庄田畋教授治疗男性不育临床用药规律

张亚梅 庄田畋

【摘要】目的：整理庄田畋教授治疗男性不育（male infertility， MI）的中药药方，分析其用药规律。方法：回顾性分析本院2019年12月至2020年6月收治且明确诊断的97例MI患者的临床资料，计算治疗MI中使用频次排前50位药物的频次、频率，并分析药物关联规则。结果：本组研究所涉及的药物共107味，累计使用1 532次。107味中药使用频次排前50味的药物累积频率达86.23%，以枸杞子、川芎、甘草、山茱萸、锁阳、牡丹皮、蒲公英、续断、山药、黄芪、菟丝子及金樱子12味中药使用频率最高。分析两药关联规则，发现补虚药+补虚药、补虚药+利水渗湿药、补虚药+清热药、利水渗湿药+利水渗湿药、利水渗湿药+清热药为常用的药物配伍。高频药物对多为相须配伍；其次为补泻结合的相使配伍，如黄芪和泽泻、车前子和黄芪等。结论：治疗MI的中药方剂较多，庄田畋教授治疗MI谨守“正虚邪实”的病机本质，以补虚药为基本组方配伍，用药主要集中在滋补、清热、活血等几类。

【关键词】男性不育；中药；用药规律；庄田畋

[中图分类号]R249；R256.5 [文献标识码]A [文章编号]2096-5249（2021）05-0043-02

The clinical medication rule of Professor Zhuang Tianyi in the treatment of male infertility

ZHANG Ya-mei， ZHUANG Tian-shi* （Guizhou University of traditional Chinese medicine， Zunyi Guizhou 563000， China）

[Abstract] Objective： to sort out Professor Zhuang Tianfu’s traditional Chinese medicine prescriptions for the treatment of male infertility （MI） and analyze their medication rules. Methods： the clinical data of 97 patients with MI admitted to our hospital from December 2019 to June 2020 were retrospectively analyzed. The frequency and frequency of the top 50 drugs used in the treatment of MI were calculated， and the drug association rules were analyzed. Results： a total of 107 drugs were used in this study， with a total of 1 532 times. The cumulative frequency of the top 50 herbs was 86.23%， and the 12 herbs were the most frequently used. By analyzing the association rules of the two drugs， it is found that tonifying deficiency drugs + tonifying deficiency drugs， tonifying deficiency drugs + diuretic and dampness clearing drugs， tonifying deficiency drugs + heat clearing drugs， diuretic and dampness clearing drugs + diuretic and dampness clearing drugs are commonly used in drug compatibility. Most of the high-frequency drugs are compatible with each other， followed by the combination of reinforcing and reducing， such as Astragalus membranaceus and Alisma orientalis， Plantago asiatica and Astragalus membranaceus. Conclusion： there are many traditional Chinese medicine prescriptions for the treatment of MI. Professor Zhuang Tian Fu strictly abides by the pathogenesis essence of “positive deficiency and evil excess” in the treatment of MI， and takes tonic deficiency drugs as the basic combination. The drugs mainly focus on tonifying， clearing heat and promoting blood circulation.

[Key words] male infertility； traditional Chinese medicine； medication regularity； zhuangtianfu

男性不育（male infertility， MI）是指夫婦未同居生活一年以上因男方因素导致女方不孕者，且未采取任何避孕措施。临床相关数据显示，有15%左右的夫妇因婚后一年无法怀孕而寻求治疗[1]。目前随着人们不良生活习惯、环境等因素的影响，使得男性精子数量与质量逐渐下降，进而导致MI发病率呈上升趋势，倍受广大临床学者的关注[2]。另外，随着二胎政策的开放，男性生育问题又面临了新的挑战。中医在治疗MI具有多种方剂，但有关治疗MI的相关研究大部分为临床经验总结，大规模中心研究不常见，临床上报道组方各有差异，不同组方间有无共同的用药规律，是由存在共同组方原则值得进一步探讨[3]。……