桂枝茯苓胶囊治疗精索静脉曲张性不育症60例临床观察

A Clinical Observation on Guizhi Fuling Capsule for Varicocele-Induced Infertility

目的观察桂枝茯苓胶囊治疗精索静脉曲张性不育症患者的临床疗效。方法 121例精索静脉曲张性不育症患者随机分为治疗组60例和对照组61例,治疗组给予桂枝茯苓胶囊(0.31g/粒),每次3粒,每日3次,口服;对照组给予迈之灵(150mg/片),每次2片,每日2次,口服;两组共治疗3个月,治疗结束后随访3个月。比较两组患者临床疗效、精液质量[包括精液量、精子密度、精子活率、前向运动精子(PR)及正常形态率],测定治疗前后左侧精索静脉管径的变化,随访观察患者配偶受孕情况。结果两组治愈率(治疗组8.33%,对照组8.20%)比较,差异无统计学意义(P>0.05)。治疗组显效率(51.67%)、有效率(26.67%)、总有效率(86.67%)与对照组(分别为47.54%、22.95%、78.69%)比较,差异有统计学意义(P<0.05),治疗组优于对照组。两组患者治疗后精液量、精子密度、精子活率、PR、正常形态率均比治疗前提高(P<0.05);并且治疗后治疗组精子密度、PR均高于对照组(P<0.05)。两组治疗后Ⅰ度、Ⅱ度左侧精索静脉管径均比治疗前缩窄(P<0.05);并且两组治疗后Ⅱ度左侧精索静脉管径比较有统计学差异(P<0.05),治疗组优于对照组。治疗后3个月随访,患者配偶共有5例确诊怀孕,其中治疗组2例,对照组3例。结论桂枝茯苓胶囊能够提高精索静脉曲张性不育患者的精液质量,缩窄Ⅰ度、Ⅱ度精索静脉管径。

Objective To observe the therapeutic effect of Guizhi Fuling Capsule [ capsule of Guizhi （ Ramulus Cinnamomi, 桂枝） and Fuling （Poria, 茯苓] for varicocele-induced infertility Methods Totally 121 cases of varicocele-induced infertility were randomized into the treatment group and control group, with 60 and 61 in each. The treatment group was given Guizhi Fuling Capsule 3 times daily. The control group was given Aescuven forte twice daily. One treatment course lasted for 3 mon merit. The diameter of left spermatic vein was ths. The therape measured by col suits The cure rate in the treatment group and control utic effect and semen quality was observed after treator Doppler ultrasound before and after treatment. Re- group was 8.33% and 8.20% respectively, with no significant difference between groups （P 〉 0. 05）. The markedly effective rate, effective rate and total effective rate in the treatment group was 51.67%, 26.67% and 86.67% respectively, which was superior to 47.54%, 22. 95% and 78.69% in the control group （P 〈 0.05）. The semen volume, sperm concentration, sperm motility, progressive motility （PR） and normal morphology rate was significantly increased in both groups after treatment （P 〈0. 05 ）, especially the sperm concentration and PR in the treatment group （P 〈 0. 05 ）. The diameter of left spermatic vein was sig- nificantly narrowed after treatment in patients with 1 and 2 degree varicocele in both groups （ P 〈 0.05 ）, especially in patients with 2 degree varicocele in the treatment group （P 〈 0. 05 ）. The patients were followed up for 3 months after treatment and there were 5 patients （2 patients in the treatment group and 3 patients in the control group） whose sexual partners got pregnant Conclusion Guizhi Fuling Capsule can improve the semen quality in patients with varicocele-indueed infertility and narrow the diameter of spermatic vein in patients with 1 and 2 degree varicocele