基于"肾主生殖"理论探讨益肾强精汤治疗阳虚型男性不育症的疗效机制OA
Exploration on the Therapeutic Mechanism of Yishen Qiangjing Decoction in Treating Yang Deficiency Type Male Infertility Based on the Theory of"Kidney Governing Reproduction"
目的:基于中医"肾主生殖"理论,深入探讨益肾强精汤对阳虚型男性不育症的作用机制,进一步验证和完善该理论在男性不育症治疗中的应用,为中医理论的传承和发展提供实践支持.方法:选取2021 年3 月—2023 年3 月于梅州市人民医院就诊的阳虚型男性不育症患者 78 例,应用信封法分为对照组(39 例,接受常规治疗)和试验组(39 例,常规治疗的基础上增加益肾强精汤治疗),比较两组临床疗效、精子质量、性激素水平变化,并对患者进行 24 个月的随访,统计生育结局,分析整体效果.结果:试验组患者临床总有疗效率达 92.31%(36/39),高于对照组 74.36%(29/39),差异有统计学意义(P<0.05);治疗后,两组患者精子液化时间、正常精子形态率、精液量、精子浓度、PR+NP均较治疗前显著改善(P<0.05),且试验组较对照组改善更佳(P<0.05);治疗后,两组患者血清FSH、LH水平均较治疗前显著降低(P<0.05),试验组较对照组更低(P<0.05);治疗后,两组患者血清T、FT水平均较治疗前显著升高(P<0.05),试验组高于对照组(P<0.05);试验组患者配偶24 个月累积受孕率明显高于对照组(P<0.05);试验组患者配偶中位受孕时间较对照组短(P<0.05);试验组患者配偶活产率、自然流产率与对照组比较,差异无统计学意义(P>0.05).结论:"肾主生殖"理论支持下的益肾强精汤可通过"调肾阳-促生精-助孕育"的整合效应,显著改善阳虚型男性不育症患者的精液质量与生殖内分泌功能,提高配偶自然受孕率,具有较高的应用价值.
Objective:To investigate the mechanism of Yishen Qiangjing Decoction in treating male infertility associated with Yang deficiency,based on the"kidney-governing reproduction"theory of traditional Chinese medicine(TCM),and to further validate and refine the application of this theory in addressing male infertility,thereby providing substantial support for the inheritance and development of TCM theory.Methods:A total of 78 male infertility patients who were treated at our hospital between March 2021 and March 2023 were recruited and randomly assigned to either a control group or an experimental group using the random number table method,with 39 participants in each group.The control group received conventional treatment,while the experimental group was administered Yishen Qiangjing Decoction based on the theoretical framework of"kidney governing reproduction"in addition to the conventional treatment.Compare the clinical therapeutic efficacy(including TCM syndrome scores),sperm quality,and sex hormone levels between the two groups.Conduct a 24-month follow-up to document fertility outcomes and analyze overall effectiveness.Results:The total clinical efficacy rate in the experimental group was 92.31%,which was significantly higher than the 74.36%observed in the control group(P<0.05).Following treatment,significant improvements were noted in sperm liquefaction time,normal sperm morphology rate,semen volume,sperm concentration,and progressive motility plus non-progressive motility(PR+NP)compared to pre-treatment values in both groups,with greater improvement in the experimental group compared to the control group(P<0.05).Post-treatment serum levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)were markedly reduced in both groups compared to baseline,with a more pronounced decrease in the experimental group relative to the control group(P<0.05).Conversely,serum testosterone(T)and free testosterone(FT)levels increased significantly post-treatment in both groups compared to baseline,with higher levels achieved in the experimental group compared to the control group(P<0.05).The cumulative pregnancy rate at 24 months was significantly higher in spouses of the experimental group than in the control group(P<0.05).The median time-to-pregnancy was significantly shorter among spouses of the experimental group compared to the control group(P<0.05).No statistically significant differences were observed between groups regarding live birth rates or spontaneous abortion rates among patientsspouses(P>0.05).Conclusion:Yishen Qiangjing Decoction,grounded in the theoretical framework of"kidney-governing reproduction,"significantly enhances the semen quality and reproductive endocrine function in male infertility patients with Yang deficiency.Through its integrated effects of"regulating kidney-yang,promoting spermatogenesis,and assisting pregnancy,"it also increases the natural pregnancy rate of their partners,demonstrating substantial clinical application value.
曾令斌;赖勇辉;黄清苑
梅州市人民医院中医科,广东 梅州 514031梅州市人民医院中医科,广东 梅州 514031梅州市人民医院中医科,广东 梅州 514031
医药卫生
"肾主生殖"理论益肾强精汤阳虚型男性不育症精子质量生育结局
Theory of"Kidney Governing Reproduction"Yishen Qiangjing DecoctionMale infertility of Yang deficiency typeSperm qualityFertility outcomes
《中医药学报》 2026 (3)
63-67,5
广东省中医药局科研项目(20211393)
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