右归丸加味治疗肾阳亏虚型左侧精索静脉曲张的临床疗效观察

发布时间：2018-05-17 22:31

本文选题：精索静脉曲张 + 肾阳亏虚　；参考：《北京中医药大学》2014年硕士论文

【摘要】：背景：目前越来越多的青壮年男性被精索静脉曲张这种疾病所困扰,此病严重的影响了病人的身心健康,成为影响男性健康、家庭和睦的一种重要疾病。经过调查发现：11岁以下的男性极少患该病,11岁至15岁男性的该病患病率则达到7%以上,16岁至20岁男性的该病患病率约为9%。随着医学的进步发展和医家经验的不断积累,不管是西医学专家还是中医学专家,对本病的研究越来越深入、细致,关于精索静脉曲张的观点、学派众多,呈现出百家争鸣之势。对该病目前仍然以西医手术治疗为主,但随着中医学对其研究的不断深入,中医药在精索静脉曲张的治疗过程中占据着越来越重要的地位。目的：客观的对右归丸加味治疗肾阳亏虚型左侧精索静脉曲张的临床疗效和安全性进行评估。方法：本研究的61例研究对象均来源于北京中医药第三附属医院泌尿外科2012年5月至2013年11月就诊的肾阳亏虚型左侧精索静脉曲张的患者。对所有61例患者都需要经严格筛选和沟通,都满足于本实验制订的病例纳入准则和排除准则。61例肾阳亏虚型左侧精索静脉曲张的患者将被按随机分组的方式分成两组：治疗组31例；对照组30例。治疗组口服中药汤剂右归丸加味,对照组服用迈之灵片。治疗三个月后,分别进行疗效评定,包括：临床症状观察指标和临床超声观察指标、不良反应的监测。结果：疗效结果-临床症状评定：治疗组31例,治愈病例为15例,有效病例为9例,无效病例为7例；对照组30例,治愈病例为11例,有效病例为7例,无效病例为12例；但此组对比无统计学意义。疗效结果-超声检查评定：治疗组31例,治愈病例为15例,有效病例为10例,无效病例为6例,总有效率为80.65%；对照组30例,治愈病例为8例,有效病例为9例,无效病例为13例,总有效率为56.67%。不良反应评定：治疗组31例,无中度、重度的不良反应病例,无出现头晕者,1例出现轻微恶心,不良反应的发生率为3.23%；对照组30例,无中度、重度的不良反应病例,2例出现轻微头晕,1例出现轻微恶心,2例出现轻微胃痛,不良反应的发生率为16.67%。故右归丸加味、迈之灵片均可改善肾阳亏虚型左侧精索静脉曲张患者的临床症状,但俩者在症状改善方面无明显差异；右归丸加味、迈之灵片均可缩小肾阳亏虚型左侧精索静脉曲张患者的血管管径,但右归丸加味的缩小血管管径的效果优于迈之灵片；右归丸加味在治疗过程中的不良反应的发生率低于迈之灵片。结论：右归丸加味治疗肾阳亏虚型左侧精索静脉曲张安全、有效；中医中药治疗精索静脉曲张的方法值得推广。
[Abstract]:Background: At present, more and more young and middle-aged men are troubled by varicocele, which seriously affects the physical and mental health of patients and becomes an important disease affecting male health and family harmony. The survey found that men under the age of 11 rarely suffer from the disease. The prevalence of the disease in men aged 11 to 15 is more than 7 percent. The prevalence of the disease in men aged 16 to 20 is about 9 percent. With the development of medicine and the accumulation of medical experience, whether Western medicine experts or traditional Chinese medicine experts, the research on this disease is more and more thorough and meticulous, and there are many schools of thought about varicocele. A hundred schools of thought contend with each other. The treatment of the disease is still mainly western medicine surgery, but with the development of traditional Chinese medicine, Chinese medicine plays an increasingly important role in the treatment of varicocele. Objective: Objective to evaluate the clinical efficacy and safety of Yougui Pill in the treatment of left varicocele with deficiency of kidney-yang. Methods: Sixty-one cases of varicocele in the left spermatic vein of deficiency of kidney-yang type in Urology Department of Beijing third affiliated Hospital of traditional Chinese Medicine from May 2012 to November 2013 were studied. All 61 patients need to be screened and communicated. 61 cases of varicocele with deficiency of kidney-yang type were randomly divided into two groups: treatment group (n = 31) and control group (n = 30). The treatment group was treated by oral Chinese medicine decoction Yougui Pill, while the control group was treated with mai Zhi Ling tablets. After three months of treatment, the curative effect was evaluated, including clinical symptom observation index, clinical ultrasonic observation index and adverse reaction monitoring. Results: Results-Clinical symptom evaluation: in the treatment group, 31 cases were cured, 15 cases were cured, 9 cases were effective cases, 7 cases were ineffective cases, in the control group, 11 cases were cured, 7 cases were effective cases, 12 cases were ineffective cases, 30 cases were cured cases, 7 cases were effective cases, 12 cases were invalid cases, 30 cases were cured, 7 cases were effective cases, 12 cases were invalid cases. But there was no statistical significance in this group. Results: in the treatment group, 31 cases were cured, 15 cases were cured, 10 cases were effective cases, 6 cases were ineffective cases, the total effective rate was 80.655.In the control group, 30 cases were cured, 8 cases were cured, and 9 cases were effective cases. The total effective rate was 56.67. Adverse reactions were assessed as follows: in the treatment group, there were 31 cases with no moderate or severe adverse reactions, 1 case with no dizziness and 1 case with slight nausea, the incidence of adverse reactions was 3.23%, while in the control group, 30 cases had no moderate or moderate adverse reactions. Severe adverse reactions occurred in 2 cases with slight dizziness and 1 case with slight nausea and 2 cases with mild stomach pain. The incidence of adverse reactions was 16.67%. Therefore, the clinical symptoms of patients with varicocele on the left side of deficiency of kidney-yang type can be improved by modified Yougui pills and mazhiling tablets, but there is no significant difference between the two groups in the improvement of symptoms. Mai Zhiling tablets can reduce the vascular diameter of patients with varicocele of deficiency of kidney-yang type, but the effect of modified Yougui pills is better than that of Mai Zhiling tablet. The incidence of adverse reactions in the course of treatment of Yougui pills was lower than that of Mizhiling tablets. Conclusion: It is safe and effective to treat varicocele on the left side of deficiency of kidney-yang type by right Gui Pill, and it is worth popularizing the treatment of varicocele with traditional Chinese medicine.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R697.24

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