不同手术方式联合疏肝健脾益肾法对精索静脉曲张不育患者疗效的对比研究

摘要

Objective To compare curative effects by laparoscopic, microscopic spermatic vein ligation and both methods combined with dispersing liver strengthening spleen tonifying kidney therapy for sperm quality improvement in varicocele infertility patients.Methods A total of 204 patients with varicocele infertility were randomly divided into group A (51 cases), group B (50 cases), group C (52 cases), and group D (51 cases). Group A received laparoscopic spermatic vein ligation, group B received microscopic surgery, group C received laparoscope + traditional Chinese medicine, and group D received microscopic surgery + traditional Chinese medicine. Sperm quality and mate pregnancy rate were compared in the four groups before and after 3 months of treatment. Results All the four groups had improved sperm quality after surgery, and group D had much better sperm density, sperm motility, sperm motility improvement than the other three groups (P<0.05). Mate pregnancy rate was respectively 41.18%, 60.00%, 59.62% and 74.51% in the four groups.Conclusion Combination of microscopic surgery and traditional Chinese medicine provides better effect than laparoscopic surgery, microscopic surgery, and laparoscope combined with traditional Chinese medicine.%目的：比较腹腔镜、显微镜下精索静脉结扎以及两种手术分别联合疏肝健脾益肾法对精索静脉曲张不育患者的精液质量改善的疗效。方法204例精索静脉曲张不育患者随机分为A组(51例)、B组(50例)、C组(52例)、D组(51例)。A组采用腹腔镜精索静脉高位结扎术， B组采用显微镜手术， C组采用腹腔镜手术+中药治疗， D组采用显微镜手术+中药治疗。比较四组治疗前、治疗后3个月的精液质量及配偶妊娠率。结果四组患者精液质量术后均较术前有所改善，其中D组在精子密度、精子活力及精子活率改善方面均明显优于另外三组(P<0.05)，四组配偶受孕率分别为41.18%、60.00%、59.62%、74.51%。结论显微镜手术联合中药治疗的效果优于腹腔镜手术、显微镜手术及腹腔镜联合中药治疗。