Clinical Study On The Treatment Of Varicocele Scrotal Pain By Percutaneous Electrical Nerve Stimulation Combined With Maizhiling

Objective:To investigate the clinical efficacy of transcutaneous electrical nerve stimulation combined with Aescuven forte in the treatment of varicocele scrotal pain.Methods:Patients with clinically diagnosed varicocele were selected from the male outpatient department of our hospital from October 2021 to December 2022.The control group was given Mai Zhiling tablet 260mg,once in the morning and once in the evening.The observation group was also given Meizhline,and received low frequency neuromuscular therapy instrument(BioStimble)for electrical stimulation.There were 4 treatments built in the treatment instrument,and each treatment was 30 minutes.Treatment was performed three times a week,with a course of 12 sessions.Before and after treatment,①visual analog scale(VAS)was used to evaluate the degree of scrotal pain.(2)Testicular atrophy index was calculated by scrotal Doppler ultrasonography,internal diameter of spermatic vein during Valsava,blood regurgitation time in spermatic vein;③Temperature difference of bilateral scrotum measured by infrared thermography;④The score of Depression Screening Scale(PHQ-9)and Generalized Anxiety Screening Scale(GAD-7)were completed to evaluate the psychological state before and after treatment.The occurrence of adverse reactions during treatment was recorded.Results:Eighty patients were enrolled in the study,40 in the control group and 40 in the observation group.After 4 weeks of treatment,78 patients completed the study,including 40 in the control group and 38 in the observation group,with 2 cases shedding due to the patient’s request to voluntarily withdraw from the study.Compared with before treatment,VAS score,bilateral scrotal temperature difference,spermatic vein diameter and GAD-7 score of patients with varicocele scrotal pain in control group and observation group were significantly decreased after treatment,and the difference was statistically significant(P<0.01).Blood regurgitation time in spermatic vein and PGQ-9 score also decreased significantly,the difference was statistically significant(P<0.05),but the atrophic index of testis did not change significantly,the difference was not statistically significant.The total effective rate was 86.8%in the observation group and 67.5%in the control group,and the difference was statistically significant(P=0.043).The cure rate was 21.1%in the observation group and 12.5%in the control group,and the difference was not statistically significant(P=0.311).The effective rate was 65.8%in the observation group and 55%in the control group,and the difference was not statistically significant(P=0.762).Two patients in the control group showed mild nausea and vomiting symptoms during the treatment,while the other patients had no obvious discomfort.Conclusions:1.Percutaneous neuromuscular electrical stimulation can obviously improve the spirit of joint Michael VC(VAS score)in patients with scrotal pain symptoms,reduce the bilateral scrotal temperature difference,color doppler ultrasound examination of Valsa gesture of spermatic vein diameter,blood reflux time.2.Aesculium aesculium alone and TNES combined with aesculium aesculium can improve the anxiety and depression symptoms of VC patients with scrotal pain,and there is no significant difference in the improvement of psychological state between the two groups.3.TNES in the treatment of varicocele has no obvious adverse reactions,strong safety,and high patient acceptance.It can be used as an effective option for the treatment of varicocele scrotal pain.