补肾活血方联合显微镜手术治疗精索静脉曲张相关性弱精症的临床观察

Clinical observation of Buslien Huoxue Recipe combined with microsurgery in the treatment of varicocele-associated asthenospermia

目的观察补肾活血方联合显微镜手术治疗肾阳虚血瘀型精索静脉曲张相关性弱精症患者的临床疗效。方法选取2021年11月至2022年12月潍坊市中医院诊治的60例原发性精索静脉曲张患者,中医辨证为肾阳虚血瘀型,随机分为试验组(n=30)和对照组(n=30)。试验组接受显微镜手术联合补肾活血方治疗,对照组只接受显微镜手术治疗。治疗3个月后,比较两组精子质量参数和内分泌激素水平。结果两组患者术后睾酮(T)水平均有不同程度的升高,同时卵泡刺激素(FSH)、黄体生成素(LH)水平降低;试验组T水平高于对照组,LH、FSH水平低于对照组,差异具有统计学意义(P<0.05)。显微手术3个月后进行随访,两组精液质量均有改善,但试验组患者的精子浓度、精子总活力、精子存活率、精子直线速度、前向运动精子百分率优于对照组,差异具有统计学意义(P<0.05)。结论补肾活血方联合显微镜手术治疗肾阳虚血瘀型精索静脉曲张相关性弱精症,能有效提高患者的精液质量,改善血清T、LH和FSH等激素水平。

Objective To investigate the clinical efficacy of Bushen Huoxue Recipe combined with microsurgery in the treatment of varicocele-associated asthenospermia of kidney Yang deficiency and blood stasis type.Methods A total of 60 patients diagnosed with primary varicocele diagnosed and treated at Weifang Hospital of Traditional Chinese Medicine were selected from November 2021 to December 2022,with traditional Chinese medicine(TCM)syndrome differentiation as kidney Yang deficiency and blood stasis type.Patients were randomly divided into the experimental group(n=30)and the control group(n=30).The experimental group received microsurgery combined with Bushen Huoxue Recipe treatment.The control group received only microscopic surgery.After 3 months,sperm quality parameters and endocrine hormone levels were compared between the two groups.Results The postoperative increase in testosterone(T)levels varied between the two groups,while follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels decreased.T level of experimental group was higher,LH and FSH was lower than that of control group,with statistically significant(P<0.05).The semen quality was improved in the follow up performed 3 months after microsurgery.While the sperm concentration,total motility,survival rate,linear velocity,and forward motion rate of the experimental group were better than those of control group,with statistically significant(P<0.05).Conclusions Bushen Huoxue Recipe combined with microsurgery can effectively improve the semen quality and serum T,LH and FSH levels in patients with varicocele-associated asthenospermia of kidney Yang deficiency and blood stasis type.