生精片联合经脐单孔腹腔镜精索静脉高位结扎术对精索静脉曲张不育症患者术后精液质量及受孕率的影响  

Effects of Shengjing Tablet Combined with High Ligation of Spermatic Vein by Umbilical Single Hole Laparoscopy on Semen Quality and Pregnancy Rate in Infertile Patients with Varicocele

作　　者：夏烨 陈向锋[2] 童国庆[1] XIA Ye;CHEN Xiangfeng;TONG Guoqing(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200025,China;Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海中医药大学附属曙光医院,上海200025 [2]上海交通大学医学院附属仁济医院,上海200127

出　　处：《中医药信息》2018年第4期94-98,共5页Information on Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81170571)

摘　　要：目的:探讨生精片联合经脐单孔腹腔镜精索静脉高位结扎术对精索静脉曲张不育症患者术后精液质量及受孕率的影响。方法:选取符合纳入标准的93例精索静脉曲张不育症患者,按照随机数字表法随机分为观察组(n=47)与对照组(n=46)。两组均进行经脐单孔腹腔镜精索静脉高位结扎术治疗,观察组术后口服生精片(连续服用6个月)。对比两组手术前及术后6个月精液质量(精子密度、精子总活力、精子前向运动率)、性功能[国际早泄评分指数-5(CIPE-5)及勃起功能指数-5(IIEF-5)]、精浆及血浆缺氧诱导因子1α(HIF-1α)水平,术后随访1年,统计两组配偶受孕率。结果:1)精液质量方面:手术前两组患者精子密度、精子总活力、精子前向运动率比较均无显著性差异(P>0.05),术后6个月两组患者精子密度、精子总活力、精子前向运动率较手术前均有所改善(P<0.05),且观察组优于对照组(P<0.05)。2)性功能方面:手术前两组患者CIPE-5、IIEF-5评分比较均无显著性差异(P>0.05),术后6个月两组患者CIPE-5、IIEF-5评分较手术前均有所提高(P<0.05),且观察组高于对照组(P<0.05)。3)HIF-1α水平方面:手术前两组患者精浆HIF-1α、血清HIF-1α水平比较无显著性差异(P>0.05),术后6个月两组患者精浆HIF-1α、血清HIF-1α水平较手术前均有所降低(P<0.05),且观察组低于对照组(P<0.05)。4)受孕率方面:术后随访1年,观察组配偶受孕率为65.96%(31/47),对照组为45.65%(21/46),两组比较有显著性差异(P<0.05)。结论:精索静脉曲张不育症患者给予生精片联合经脐单孔腹腔镜精索静脉高位结扎术治疗,疗效显著,可有效提高患者精液质量及性功能,有利于促进配偶受孕。Objective： To investigate the effects of Shengjing tablet combined with high ligation of spermatic vein by umbilical single hole laparoscopy on semen quality and pregnancy rate in infertile patients with varicocele. Methods： 93 infertile patients with varicocele were randomly divided into the observation group（ n = 47）and the control group（ n = 46）. The two groups were treated by high ligation of spermatic vein by umbilical single hole laparoscopy,and the observation group was also treated with Shengjing tablets afterwards for six successive months. Semen quality（ sperm density,total sperm viability,sperm forward motility）,sexual function（ CIPE-5 and IIEF-5） and HIF-1α level were compared between pre-treatment and post-treatment,and pregnancy rates of the spouse were recorded during one-year follow-up between the two groups.Results： In terms of semen quality,there were no significant differences in sperm density,sperm total viability and sperm forward motility between the two groups before the treatment（ P〈0. 05）; they were all significantly improved six months after the operation（ P〉0. 05）,of which the observation group was better than the control group（ P〈0. 05）. In terms of sexual function,there were no statistical difference in socres of CIPE-5 and IIEF-5 between the two groups before the treatment（ P〉0. 05）,they were all increased after the surgery in the two groups（ P〈0. 05）,of which the observation group was improved more than the control group（ P〈0. 05）. In terms of HIF-1 level,there were no significant difference in seminal HIF-1α and serum HIF-1α between the two groups before the surgery（ P〉0. 05）,they were both improved after the surgery（ P〈0. 05）,and the observation group was better than the control group（ P〈0. 05）. In terms of pregnancy rate of spouse during one-year follow-up,it was 65. 96%（ 31/47） in the observation group,which was significantly higher than 45. 65%（ 21/46） in the control group（ P〈0. 05）. Co

关 键 词：精索静脉曲张不育症 经脐单孔腹腔镜精索静脉高位结扎术 生精片 精液质量 CIPE-5 IIEF-5 配偶受孕率 

分 类 号：R285.6[医药卫生—中药学]