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目的：研究腹腔镜下高位结扎术联合自拟中药汤剂对原发性精索静脉曲张（VC）合并不育症患者精液质量的影响。方法104例原发性精索静脉曲张合并不育症患者随机分成A、B、C 3组。A组行腹腔镜下精索静脉高位结扎术，术后予服用自拟中药汤剂，3个月为1个疗程，服用2个疗程。B组腹腔镜下精索静脉高位结扎术，术后不服任何药物。C组未行手术治疗，仅服自拟中药汤剂，3个月为1个疗程，服用2个疗程。随访6个月，观察患者治疗后精液质量变化。结果104例患者，其中失访11例，余93例进行比较发现，治疗后第3个月及第6个月，A组精子存活率、a级精子比例、（a+b）级精子比例较B组及C组均有明显提高（P＜0.05），治疗后第6个月精液质量改善总有效率达93.5%，但在术后1月的精液质量检测中未见明显变化（P＞0.05）。结论腹腔镜下高位结扎术联合自拟中药汤剂能够改善原发性精索静脉曲张合并不育症患者的精液质量，是有效且微创的方法。“,”Objective To investigate the effects of high ligation in laparoscopic treatment combined with traditional Chinese medicine (TCM) on semen quality of infertility patients with primary varicocele. Methods Total of 104 infertility patients with primary varicocele were recruited in the study and randomly divided into three groups. Patients in group A took the decoction of TCM for a course of three months after laparoscopic high ligation of spermatic vein,and taking two courses. Patients in group B was treated with laparoscopic high ligation of spermatic vein, without taking any medication. Patients in group C only took the decoction of TCM for a course of three months, and taking two courses. All the patients were followed up for 6 months. and The semen quality were detected and recorded. Results In 104 patients, 11 cases of which lost follow-up, and 93 cases completed follow-up. After three months or six months treatment, the survival rate of sperm, the percentage of sperm of grade a and the percentage of sperm of grade a + b in group A wereall significantly higher than those in group B or C(P0.05). Conclusion High ligation in laparoscopic treatment combined with TCM was an effective treatment method for infertility patients with primary varicocele.