| BackgroundThe number of male infertility patients shows a rising trend in the world. In our country, infertile couples has accounted for about10%, the man-caused infertility has accounted for20%of infertile couples.Modern medicine has not made the etiology and pathogenesis of male infertility clear. World Health Organization (WHO), divides the cause of male infertility into16categories. Andrology Branch of Chinese Medical Association divides the causes of male infertility into front testicle factor, testicle factor, after testicle factor and idiopathic factor. Modern medicine can only explain the part of pathogenesis of male infertility. Some scholars have proposed the pathogenesis of the oxygen free radicals, nitric oxide, trace element, immunological infertility, endocrine disorders and radiation that inducing male infertility. Traditional Chinese Medicine (TCM) basically divides the cause of male infertility into seven categories including congenital factors; excessive intercourse; emotional disorders; chronic illness,over tiredness; improper diet; toxin invasion; genitourinary trauma. Most scholars believe that the "kidney deficiency" is the fundamental of male infertility. The ideas of liver excess and kidney deficiency, damp-heat, blood stasi s and the others inducing male infertility are proposed by different people but base on the idea of taking kidney deficiency as Fundamental.Traditional Chinese Medicine (TCM) treatment of male infertility is based on treatment according to pattern now. Most TCM formula of male infertility is just different in addition and subtraction on the basis of Five-Seed Progeny Pill, Golden Cabinet’s Kidney Qi Pill, Left-Restoring Pill and Right-Restoring Pill and so on. TCM therapeutic methods are based on supplementing kidney and kidney essence and combined with other therapeutic methods.Related pharmacological experiments show that the mechanism of class of Chinese medicine for the treatment of deficiency of kidney essence may be:①immune regulation, removing or alleviating the pathological damage caused by the allergy on the reproductive system;②endocrine regulation, adjusting the hypothalamic-pituitary-gonadal axis, from the regulation of the endocrine factors of sperm production and maturation to enhancing and maintaining the quality of sperm;③having antioxidant function, superoxide dismutase (SOD), NADH dehydrogenase and H-ATPase activity,removing the free radicals named malondialdehyde(MDA) generated by oxidation reaction, thereby reducing the injury of the sperm;④enhancing the reproductive gland function, thereby enhancing the reproductive capacity. PurposeTo evaluate of the efficacy of Supplement Kidney and Improve Sperm Motility Decoction for curing male infertility patients of deficiency of kidney essence objectively.MethodPatients aged23to50years old from Beijing University of Chinese Medicine Dongzhimen Hospital’s, outpatient in June2010to June2011may be included in the study according to some standards. The Western diagnostic standard, exclusion standards and TCM standards were based on " WHO manual for the standardized investigation, diagnosis and vwanagtweut of the infetile male’," Andrology" edited by YingLu Guo and LiQuan Hu, Chinese wiedicine clinical diagnosis and treatment term-inology (syudrowes part)(national standards publish by State Bureau of Technical Supervision GB/T16751.2-1997) and refered to TCM diagnostics of Chinese Medicine edited by ShaoLiang Ji and ZhaoZhi Cheng. According to the above criteria,50patients was included in the study and determined whether to suspend the study of patients. Patients in the study will be given recipe particle therapy, and0-7days after the start of the study,30+5days,60+5days,90+5days, inspection and TCM syndrome score to evaluate the efficacy according to the efficacy standard. The efficacy standard was based on " world Health Organization vuale infertility standardization checlz with the clinic vauual" and "Traditional chiuese Drug Guidelines, for clinical research".ResultThis study included50cases, all of the50cases were completed.6cases were ineffective,the ineffective rate was12%;17cases were effective, the effective rate of34%;13cases markedly effective,the effective rate was26%;14cases cured, the cure rate is28%of the total effective number of cases was44, with a total effective rate of88%. The difference of semen volume and sperm density before the treatment, after the treatment was statistically significant (P<0.001); the difference of semen liquefaction before the treatment, after the treatment was not statistically significant (p=0.158>0.05); The differences of the rate of a sperm, a+b sperm and sperm activity were statistically significant (P<0.01); the differences of E2level,FSH level before the treatment and after the treatment were not significant (P>0.05). The difference of LH, PRL,and T level before the treatment and after the treatment was statistically significant (P<0.01); the differences before the treatment and after the treatmentofhair loss, loose teeth, weak waist, tinnitus, forgetfulness, nocturnal emission, premature ejaculation, premature aging, impotence, pale tongue, white coating, thready and weak pulse and other main TCM syndromes points and score points were statistically significant (P<0.01).ConclusionSupplement Kidney and Improve Sperm Motility Decoction in the treatment of kidney essence deficiency in infertile men could increase semen volume and improve sperm density, the rate of a sperm, a+b sperm (sperm motility)and sperm motil ity, but showed no significant on sperm abnormality rate, semen liquefaction; could improve the level of serum testosterone (T)and serum luteinizing hormone (LH) levels of male infertility patients, have a certain effect in lowering serum prolactin while showed no significant effect in reducing serum estrogendiol level and changing the E2and FSH levels; showed efficacy in improving hair loss, loose teeth, weak waist, tinnitus, forgetfulness, nocturnal emission, premature ejaculation, premature aging, impotence, pale tonguethe,white fur, thready weak pulse and other main symptoms of kidney essence vacuity of male infertility patients. |
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