Male sterility (MS) means infertility caused by disorders of male reproductive system. Its clinical manifestations include abnormal sperm such as spermacrasia, aspermia, dead spermatozoon, azoospermia etc, and disturbance of sexual function, such as impotence, spermatorrhea, nonejaculation etc. The cause of the disease is rather complex. It may be roughly classified into two kinds: the functional cause and the organic one or the primary one and secondary one. In traditional Chinese medicine (TCM), MS belongs to the categories of "cold semen," "scanty semen," "impotence" and "persistent erection" etc.

CLINICAL TREATMENT

1. Types based on symptom-sign differentiation and their treatment.

Some physicians classified male sterility into two types:

1. Deficit due to deficiency of kidney

Manifestations: Lumbago, weak legs, fatigue, lack of strength, clear urine in larger quantities, much urine at night, indifferent sexual desire, long time infertility after marriage, pale tongue with thin--white coating, slender and taut or slender--soft and forceless pulse.

Formula of drugs: Radix Rehmanniae Praeparata, Rhizoma Dioscoreae, Radix Polygoni Multiflori (prepared), Fructus Mori, Radix Astragali seu Hedysari at 15 g each; Semen Plantaginis, Fructus Lycii, Semen Cuscutae, Fructus Rubi at 12 g each; Fructus Corni 6g.

Modifications: For cases with emphasis on yang deficiency, Herba Epimedii, Rhizoma Curculigi at 15g each, Radix Morindae Officinalis 10g, Colla Cornus Cervi 12g were added; for cases with emphasis on yin deficiency, Fructus Ligustri Lucidi, Herba Ecliptae at 12 g each, Colla Plastri Testudinis 15 g were added; for spermacrasia, Colla Plastri Testudinis and Colla Corni Cervi (both were melted) were swallowed at 5 g each with honey and egg; for cases having much monstrous sperm, Radix Angelicae Sinensis, Semen Persicae at 10 g each, and Radix Salviae Miltiorrhizae 15 g were added; for spermatorrhea, Ootheca Manitidis 10 g, Semen Euryales 15 g, Fructus Rosae Laevigatae 15 g, Rhizoma Alismatis 12 g, Cortex Phellodendri 10 g were added; for azoospermia, Radix Codonopsis Pilosulae 15 g, Radix Angelicae Sinensis 10 g, Colla Corii Asini 10 g and Radix Astragali seu Hedysari 15 g were added.

2. Damp-heat in lower burner

Manifestations: Swelling and cramps in the perineum and lower-abdomen, thirst, a bitter taste in mouth, yellowish urine, red tongue with yellow-greasy coating, string-like and slippery pulse.

Formula of drugs: Radix Rehmanniae, Rhizoma Polygoni Cuspidati, Flos Lonicerae at 15 g each; Herba Dianthi, Semen Plantaginis at 12 g each; Rhizoma Dioscoreae Septemlobae, Cortex phellodendri, Caulis Akebiae at 10 g each; talcum 30 g, Radix Glycyrrhizae 5 g.

Modifications: For dysphoria and insomnia, Fructus Gardeniae 10 g, Caulis Polygoni Multiflori 15 g, Cortex Albiziae 10g were added, for purulent sperm, Herba Taraxaci 15 g, Rhizoma Smilacis Glabrae 15 g were added; for dribbling urine, Herba Leonuri, Fructus Alpiniae Oxyphyllae at 12 g each were added; for abnormal seminal liquifaction, Radix  Salviae Miltiorrhizae 15 g, Radix Paeoniae Rubra 12 g, Rhizoma Acori Graminei 6 g, Radix Polygalae 5 g were added; for non-ejaculation during coitus, Squama Manitis10 g, Nidus Vespae 10 g (burned to ash and taken with the decoction), Fructus Liquidambaris 10 g were added.

Administration: The above drugs were decocted and taken at one dose daily in two separate portions. One month was set as a course of treatment. For patients with prostatitis, the third decoction from the above formula was used for a 20 minute of hip bath before bed time at the same time of oral intake. 78 cases were treated with the above prescription. Of them,50 cases or 64% of the cases belonged to the type "deficit due to deficiency in the kidney"; 28 cases or 36% of the cases were grouped into the type "dampness-heat in lower burner". As a result, the clinical curative rate was 64%  and the total effective rate was 93. 59%. The results in the type "deficit due to deficiency of the kidney" was a little bit better than in the type "dampness--heat of lower jiao." But statistically, no distinctive difference was found between the two types. It was found through observation that in the five cases who had no response, 3 cases had aspermia. This reveals that one confronts definite difficulties in treating aspermia with the aid of TCM.

Simple recipes and proved recipes

Some experts treated infertility of abnormal sperm with Semen-benefiting Decoction.

Formula of drugs: Radix Rehmanniae Praeparata, Herba Epimedii, Radix Codonopsis Pilosulae at 15 g each, Rhizoma Curculiginis, Semen Cuscutae, Fructus Rubi, Fructus Morii, Radix Angelicae Sinensis, Fructus Corni, Radix Astragali seu Hedysari, Radix Dipsaci, Semen Astragali Complanati, Poria at 10 g each; Peni et Testes Callorhini l/2 piece.

Modifications: In case of lucocytes in the seminal fluid showing damp--heat in lower burner, Rhizoma Smilacis Glabrae 30g, Herba Lophatheri 10 g, Flos Lonicerae 20 g were added; in case of spermatorrhea and premature ejaculation, Herba Cynomorii, Fructus Schisandrae at 10 g each, Semen Euryales 15 g were added.

Administration: One dose of the above formula was given daily. The drugs were first decocted in water. Patients took the decoction twice a day, in the morning and evening. Half a month constituted a course of treatment.  

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