保留动脉显微手术联合麒麟丸治疗双侧精索静脉曲张致少弱精子症  

Testicular artery-sparing microscopic varicocelectomy combined with Qilin Pills for bilateral varicocele-induced oligoasthenospermia

作　　者：张华锋[1] 赵佳[2] 

机构地区：[1]青州市人民医院/青岛大学医疗集团青州医院泌尿外科,山东青州262500 [2]潍坊医学院附属益都中心医院中心实验室,山东青州262501

出　　处：《中华男科学杂志》2016年第10期902-905,共4页National Journal of Andrology

摘　　要：目的:探讨保留睾丸动脉显微手术联合服用麒麟丸治疗双侧精索静脉曲张(VC)合并少弱精子症的临床疗效。方法:60例双侧精索静脉曲张并少弱精子症患者,随机分为两组,单纯手术组30例,显微手术联合服用麒麟丸组30例,疗程12周,每次服用6 g,每日3次,观察治疗后第4、8、12周两组患者精子浓度、精液量、精子活力(a+b级)、畸形精子百分率、血清Inh B、LH、TT和FSH水平变化,并计算睾酮分泌指数(TSI=TT/LH)。结果:患者均手术成功,术后症状消失,精子浓度、精液量、精子活力明显提高,畸形精子百分率明显降低,术后血清Inh B、TT、TSI明显改善,FSH、LH含量降低,与术前比较,差异有统计学意义(P﹤0.01)。手术联合服用麒麟丸组治疗12周后血清Inh B、LH、TT及TSI分别为(138.96±22.26)ng/L、(3.17±0.12)IU/L、(13.98±3.02)nmol/L、(4.41±0.53)nmol/IU,单纯手术组治疗12周后分别为(129.54±22.23)ng/L、(3.59±0.11)IU/L、(12.68±3.12)nmol/L、(3.53±0.51)nmol/IU,两组间对比差异有显著性(P﹤0.05)。手术联合服用麒麟丸组受孕22例,受孕率为73.4%,比单纯手术组受孕11例、受孕率为36.6%效果显著(P﹤0.05)。结论:保留睾丸动脉显微手术联合服用麒麟丸治疗双侧精索静脉曲张所致少弱精子症,对于术后精液质量改善明显、疗效满意。Objective： To explore the clinical effect of testicular artery-sparing microscopic varicocelectomy （MV） in combina- tion with Oilin Pills （QL） in the treatment of bilateral varicocele-induced oligoasthenospermia. Methods ： Sixty patients with bilateral varicocele-induced oligoasthenospermia were randomly assigned to receive MV （ n = 30 ） or MV ± QL （ n = 30）, those in the latter group treated with oral QL for 12 weeks postoperatively. At 4, 8, and 12 weeks after operation, we compared the semen volume, sperm concentration, sperm motility, the levels of serum Inh B, luteinizing hormone （LH） and total testosterone （TT）, and the testosterone secretion index （TSI） between the two groups. Results： After surgery, all the patients showed disappearance of varicocele symp- toms, remarkably improved semen volume, sperm concentration, sperm motility, serum Inh B and TT levels, TSI, decreased LH and FSH （P 〈0.01 ）. At 12 weeks after treatment, statistically significant differences were found between the MV and MV ± QL groups in Inh B （138.96 ±22.26 vs 129.54 ±22.23） ng/L, LH （3.17 ±0.12 vs 3.59 ±0.11） IU/L, TT （13.98 ±3.02 vs 12.68 ±3.12） nmol/L, and TSI （4.41 ± 0.53 vs 3.53 ± 0.51 ） nmol/ IU （P 〈 0.05 ）. The pregnancy rate was significantly higher in the MV ± QL than in the MV group （73.4% vs 36.6% , P 〈 0.05）. Conclusion ： Testicular artery-sparing microscopic varicocelectomy combined with Qilin Pills is an effective strategy for the treatment of bilateral varicocele-induced oligoasthenospermia by significantly improving the semen quality of the patient.

关 键 词：显微精索精脉曲结扎术 麒麟丸 少弱精子症 治疗 

分 类 号：R699[医药卫生—泌尿科学]