Zhou Shao-Hu, Weng Zhi-Wei, Li Tang-Lin
Department of Reproductive Medicine, The First Affiliated Hospital of Guanzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, China.
Zhonghua Nan Ke Xue. 2013 Jul;19(7):647-51.
To investigate the effect of the method of tonifying the kidney and activating blood circulation on the testosterone secretion index (TSI) in late-onset hypogonadism (LOH) male patients with kidney deficiency and its possible mechanisms.
We screened 60 LOH male patients with kidney deficiency based on the scores on Partial Androgen Deficiency in Aging Males (PADAM), the levels of serum total testosterone (TT) and luteinizing hormone (LH), and TSI (TT/LH). We randomly divided the patients into a Nan Geng Ning (NGN) group (n = 40, aged 55.02 +/- 11.37 years) and a control group (n = 20, aged 54.56 +/- 12.12 years) to be treated orally with NGN decoction and testosterone undecanoate capsules, respectively, both for 12 consecutive weeks. We obtained the scores on psychological status, physical status and sexual function and observed the changes in serum TT, LH and TSI after 4, 8 and 12 weeks of treatment.
Compared with the baseline, both the NGN and control groups showed a significant reduction after 12 weeks of medication in the LH level ([5.32 +/- 2.08] vs [4.89 +/- 1.46] IU/L and [5.36 +/- 2.07] vs [4.81 +/- 1.75] IU/L, P < 0.05), psychological status score (5.2 +/- 1.3 vs 2.7 +/- 1.4 and 4.8 +/- 2.2 vs 2.9 +/- 1.2, P < 0.05), physical status score (6.9 +/- 2.5 vs 2.9 +/- 1.6 and 7.1 +/- 2.7 vs 3.1 +/- 1.5, P < 0.05) and sexual function score (10.2 +/- 3.3 vs 4.5 +/- 2.9 and 9.8 +/- 3.1 vs 4.8 +/- 3.0, P < 0.05), but a remarkable increase in the TT level ([11.13 +/- 0.69] vs [14.55 +/- 0.75] nmol/L and [10.99 +/- 0.74] vs [14.74 +/- 0.83] nmol/L, P < 0.05) and TSI ([2.14 +/- 0.65] vs [2.99 +/- 0.72] nmol/IU and ([2.05 +/- 0.73] vs [3.11 +/- 0.65] nmol/IU, P < 0.05). However, no significant differences were found between the NGN and control groups at 12 weeks in LH ([4.89 +/- 1.46] vs [4.81 +/- 1.75] IU/L, P > 0.05), TT ([14.55 +/- 0.75] vs [14.74 +/- 0.83] nmol/L, P > 0.05), TSI ([2.99 +/- 0.72] vs [3.11 +/- 0.65] nmol/IU, P > 0.05), psychological status score (2.7 +/- 1.4 vs 2.9 +/- 1.2, P > 0.05), physi- cal status score (2.9 +/- 1.6 vs 3.1 +/- 1.5, P > 0.05) and sexual function score (4.5 +/- 2.9 vs 4.8 +/- 3.0, P > 0.05). There were no adverse events in either of the two groups throughout the whole experiment.
The method of tonifying the kidney and activating blood circulation could significantly improve the clinical symptoms of LOH with kidney deficiency and increase the patient's serum TT level and TSI. NGN decoction works on LOH by acting on the hypothalamic-pituitary-gonad axis.
探讨补肾活血法对老年迟发性性腺功能减退（LOH）肾虚男性患者睾酮分泌指数（TSI）的影响及其可能机制。
根据中老年男性部分雄激素缺乏（PADAM）评分、血清总睾酮（TT）及黄体生成素（LH）水平、TSI（TT/LH），筛选出60例LOH肾虚男性患者。将患者随机分为男更年宁（NGN）组（n = 40，年龄55.02±11.37岁）和对照组（n = 20，年龄54.56±12.12岁），分别口服NGN汤剂和十一酸睾酮胶囊，均连续治疗12周。于治疗4、8、12周时获取心理状态、身体状态及性功能评分，并观察血清TT、LH及TSI的变化。
与基线相比，NGN组和对照组用药12周后LH水平（[5.32±2.08] vs [4.89±1.46] IU/L和[5.36±2.07] vs [4.81±1.75] IU/L，P<0.05）、心理状态评分（5.2±1.3 vs 2.7±1.4和4.8±2.2 vs 2.9±1.2，P<0.05）、身体状态评分（6.9±2.5 vs 2.9±1.6和7.1±2.7 vs 3.1±1.5，P<0.05）及性功能评分（10.2±3.3 vs 4.5±2.9和9.8±3.1 vs 4.8±3.0，P<0.05）均显著降低，而TT水平（[11.13±0.69] vs [14.55±0.75] nmol/L和[10.99±0.74] vs [14.74±0.83] nmol/L，P<0.05）及TSI（[2.14±0.65] vs [2.99±0.72] nmol/IU和[2.05±0.73] vs [3.11±0.65] nmol/IU，P<0.05）显著升高。然而，12周时NGN组与对照组在LH（[4.89±1.46] vs [4.81±1.75] IU/L，P>0.05）、TT（[14.55±0.75] vs [14.74±0.83] nmol/L，P>0.05）、TSI（[2.99±0.72] vs [3.11±0.65] nmol/IU，P>0.05）、心理状态评分（2.7±1.4 vs 2.9±1.2，P>0.05）、身体状态评分（2.9±1.6 vs 3.1±1.5，P>0.05）及性功能评分（4.5±2.9 vs 4.8±3.0，P>0.05）方面均无显著差异。整个实验过程中两组均未出现不良事件。
补肾活血法可显著改善LOH肾虚患者的临床症状，提高患者血清TT水平及TSI。NGN汤剂通过作用于下丘脑 - 垂体 - 性腺轴发挥治疗LOH的作用。
