王建宏 马平 路艺 石东

【摘 要】 目的：观察健脾补肾分时治疗男性更年期综合征的临床疗效。方法：将男性更年期综合征脾肾阳虚证90例患者按就诊顺序随机分为观察组、治疗组1和治疗组2各30例，采用健脾补肾分时治疗，观察治疗前后PADAM症状评分、中医证候积分及实验室检查的变化情况。结果：观察组总有效率为93%，治疗组1总有效率为90%，治疗组2总有效率为86%，三组疗效比较（P>0.05）; 治疗后三组PADAM症状评分均降低（P<0.001），治疗后观察组、治疗组1和治疗组2的激素TT和FT都明显升高（P<0.05）;FSH、LH和E2均降低（P<0.05）。结论：健脾补肾分时治疗方法能够有效治疗脾肾阳虚型男性更年期综合征。

【关键词】 十一酸睾酮;男性更年期;健脾补肾;分时治疗

【中图分类号】R697+.22 【文献标志码】 A 【文章编号】1007-8517（2021）15-0099-05

Abstract：Objective To observe the clinical effect of spleen and kidney-reinforcing time-sharing treatment on male menopause syndrome. Methods Ninety cases of spleen and kidney yang deficiency syndromes were treated with spleen and tonifying kidney at different time points. The patients were randomly divided into observation group， control group 1 and control group 30 each in accordance with the order of consultation. Changes in candidate points and laboratory tests. Results The total effective rate in the observation group was 93%， the total effective rate in the control group 1 was 90%， and the total effective rate in the control group 2 was 86%. The efficacy of the observation group， the comparison between the control group 1 and the control group 2（P>0.05）; The PADAM symptom scores in the last three groups were all reduced （P<0.001）. After treatment， the hormones TT and FT in the observation group， control group 1， and control group 2 were significantly increased （P<0.05）; FSH， LH， and E2 were all reduced （P<0.05）. Conclusion The method of strengthening the spleen and invigorating the kidney can effectively treat the menopause syndrome of spleen-kidney yang deficiency type men.

Keywords：Testosterone Undecanoate;Menopause;Spleen and Kidney; Time-Sharing Treatment

男性更年期綜合征是男性从中年向老年的过渡时期，由于机体衰老、内分泌功能减退等因素导致出现以心血管、精神心理、体能、性功能异常为主的一系列临床、生化、生理综合征，此综合征主要反应了与年龄增长的相关性[1]。多数男子是在无任何症状情况下不知不觉中度过的，但也有部分男子会出现临床症状[2]。因中年向老年过渡时其体内雄激素水平下降及内分泌功能减退尤以性功能减退较明显故又称中老年男性雄性激素部分缺乏综合征、年龄相关性睾酮缺乏综合征、男性迟发型性腺功能减退症等病名[3]。现代医学治疗本病时以睾酮补充替代疗法为主（TST），并根据相应的临床症状酌加抗抑郁药或调整植物神经功能药物。但是由于药物不良反应及药物造成各种风险，其治疗手段不被患者所接受，而致疗效不甚理想[4]。中医治疗此病具有一定的优势，其不良反应少，笔者运用健脾补肾分时治疗男性更年期综合征患者，取得较好的临床效果，现报告如下。