精索静脉曲张切除术联合麒麟丸治疗精索静脉曲张相关性男性不育症：一项多中心回顾性研究

[Varicocelectomy combined with Qilin Pills for the treatment of varicocele-associated male infertility: A multi-center retrospective study].

作者信息

Yang Nian-Qin, Xie Cong, Wang Jun-Kai, Ge Min-Yao, Xu Jun

机构信息

Department of Urology, Zhongshan Hospital of Fudan University, Shanghai 200032, China.

Department of Andrology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.

出版信息

Zhonghua Nan Ke Xue. 2020 Jun;26(6):547-552.

PMID:33356045

Abstract

OBJECTIVE

To investigate the effect of varicocelectomy (VCE) combined with medication of Qilin Pills (QLP) in the treatment of varicocele (VC)-associated male infertility.

METHODS

We retrospectively analyzed the clinical data on 180 cases of VC-associated male infertility treated in our hospitals between October 2017 and March 2019, 67 by VCE ( the control group) and 113 by VCE in combination with 6-month medication of QLP after operation (the VCE+QLP group). We obtained the semen parameters from the patients before and at 1, 2, 3 and 6 months after surgery, measured their sperm DNA fragmentation index (DFI) before and at 6 months after operation, and recorded the rate of pregnancy at months postoperatively.

RESULTS

There were no severe complications in any of the cases after surgery or during the whole course of medication. Compared with the baseline, the patients in control group showed significant increases at 6 months postoperatively in sperm concentration (［17.1 ± 12.4］ vs ［29.5 ± 14.4］ ×10⁶/ml, P < 0.01), sperm motility (［33.6±13.5］% vs ［54.5±12.0］% , P <) and the percentage of progressively motile sperm (PMS) (［22.8 ± 10.9］% vs ［43.7 ± 11.7］%, P <) but a remarkable decrease in sperm DFI (16.5 ± 7.6］% vs ［13.3 ± 4.4］% , P <), and so did those in the VCE+QLP group in sperm concentration (［16.8 ± 10.7］ vs ［38.9 ± 24.1)×10⁶/ml, P < 0.01), sperm motility (［32.8 ± 14.0］% vs ［50.1 ± 15.0)%, P <), PMS (［21.8 ± 11.3］% vs ［39.6 ± 13.3］% , P <) and sperm DFI (［17.8 ± 9.0］% vs ［11.8 ± 4.8］%, P <). There were even more statistically significant differences between the control and VCE+QLP groups at 6 months in the above semen parameters (P < 0.01) and in the rate of natural pregnancy (32.8% ［22/67］ vs 48.7% ［55/113］, P < 0.05).

CONCLUSIONS

Varicocelectomy combined with medication of Qilin Pills can effectively improve semen quality and increase the rate of natural pregnancy in the treatment of VC-associated male infertility.

摘要

目的

探讨精索静脉曲张切除术（VCE）联合麒麟丸（QLP）治疗精索静脉曲张（VC）相关性男性不育症的疗效。

方法

回顾性分析2017年10月至2019年3月在我院接受治疗的180例VC相关性男性不育症患者的临床资料，其中67例行VCE（对照组），113例行VCE联合术后6个月QLP药物治疗（VCE+QLP组）。我们获取了患者手术前、术后1、2、3和6个月的精液参数，测量了他们术前和术后6个月的精子DNA碎片化指数（DFI），并记录了术后各月的妊娠率。

结果

所有病例术后及整个用药过程中均未出现严重并发症。与基线相比，对照组患者术后6个月精子浓度（［17.1±12.4］对［29.5±14.4］×10⁶/ml，P<0.01）、精子活力（［33.6±13.5］%对［54.5±12.0］%，P<）和前向运动精子百分比（PMS）（［22.8±10.9］%对［43.7±11.7］%，P<）显著升高，但精子DFI显著降低（［16.5±7.6］%对［13.3±4.4］%，P<），VCE+QLP组患者精子浓度（［16.8±10.7］对［38.9±24.1］×10⁶/ml，P<0.01）、精子活力（［32.8±14.0］%对［50.1±15.0］%）、PMS（［21.8±11.3］%对［39.6±13.3］%，P<）和精子DFI（［17.8±9.0］%对［11.8±4.8］%，P<）也有类似变化。对照组和VCE+QLP组在术后6个月上述精液参数（P<0.01）及自然妊娠率（32.8%［22/67］对48.7%［55/113］，P<0.05）方面存在更显著的统计学差异。