四妙散加味聯(lián)合左卡尼汀治療少、弱精癥療效觀察

陳其華 趙丹

【摘要】目的：觀察中藥四妙散加味治療濕熱下注證少、弱精癥臨床療效。方法：選取符合標(biāo)準(zhǔn)的42例患者，服用四妙散加味和左卡尼汀口服液聯(lián)合治療。結(jié)果：42例患者治療后痊愈16例，顯效18例，有效4例，無(wú)效4例，總有效率為90.48%。治療4周后自身前后對(duì)照精液量、活動(dòng)率、精子密度、（a+b）級(jí)精子含量差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）；治療8周后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療12周后差異具有顯著統(tǒng)計(jì)學(xué)意義（P<0.01）。結(jié)論：四妙散加味聯(lián)合左卡尼汀口服液治療少、弱精癥具有較好臨床療效，值得進(jìn)一步研究。

【關(guān)鍵詞】四妙散；濕熱下注證；少、弱精癥

【Abstract】Objectives： To observe the clinical curative effect of traditional Chinese medicine （TCM） Simiaosan jiawei in treating asthenozoospermia. Methods： 42 patients meeting the criterion were selected and treated with Simiaosan jiawei combined with l-carnitine. Results： According to the results of 42 patients， there were 16 cured cases after treatment， 18 cases with markedly effect， 4 cases with effective results and 4 invalid cases. The total effective rate was 90.48%. The differences in semen quantity， activity rate， sperm density， and sperm （grade a + b） content between 4 weeks after treatment and before the treatment had no statistical significance （P> 0.05）. The difference between 8 weeks after treatment and before the treatment was statistically significant （P< 0.05）； The differences between 12 weeks after treatment and before the treatment had statistical significance （P< 0.01）. Conclusion： Simiaosan jiawei combined with l-carnitine has good clinical curative effect in the treatment of asthenozoospermia， which is worthy of further investigation.

【Key words】Simiaosan jiawei； Damp-heat syndrome； Asthenozoospermia

【中圖分類號(hào)】R277.33【文獻(xiàn)標(biāo)志碼】A

據(jù)統(tǒng)計(jì)我國(guó)育齡夫婦中不孕不育患者約占10%，其中男方因素占30%3.41 years old， and the pelvic organ prolapse quantification （POP-Q） stage was III～I(xiàn)V stage. Pre- and post-operative symptoms were assessed using the urinary distress inventory （UDI-6） and the incontinence impact questionnaire （IIQ-7）， and the international continence society criteria were used for the urodynamic evaluation. Results： Among the total 30 patients， 22 patients underwent partial colpocleisis and another 8 underwent the total colpocleisis. Seven women underwent also a concomitant trans-obturator tension-free （TOT） procedure. Of the patients， 65.7%， 26.8% and 7.5% were ‘very satisfied， ‘satisfied and ‘not satisfied， respectively. After the colpocleisis operations， UDI-6 and IIQ-7 scores were improved significantly （P>0.05）. Post-operative urinary retention was not observed and prolapse recurred in one patient. Conclusion： Colpocleisis is a safe and effective surgical technique in treating the pelvic organ prolapse for the elderly female patients， with a high patient satisfaction rate.

【Key words】Colpocleisis； Pelvic organ prolapse； Efficacy； Satisfaction rate

【中圖分類號(hào)】R713.4【文獻(xiàn)標(biāo)志碼】A

盆腔臟器脫垂（pelvic organ prolapse， POP）常因盆底支持組織缺損或松弛而引起，使得盆腔臟器脫離原先正常的解剖位置，包括子宮脫垂、陰道脫垂，同時(shí)伴有膀胱、直腸和小腸膨出。該病的臨床癥狀一般表現(xiàn)為慢性盆腔痛、走路或站立時(shí)有下墜感或壓迫感以及性交不適，影響患者正常生活[1，2]。如今，隨著人口老齡化現(xiàn)象的加劇，POP發(fā)病率呈上升趨勢(shì)。婦女健康研究顯示已婚婦女子宮脫垂發(fā)病率為0.04%～0.14%，51～60歲婦女發(fā)病率為0.33%，60歲以上為0.71%。而對(duì)于年老體弱、不能耐受較大手術(shù)且不需保留性交功能患者，陰道封閉術(shù)（包括陰道全封閉術(shù)和部分陰道封閉術(shù)）是該病的首選治療方式[3，4]。本研究旨在探討陰道封閉術(shù)治療盆腔臟器脫垂的有效性及患者的滿意度。現(xiàn)報(bào)告如下。

1資料與來(lái)源

1.1一般資料

納入標(biāo)準(zhǔn)包括年齡大于66歲小于85歲，平均為（70.58±3.41）歲，其中61～70歲8例，71～80歲15例，81～90歲7例；盆腔臟器脫垂量化評(píng)分系統(tǒng)（POP-Q）分期為III～I(xiàn)V期。排除生……