基于积病角度论治精索静脉曲张性不育症

Treatment of Varicocele Infertility Based on Accumulated Disease

精索静脉曲张常引起阴囊疼痛,精液异常,是导致男性不育症的重要病因之一。目前,中医药治疗轻中度精索静脉曲张性不育有较好效果,手术联合中药治疗重度曲张性不育症亦有较好效果。然而,中医药治疗精索静脉曲张性不育症的机制还不是十分清楚。《内经》中最早提出“积”的概念,古代医籍将“积”归于“积聚”“癥瘕”范畴,并指出积病多因寒凝、气滞、血瘀、津液凝涩,日久而成,并提出相应的治则。临证中发现,积病与精索静脉曲张有类似的表现,均为“有形”之状与疼痛不适,同时精索静脉曲张性不育症形成亦与寒凝、气滞、血瘀、津液凝涩有关系。因此,积病临床表现、病因病机方面与筋瘤类似,故认为可以从积病的角度认识精索静脉曲张性不育症,为临床治疗精索静脉曲张性不育症提供新的思路。

Varicocele often causes scrotal pain and semen abnormality,and is one of the important causes of male infertility.At present,traditional Chinese medicine is effective in the treatment of mild to moderate varicocele infertility,and surgery combined with traditional Chinese medicine is also effective in the treatment of severe varicocele infertility.However,the mechanism of traditional Chinese medicine in the treatment of varicocele infertility is not very clear.The concept of“accumulation”was first proposed in the Huangdi Neijing.Ancient medical books classified“accumulation”in the categories of“accumulation-gathering”and“abdominal mass”,and pointed out that accumulation disease was mostly caused by cold condensation,stagnation of Qi,blood stasis and body fluid condensation,and put forward the corresponding rules.The clinical manifestation,etiology and pathogenesis of accumulation diseases are similar to varicocele.Therefore,we believe that varicocele infertility can be understood from the perspective of accumulation disease,so as to provide new ideas for the clinical treatment of varicocele infertility.