精索靜脈曲張之中醫診療病例報告

精索靜脈曲張是指男性陰囊附近精索處不正常的靜脈彎曲與擴大，臨床症狀除了陰囊墜脹感、鈍痛或活動、出力時誘發劇烈疼痛外，更可能導致睪丸溫度上升，影響精子生成，造成男性不孕症。在中醫中則歸屬「筋瘤」、「筋疝」的範疇，可責之於肝氣鬱結、經絡瘀阻，甚或腎精不足。本病例報告為一29歲男性，自述近半年有反覆左下腹抽痛引至左側鼠蹊部，伴隨左睪丸脹痛，疼痛數字等級量表（Numerical Rating Scale）為8分，泌尿科就診建議手術治療，而病患同時於中醫內科門診就診，調治三個月後，疼痛強度及發作頻率顯著下降。

關鍵字

精索靜脈曲張；肝鬱氣滯；氣滯血瘀；橘核丸

並列摘要

Varicocele is a vascular lesion characterized by the dilation of gonadal veins in the scrotum. Clinical presentation may include scrotal swelling, and scrotal pain which aggravated by exertion. This condition is also related to increased testicular temperature, which has adverse effect on spermatogenesis and may led to infertility. In traditional Chinese medicine field, varicocele was described as ＂tendon tumor＂. Liver qi stagnation, meridian stasis or deficiency of kidney essence are possible causes. Here, we reported a case of 29-year-old man with recurrent left lower quadrant abdominal pain, radiating to inguinal area, along with left scrotal swelling. Diagnosis of varicocele was confirmed in Urology out-patient-department, and surgical intervention was suggested. Patient started to visit Chinese medicine's out-patient-department at the same time and took concentrated Chinese herb powders which mainly containing the formula of Ju-He-Wan. After 3 months of treatment, the intensity and frequency of abdominal and scrotal pain significantly decreased. This case provides clinical observation experiences of Chinese medicine's effect on varicocele.