补肾活血胶囊治疗肾阳虚血瘀型精索静脉曲张的临床及实验研究

目的:采用随机、双盲、对照方法,研究补肾活血胶囊的临床疗效,同时结合大鼠模型实验探讨补肾活血胶囊的药理作用。方法:临床治疗中随机将65例病人分成两组,对照组32例,治疗组33例。两组病人均行精索静脉高位结扎手术。对照组术后口服氯米芬,治疗组术后口服补肾活血胶囊。对两组病例治疗前后症状、体征、T,LH,FSH及精液运动参数变化进行比较。实验研究方面,将30只雄性SD大鼠随机分为3组,模型治疗组,模型对照组,假手术组各10只。模型治疗组给予中药灌胃,假手术组及模型对照组均给予生理盐水灌胃,均按10 mL/(kg·d)剂量,均连用3月。观察实验性精索静脉曲张大鼠睾丸组织结构即生殖细胞成熟程度S,管壁生殖细胞层数P,管周膜厚度M,曲细精管内径D的变化,并按照Makler评分法进行评分。结果:精索静脉曲张患者存在精液常规参数,精子运动参数异常改变,内分泌功能相对紊乱的状态。治疗组在改善异常的精液常规参数、精子运动参数及调整内分泌功能相对紊乱方面优于对照组。实验研究方面,Makler评分模型对照组显著低于假手术组,二者差异有显著性;Makler评分模型治疗组高于模型对照组,二者差异有显著性,与假手术组比较差异无显著性。结论:补肾活血胶囊对于改善精子的运动能力及患者临床症状和体征,纠正紊乱的内分泌功能疗效显著。对于修复损伤的大鼠模型的睾丸组织结构具有一定积极作用。

Clinical and Experimental Study on Effect of Bushen Huoxue Capsule in Treating Varicocele of Kidney Yang Deficiency and Blood Stasis Syndrome

Objective ： By applicating randomized, double - blind, controlled method, to observe the effect of Bushen Huoxue Capsule in treating kidney Yang deficiency and blood stasis syndrome of varicocele and to explore its mechanism. Methods： In the clinical study,65 patients were divided into two groups on random： the treatment group （33 cases treated with Bushen Huoxue Capsule after surgery） and the control group （32 cases treated with clomiphene citrate after surger- y）. Before and after treatment, the clinical symptoms, physical sign, endocrine hormone （ T, LH, FSH） , sperm routine pa- rameter, and sperm motility parameter were observed. In the experimental study,30 male SD rats were randomly divided into three groups： the sham -operation group, the model control group and the model treatment group. After surgery, rats in the sham - operation group and the model control group were treated with 0.9% NaC1. Rats in the model treatment group were treated with Bushen Huoxue Capsule. Testicle organizational structure of rats was observed, and Makler grad- ing was made. Results ： In the clinical study, Bushen Huoxue Capsule was effective to rectify endocrine dysfunction and improve sperm routine parameter,and sperm motility parameter. The difference between the treatment group and the con- trol group was significant. In the experimental study, the Makler grading of the model treatment group was significantly higher than that of the model control group, and had no significant difference compared with that of the sham - operation group. Conclusion： Surgery combined Bushen Huoxue Capsule is an effective recipe in treating kidney Yang deficiency and blood stasis syndrome of varicocele. Bushen Huoxue Capsule can restore the damage testicle organizational structure of experimental varicocele rats.