Analysis of 46 cases of infertility treated by laparoscopic bilateral spermatic vein high ligation combined with Wuzi Yanzong Pill Plus OBJECTIVE: To observe the clinical efficacy of laparoscopic bilateral spermatic vein high ligation combined with Wuzi Yanzong Pill Plus in the treatment of infertility. Methods:Forty-six patients with confirmed varicocele infertility underwent bilateral high ligation of spermatic veins with preservation of the spermatic artery. The patients were treated with Wu Zi Yan Zong Wan with additional flavor 1 week after surgery. The semen routine was rechecked at 3 and 6 months after surgery. Results:The postoperative sperm viability and sperm density were significantly improved compared with those before surgery. CONCLUSION: Laparoscopic high ligation of spermatic vein combined with Wuzi Yanzong Pill for infertility patients with varicocele can significantly improve semen quality. Varicocele, laparoscopy, Wu Zi Yan Zong Wan, infertility From March 2007 to May 2010, we treated 46 infertility patients with varicocele with laparoscopic bilateral high ligation of spermatic veins combined with Wu Zi Yan Zong Wan with flavor. The results are reported as follows. Data and methods 1. Clinical data: 46 infertile patients with abnormal semen quality were aged 27-36 years, with an average of 31 years. The sperm viability ranged from 8% to 52%, grade A from 3% to 17%, sperm density (4 to 13) million/ml, and malformation rate from 3% to 17%. Bilateral varicocele was confirmed by ultrasound. The history of infertility was >1 year. 2, Surgical method: All patients were treated with general anesthesia. The patient was placed in a lying position with the head low and feet high at 15°. A subumbilical incision was made, a 10 mm Trocar was placed, and a 5 mm Trocar was inserted at the midpoint of the left and right umbilicus and the anterior superior iliac spine. The varicose vein was severed by double ligation with a No. 7 silk thread. The opposite side was treated in the same way. 3. Postoperative medication: One week after surgery, according to the patient’s TCM evidence, Wu Zi Yan Zong Wan was used as the basis with appropriate addition and subtraction. The basic formula: Cuscuta sinensis 15 g, Fructus Lycii 15 g, Raspberry 15 g, Schisandra chinensis 9 g, Plantago ovata 15 g. For Qi deficiency, add Astragalus membranaceus 30 g, Radix Codonopsis pilosulae 15 g, Radix Angelicae Sinensis 15 g, Colla Corii Asini 10 g; for Yang deficiency, add Radix et Rhizoma Polygonati 6 g; for Yin deficiency, add Radix et Rhizoma Polygonati 10 g, Radix et Rhizoma Macrocephala 10 g; for blood stasis, add Radix et Rhizoma Peach 12 g, Radix et Rhizoma Safflower 12 g. The above drugs were soaked in water for 1 h, and then decocted on a gentle fire. The above drugs are soaked in water for 1h, then decocted for 30 min after boiling, and the decoction is taken twice in the morning and evening. 1 dose per day, 28 d for 1 course of treatment. The treatment was continued for 3 courses, with slight addition or subtraction according to the patient’s type of evidence. Results: All 46 cases were operated successfully. The operation time was 35-55 min, with an average of 44 min. 24 h after the operation, the patient was discharged from the hospital in 72 h. Discussion: In recent years, with the deterioration of the living environment and the increase of social pressure, the number of patients with infertility has gradually increased. Their total treatment outcome is not satisfactory. Varicocele is one of the more important causes of infertility. Laparoscopic high level ligation of spermatic veins was first reported by Hagood in 1992 and is now commonly performed in China. It is based on the same principles as open surgery and has similar surgical results. However, laparoscopic treatment of varicocele has the following advantages: ①Bilateral varicocele can be treated together without additional incisions. (2) Clear surgical field, precise efficacy, and low recurrence rate. ③Small trauma, quick recovery and short hospital stay. ④Small scar and cosmetic significance, especially for unmarried men. Although some people currently believe that there is no significant difference in semen quality improvement with or without preserving the spermatic artery, we believe that for infertility patients, preserving the artery can provide an adequate blood supply. According to Chinese medicine: the birth and growth of spermatozoa is closely related to the deficiency of kidney essence. The kidneys are the foundation of the body, which contains the yin and yang, and is the place where the body develops and reproduces offspring. As Su Wen? The last ancient great true theory of cloud: “the man two eight kidney gas, the day sebum to, the essence overflow diarrhea, Yin and Yang, so can have children; …… man seven eight liver gas failure, tendons can not move, the day sebum exhausted, less essence kidney failure, the body are extreme. This means that the kidneys are full of sperm overflow diarrhea, then there are sons; the sperm is weak, less sperm and weakened reproductive function. The pathogenesis of male infertility is mainly the weakness of kidney qi and lack of sperm and blood. The formula consists of Semen Cuscutae, Fructus Lycii, Fructus Raspberry, Fructus Schisandrae and Psyllium. The five herbs in this formula are classified as liver and kidney meridians, of which Cuscuta is sweet and pungent and warm, has the effect of tonifying yang and benefiting yin, regulating the liver and kidney and benefitting essence and blood, strengthening the waist and knees and solidifying the lower yuan, still favoring yang; Wolfberry is sweet and calm, nourishing the liver and kidney, benefiting essence and brightening the eyes; Raspberry is sweet and acidic and warm, has the effect of tonifying the liver and kidney and fixing essence, strengthening the kidney without the bias of dryness and heat; Wu Zi is sour and salty and warm, its skin tastes sweet, its core is hard, has the effect of astringent lung and nourishing the kidney, astringent essence It also has a regulatory effect on the pituitary-adrenocortical system; psyllium is sweet and cold and has the effect of nourishing Yin and nourishing the liver and kidney. A study on the serum containing Wu Zi Yan Zong Wan found that it has a certain protective effect on the decrease of sperm vitality in rats. According to the patient’s type of evidence, products that benefit Qi and nourish Blood, regulate Qi and invigorate Blood can be added appropriately. During the treatment, no significant changes in the patient’s pattern were observed. Because the selected case was an infertility patient with poor preoperative semen quality, the improvement of semen quality was not satisfactory if treated with surgery alone. The patient was treated postoperatively with the addition of Wuzi Yanzong Pill, and the results obtained were similar to other reported improvements in semen quality in patients with varicocele alone. The present study lacks comparison yet and the number is small. Further studies are awaited. There are many factors that cause infertility and improvement in semen quality is only one of the necessary conditions. In the current study, improvement in semen quality did not equal certainty of fertility. At present, laparoscopic high spermatic vein ligation combined with Wuzi Yanzong Pill plus subtractive treatment can be used as a treatment for infertility.