目的：探索优尔精医用降温贴对合并精索静脉曲张的男性不育患者精液质量的改善情况。方法自2015年7月至2016年6月，共有76名患有精索静脉曲张的男性不育患者入治疗组，于上海交通大学医学院附属国际和平妇幼保健院男性科、上海交通大学医学院附属仁济医院男科和复旦大学附属中山医院泌尿科门诊接受治疗。76例患者随机分为两组，组1共40例，予以优尔精+VitE治疗；组2共36例，单纯予以VitE治疗。于术前及治疗后4周，8周，12周测量阴囊表面温度及精液参数。另有39名无精索静脉曲张、精液质量正常的男性为对照组，检测其阴囊表面温度和精液参数。结果76名精索静脉曲张患者治疗前阴囊表面平均温度为35.2℃，显著高于无精索静脉曲张的志愿者（33.5℃），差异具统计学意义（P＜0.05）。组1治疗前平均阴囊温度为35.3℃，与组2（35.1℃）相比无显著性差异。治疗12周后，组1平均阴囊温度降至34.2℃，明显低于组2（35.0℃），差异具统计学意义（P＜0.05）；组1精子密度平均为26.8×106/mL，明显高于组2（22.5×106/mL），差异具统计学意义（P＜0.05）。组1前向运动精子比率增至34.5%，明显优于组2（28.8%），差异具统计学意义（P＜0.01）。结论精索静脉曲张患者阴囊温度升高是造成其精液参数下降的原因之一，应用优尔精医用降温贴可通过降低阴囊温度，有效改善精液参数。%Objective To explore the therapeutic effects of scrotal cooling patch combined with Vitamin E on infertile males with varicocele.Methods From July 2015 to June 2016, there were 76 infertile males with varicocele enrolled in the research,they were divided randomly into two groups and recept treatments in three hospitals. 40 patients in Group one took Vitamin E, at the same time using scrotal cooling patch nocturnally. 36 patients in Group two only took Vitamin E. Scrotal temperature and semen analysis were performed before and 4,8,12 weeks after treatment. 39 normozoospermiaic males without varicocele were enrolled as control group.Results Compared with control group, 76 infertile males with varicocele showed higher scrotal temperature(35.2℃vs control group 33.5℃,P<0.05 ) and deteriorated semen quality. Patients in group one showed the same level of scrotal temperature and semen parameters compared with that of group two before treatment. Patients in group one showed decreased scrotal temperature and increased semen parameters monthly. After 12-week treatment, the average scrotal temperature of patients in group one was statistically lower than that in group two (34.2℃vs35.0℃), the average sperm density and progressive motile sperm percentage in group one were higher than that in group two(26.8×106/mL vs22.5×106/mL, 34.5% vs 28.8%,P<0.05).Conclusion Consecutively scrotal and testicular cooling is able to improve semen quality in infertile males with varicocele.
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