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温针灸联合西药治疗肾虚型少弱畸精子症的临床疗效及其对精浆中IL-6和IL-10水平的影响

[Clinical efficacy of warming acupuncture combined with western medication for oligoasthenoteratozoospermia of kidney- insufficiency and its effects on IL-6 and IL-10 levels in seminal plasma].

作者信息

Qiu Shuo, Liang Shangjie, Shen Chuchu, Ji Tengyan, Li Hao, Zhang Hongru

机构信息

School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; Yangzhou Hospital Affiliated to Nanjing University of Chinese Medicine, Yangzhou Hospital of TCM, Yangzhou 225000, Jiangsu Province.

School of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China.

出版信息

Zhongguo Zhen Jiu. 2025 Aug 12;45(8):1092-1098. doi: 10.13703/j.0255-2930.20250124-k0001. Epub 2025 Jun 10.

DOI:10.13703/j.0255-2930.20250124-k0001
PMID:40825693
Abstract

OBJECTIVE

To observe the clinical efficacy of warming acupuncture combined with western medication for oligoasthenoteratozoospermia of kidney- insufficiency and its effects on the levels of interleukin (IL)-6 and IL-10 in seminal plasma.

METHODS

A total of 60 patients with oligoasthenoteratozoospermia of kidney- insufficiency were randomly divided into a combination group and a medication group, with 30 cases in each group. The medication group was treated with levocarnitine oral solution orally, 10 mL once, 3 times a day. On the basis of the treatment in the medication group, warming acupuncture was applied at Baihui (GV20), Guanyuan (CV4) and Mingmen (GV4) in the combination group, once every other day, 3 times a week. Both groups were treated for 12 weeks. Before and after treatment, the TCM syndrome score was observed, the semen routine indexes (the sperm concentration, progressive [PR] sperm motility, PR + non-progressive [NP] sperm motility and sperm malformation rate), the serum sex hormones indexes (follicle-stimulating hormone [FSH], luteinizing hormone [LH], testosterone [T] and estradiol [E]), as well as the IL-6 and IL-10 levels in seminal plasma were detected, and the clinical efficacy was evaluated after treatment in the two groups.

RESULTS

After treatment, except for the hyposexuality score in the medication group, the each item scores and total scores of TCM syndrome were decreased compared with those before treatment (<0.01, <0.05), the sperm malformation rates, serum FSH and LH levels, IL-6 levels in the seminal plasma were decreased compared with those before treatment (<0.01, <0.05), the PR sperm motility, PR + NP sperm motility, serum T levels, IL-10 levels in the seminal plasma were increased compared with those before treatment (<0.01, <0.05) in the two groups; the sperm concentration was increased compared with that before treatment in the combination group (<0.01). After treatment, compared with the medication group, except for the hyposexuality and frequent nocturia scores, the each item scores and total score of TCM syndrome were lower (<0.01, <0.05); the sperm concentration, PR sperm motility and PR + NP sperm motility, serum T level, IL-10 level in the seminal plasma were higher (<0.01, <0.05); sperm malformation rate, serum FSH and LH levels, IL-6 level in the seminal plasma were lower (<0.01, <0.05) in the combination group. The total effective rate was 83.8% (25/30) in the combination group, which was superior to 60.0% (18/30) in the medication group (<0.05).

CONCLUSION

Warming acupuncture combined with western medication can effectively treat oligoasthenoteratozoospermia of kidney- insufficiency, regulate the levels of sex hormones, and its mechanism may be related to the down-regulation of IL-6 level and the up-regulation of IL-10 level in seminal plasma.

摘要

目的

观察温针灸联合西药治疗肾虚型少弱畸精子症的临床疗效及其对精浆中白细胞介素(IL)-6、IL-10水平的影响。

方法

将60例肾虚型少弱畸精子症患者随机分为联合组和药物组,每组30例。药物组口服左卡尼汀口服液,一次10 mL,一日3次。联合组在药物组治疗基础上,选取百会(GV20)、关元(CV4)、命门(GV4)行温针灸治疗,隔日1次,每周3次。两组均治疗12周。观察治疗前后中医证候积分,检测精液常规指标(精子浓度、前向运动[PR]精子活力、PR+非前向运动[NP]精子活力及精子畸形率)、血清性激素指标(卵泡刺激素[FSH]、黄体生成素[LH]、睾酮[T]及雌二醇[E])以及精浆中IL-6、IL-10水平,并评价两组治疗后的临床疗效。

结果

治疗后,与治疗前比较,两组中医证候各条目积分及总分均降低(<0.01,<0.05),药物组性欲低下积分除外;两组精子畸形率、血清FSH及LH水平、精浆中IL-6水平均降低(<0.01,<0.05),联合组精子浓度升高(<0.01);两组PR精子活力、PR+NP精子活力、血清T水平、精浆中IL-10水平均升高(<0.01,<0.05)。治疗后,与药物组比较,联合组中医证候各条目积分及总分更低(<0.01,<0.05),性欲低下、夜尿频多积分除外;精子浓度、PR精子活力及PR+NP精子活力、血清T水平、精浆中IL-10水平更高(<0.01,<0.05);精子畸形率、血清FSH及LH水平、精浆中IL-6水平更低(<0.01,<0.05)。联合组总有效率为83.8%(25/30),优于药物组的60.0%(18/30)(<0.05)。

结论

温针灸联合西药能有效治疗肾虚型少弱畸精子症,调节性激素水平,其机制可能与下调精浆中IL-6水平、上调IL-10水平有关。

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