通精冲剂与手术治疗精索静脉曲张不育症的临床研究

目的进一步观察通精冲剂治疗精索静脉曲张不育症的治疗效果。方法将75例Ⅱ(中度)～Ⅲ度(重度)精索静脉曲张伴精液质量异常的不育患者，分成中药治疗组(44例)与手术治疗组(31例)进行对照研究。中药组采用通精冲剂治疗，手术组采用精索静脉高位结扎术或(和)加腹壁下静脉转流术。所有患者均定期复诊或随访。用精液电脑自动分析仪(CASA)对两组治疗前后的精子计数、活率、各项运动参数以及配偶怀孕等情况进行观察。结果治疗前中药组与手术组各项指标大多差异无显著性，中药组精子密度、运动精子数、前向运动精子数等低于手术组；治疗后中药组CASA分析，精子质量明显改善，而手术组手术前后差异无显著性(P＞0.05)。结论用通精冲剂治疗精索静脉曲张引起不育症，可达到手术治疗的临床效果，而且精子运动参数改善明显。表明手术治疗仅单纯改善局部情况，而中药通精冲剂治疗还能进一步调节全身功能。

Comparative Clinical Study on Treatment of Varicocele Caused Infertility by Tongjing Granule and Surgical Operation

Objective: To observe the effect of Tongjing granule (TJG) in treating varicocele caused infertility. Methods: Comparative observation was carried on 75 cases of male infertility caused by moderate or severe varicocele with abnormal semen, they were divided into two groups: the 44 patients in the TCM group treated with TJG and the 31 patients in the operation group treated by surgical operation (high ligation of spermatic vein and/or inferior epigastric venous bypass). All patients were followed up periodically to observe the amount, survival rate and activity of sperm by computerized automatic seminal analyser (CASA), as well as the occurrence of pregnancy in their partner. Results: No significant difference was found in various parameters between the two groups. After treatment, the improvement of seminal density, amount of active sperms and forward moving sperms were lower in the TCM group than that in the operation group, but according to CASA, the improvement of TCM group is better than that of operation group. There was insignificance in the operation group between pre and post treatment, P>0 05.Conclusion: TJG could treat the varicocele caused infertility with the clinical effect similar to the surgical operation, and was superior in improving motility of sperm. It indicates that surgical operation could only improve the local lesion, but TJG could modulate the general condition of patients also.