本文選題：精索靜脈曲張 + 腎陽虧虛��； 參考：《北京中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：背景： 目前越來越多的青壯年男性被精索靜脈曲張這種疾病所困擾,此病嚴重的影響了病人的身心健康,成為影響男性健康、家庭和睦的一種重要疾病。經(jīng)過調(diào)查發(fā)現(xiàn)：11歲以下的男性極少患該病,11歲至15歲男性的該病患病率則達到7%以上,16歲至20歲男性的該病患病率約為9%。隨著醫(yī)學(xué)的進步發(fā)展和醫(yī)家經(jīng)驗的不斷積累,不管是西醫(yī)學(xué)專家還是中醫(yī)學(xué)專家,對本病的研究越來越深入、細致,關(guān)于精索靜脈曲張的觀點、學(xué)派眾多,呈現(xiàn)出百家爭鳴之勢。對該病目前仍然以西醫(yī)手術(shù)治療為主,但隨著中醫(yī)學(xué)對其研究的不斷深入,中醫(yī)藥在精索靜脈曲張的治療過程中占據(jù)著越來越重要的地位。 目的： 客觀的對右歸丸加味治療腎陽虧虛型左側(cè)精索靜脈曲張的臨床療效和安全性進行評估。 方法： 本研究的61例研究對象均來源于北京中醫(yī)藥第三附屬醫(yī)院泌尿外科2012年5月至2013年11月就診的腎陽虧虛型左側(cè)精索靜脈曲張的患者。對所有61例患者都需要經(jīng)嚴格篩選和溝通,都滿足于本實驗制訂的病例納入準則和排除準則。61例腎陽虧虛型左側(cè)精索靜脈曲張的患者將被按隨機分組的方式分成兩組：治療組31例；對照組30例。治療組口服中藥湯劑右歸丸加味,對照組服用邁之靈片。治療三個月后,分別進行療效評定,包括：臨床癥狀觀察指標和臨床超聲觀察指標、不良反應(yīng)的監(jiān)測。 結(jié)果： 療效結(jié)果-臨床癥狀評定：治療組31例,治愈病例為15例,有效病例為9例,無效病例為7例；對照組30例,治愈病例為11例,有效病例為7例,無效病例為12例；但此組對比無統(tǒng)計學(xué)意義。療效結(jié)果-超聲檢查評定：治療組31例,治愈病例為15例,有效病例為10例,無效病例為6例,總有效率為80.65%；對照組30例,治愈病例為8例,有效病例為9例,無效病例為13例,總有效率為56.67%。不良反應(yīng)評定：治療組31例,無中度、重度的不良反應(yīng)病例,無出現(xiàn)頭暈者,1例出現(xiàn)輕微惡心,不良反應(yīng)的發(fā)生率為3.23%；對照組30例,無中度、重度的不良反應(yīng)病例,2例出現(xiàn)輕微頭暈,1例出現(xiàn)輕微惡心,2例出現(xiàn)輕微胃痛,不良反應(yīng)的發(fā)生率為16.67%。故右歸丸加味、邁之靈片均可改善腎陽虧虛型左側(cè)精索靜脈曲張患者的臨床癥狀,但倆者在癥狀改善方面無明顯差異；右歸丸加味、邁之靈片均可縮小腎陽虧虛型左側(cè)精索靜脈曲張患者的血管管徑,但右歸丸加味的縮小血管管徑的效果優(yōu)于邁之靈片；右歸丸加味在治療過程中的不良反應(yīng)的發(fā)生率低于邁之靈片。 結(jié)論： 右歸丸加味治療腎陽虧虛型左側(cè)精索靜脈曲張安全、有效；中醫(yī)中藥治療精索靜脈曲張的方法值得推廣。
[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.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R697.24

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