Clinical Study Of Yishen Tongluo Decoction For The Treatment Of Necrospermia Infertility Caused By Kidney-deficiency And Collateral-obstruction

Objective:To observe the pregnancy rate of spouse,sperm survival rate,sperm DNA fragment index DFI,sperm motility and TCM symptom score before and after treatment in patients with infertility caused by kidney-deficiency and collateral-obstruction,and to evaluate the clinical efficacy of Yishen Tongluo Decoction in treating sterility due to kidney deficiency and collateral obstruction,and to explore the mechanism of action,so as to provide data support for the popularization and application of Yishen Tongluo Decoction.Methods:Eighty patients who met the inclusion and exclusion criteria are divided into treatment group and control group,40 cases in each group.The treatment group is given Yishen Tongluo Decoction orally,while the control group is given Levocarnitine Oral Solution orally,12 weeks as a course of treatment,following up for 4 weeks.The semen parameters,sperm DNA fragment index(DFI)and TCM symptom score are recorded before and after treatment.The final pregnancy status of the spouse is inquired after 4 weeks of follow-up after treatment,and the statistical analysis is carried out to evaluate the clinical effect of the two groups.Results:(1)After a full course of treatment,there are 3 cases in the treatment group and 4 cases in the control group fall off,remaining 37 cases in the treatment group and36 cases in the control group.The total effective rate of the treatment group is 72%,3cases are recovery,6 cases are markedly effective,18 cases are effective and 10 cases are ineffective.The total effective rate of the control group is 47.2%,1 case is recovery,3 cases are markedly effective,13 cases are effective and 19 cases are ineffective.The total effective rate of the two groups is 5.053,P=0.025.The treatment group is superior to the control group.The clinical efficacy is tested by rank sum test.The results show that the treatment group is superior to the control group(Z =2.328,P=0.02).(2)Pregnancy rates after treatment are compared between the two groups(P=0.627),and there is no significant difference between the two groups.(3)Aftertreatment,the sperm DNA fragment index of both groups improved,compared with before treatment(P < 0.001),after treatment,the two groups are compared t=-4.472,P< 0.001,the treatment group is better than the control group.(4)After treatment,the sperm survival rate of both groups is improved,P=0.004 is ompared between the two groups,and the treatment group is better than the control group.(5)The rate of forward motile sperm in both groups improved after treatment,P=0.001,the treatment group is better than the control group.(6)The total sperm motility of the two groups improved after treatment,P=0.000,the treatment group is better than the control group.(7)After treatment,the blood,urine and feces,liver and kidney function and ECG of the two groups are not abnormalities.Conclusion:Yishen Tongluo Decoction can improve sperm survival rate,increase forward motile sperm ratio and total sperm motility,and reduce sperm DNA fragmentation index in infertile patients with dead sperm.Yishen Tongluo Decoction has a good curative effect in the treatment of sterility due to dead spermatozoa,and has no adverse reactions.It is worthy of clinical application.