml],差异不具有统计学意义(P>0.05).对照组患者前向运动精子百分率[(18.5±4.5)%vs(29.5±6.2)%]、精子浓度[(42.0±38.3)× 106/ml vs(45.0±34.1)× 106/ml]均存在明显提升,差异具有统计学意义(P<0.05);精液量[(2.90±0.78)ml vs(3.04±0.89)ml],中医证候评分[(17.8±4.8)% vs(17.2±4.5)%],差异均不具有统计学意义(P>0.05).治疗后试验组前向运动精子百分率、精子浓度、中医证候评分的改善均优于对照组(P<0.05).生殖激素与配偶临床妊娠率方面,两组间治疗前后均未见统计学差异(P>0.05).两组患者治疗前后安全性良好,未见严重不良反应.结论:五子玉液汤可改善气阴两虚型2型糖尿病合并弱精子症患者的精子活力和浓度,临床有效且安全性良好.
Wuziyuye Decoction for type-Ⅱ diabetes mellitus with qi-yin deficiency complicated by asthenospermia:A randomized controlled trial
Objective:To evaluate the clinical efficacy and safety of Wuziyuye Decoction in the treatment of type-Ⅱ diabetes mellitus(DM)with qi-yin deficiency complicated by asthenospermia.Methods:We selected 100 cases of type-Ⅱ DM with qi-yin deficiency complicated by asthenospermia treated in the First Hospital Affiliated to Ningbo University from January 2023 to March 2024,and randomly assigned them to receive Wuziyuye Decoction(the trial group,n=50)and oral L-carnitine solution(the control group,n=50)in addition to Western medicine to reduce fasting blood glucose to normal in both groups.After 12 weeks of medica-tion,we followed up the patients for 24 weeks,obtained their semen parameters,traditional Chinese medicine(TCM)syndrome scores and levels of reproductive hormones,and the clinical pregnancy outcomes of their partners,followed by comparison of the data collected between the two groups before and after treatment.Results:After 12 weeks of treatment,the trial group showed significant improve-ment over the baseline in the percentage of progressive motility(PR%)([35.5±6.1]%vs[18.0±4.2]%,P<0.05),sperm concentration([54.0±33.4]vs[40.0±36.1]× 106/ml,P<0.05),and TCM syndrome score(4.5±2.3 vs 18.5±5.2,P<0.05),but no statistically significant difference in the semen volume([2.85±0.36]vs[2.84±0.59]ml,P>0.05),while the controls exhibited markedly improved percentage of PR%([29.5±6.2]%vs[18.5±4.5]%,P<0.05)and sperm concentration([45.0±34.1]vs[42.0±38.3]× 106/ml,P<0.05),but no statistically significant difference in the semen volume([3.04±0.89]vs[2.90±0.78]ml,P>0.05)and TCM syndrome score(17.2±4.5 vs 17.8±4.8,P>0.05).The patients treated with Wuziyuye Decoction achieved even more significant improvement than the controls in the percentage of PR%,sperm concentration and TCM syndrome score(P<0.05),but there were no statistically significant differences in the reproductive hormone levels and clinical pregnancy outcomes between the two groups of patients after treatment(P>0.05).And no severe adverse reactions were observed in either group.Conclusion:Wuziyuye Decoction is safe and effective for the treatment of type-Ⅱ DM with qi-yin deficiency complicat-ed by asthenospermia by improving the sperm motility and concentration of the patient.

male infertilityasthenospermiadiabetes mellitusWuziyuye Decoctionqi-yin deficiency syndrome

余怡、徐刚、金萍、沈宏平、吴科荣、徐立奇、陈雪琴、商学军

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宁波大学附属第一医院,生殖医学中心,浙江宁波 315010

宁波大学附属第一医院,内分泌科,浙江宁波 315010

宁波大学附属第一医院,中医科,浙江宁波 315010

宁波大学附属第一医院,泌尿外科,浙江宁波 315010

解放军第九○六医院生殖中心,浙江宁波 315000

南京大学医学院附属金陵医院/东部战区总医院泌尿外科,江苏南京 210018

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男性不育 弱精子症 2型糖尿病 五子玉液汤 气阴两虚型 疗效观察

2024

中华男科学杂志
南京军区南京总医院

中华男科学杂志

CSTPCD
影响因子:1.052
ISSN:1009-3591
年,卷(期):2024.30(12)