仲崇副　刘丰瑞　史卓卓　高兆旺

摘要 精索静脉曲张是泌尿男科临床常见疾病，主要表现为睾丸坠胀不适、阴囊潮湿、少弱精等症状，现代医学和中医学在临床治疗尚无特效药物。脉络舒通丸为国医大师唐祖宣为治疗湿热瘀阻型血栓性浅静脉炎等血管疾病所创，在临床应用中发现对于治疗精索静脉曲张所导致的症状也有较好的临床疗效。现分别从中西医角度探析脉络舒通丸治疗精索静脉曲张的组方机制，为临床应用提供理论依据。

关键词 脉络舒通丸;精索静脉曲张;湿热瘀阻证;组方分析;不育;少弱精;睾丸坠胀;阴囊潮湿

Abstract Varicocele is a common disease in male urology clinic，mainly manifested as testicular pendent distension discomfort，scrotal moisture，less weak semen and other symptoms.There is no specific drug in clinical treatment of modern medicine and traditional Chinese medicine.Mailuo Shutong Pills was created by TANG Zuxuan，a Chinese medical master，for the treatment of damp and heat stasis type thrombotic superficial phlebitis and other vascular diseases.In clinical application，it was found to have a good clinical effect on the treatment of symptoms caused by varicose vein.This paper analyzes the formulation mechanism of Mailuo-Shutong Pill in the treatment of varicocele from the perspective of traditional Chinese and western medicine，and provides theoretical basis for clinical application.

Keywords Mailuo Shutong Pills; Varicocele; Syndrome of dampness and heat stagnation and blockage; Formulation analysis; Infertility; Less weak semen; Testicular pendent distension; Scrotal moisture

中图分类号：R289.5;R711文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.18.025

精索静脉曲张（Varicocele，VC）是一种血管病变，指精索内蔓状静脉丛的异常扩张、伸长和迂曲[1]，大多数于左侧发病，左侧发病者占77%～92%，右侧发病相对较少见。精索静脉曲张的症状主要表现在阴囊潮湿或者阴囊部位的坠胀疼痛不适，也有部分患者会影响精液质量，导致不育。曲张的精索静脉状如蚯蚓，盘曲在阴囊内，导致睾丸温度升高、缺氧、精索静脉内压力增大、肾和肾上腺代谢物逆流、局部血流微循环障碍等综合病理生理改变，进而造成睾丸生精功能及相关生殖内分泌障碍而终致不育，相关统计表明在男性不育中其发病率为25%～40%[2]。其造成的疼痛症状可能与曲张的精索静脉牵拉骨盆部位神经相关[3]。

目前的治疗主要以药物对症治疗和手术治疗为主，近年来，随着中医药对精索静脉曲张研究的不断深入，临床研究发现脉络舒通丸是治疗湿热瘀阻型精索静脉曲张的有效药物[4]。……