A Systematic Review On Clinical Effects Of Oligoasthenospermatism Treated With BuShen Recipe And Clomiphene Citrate

With the deterioration of human living environment,many factors of reproductive toxicity continue to increase,and the quality and fertility of men's semen decrease continuously.As the most common cause of male infertility,the etiology of oligospermia and asthenospermia is not clear,the pathogenesis is complex,which brings great difficulty to clinical treatment.At present,the medical treatments of western medicine are from many aspects,but the effect is still lack of strong evidence support.Although assisted reproductive technology has flourished in the last few decades,the high cost of treatment has brought a huge financial burden to the family.According to the traditional Chinese medicine theory,oligospermia and asthenospermia disease relates to kidney closely related with the transport function of the spleen and the sparse release function of the liver.Although the performances of oligospermia and asthenospermia are different,the basic pathogenesis is kidney deficiency,and most fundamental treatment is invigorating the kidney.In clinical treatment,according to the specific characteristics of the patients,the treatments of tonifying both Yin and Yang,warming kidney and activating Yang action,invigorating kidney and spleen,reinforcing kidney and activating circulation,tonifying kidney and reregulating live are used.A large number of studies have reported the effectiveness of kidney tonifying therapy in the treatment of oligospermia and asthenospermia.However,due to the diversity of control drugs,it is difficult to overall measure the clinical efficacy of traditional Chinese medicine for tonifying kidney.Clomiphene is anti-estrogen drugs,and is commonly used for the treatment of oligospermia and asthenospermia in clinic,which was reported by a large number of domestic and foreign literature.So this research choses clomiphene as control drug,and uses the method of system evaluation,measures the kidney nourishing medicine in the efficacy and safety of treatment in oligospermia and asthenospermia.Objective:Through systematicly evaluating the randomized controlled trials on the use of tonifying kidney,we compared the treatments,effect and safety by using clomiphene to treat oligospermia and asthenospermia with that by using traditional Chinese medicine,and provide strong support for aspects of evidence-based medicine.Methods:1.Literature collection:Use of computer retrieval Chinese Journal Full-text Database(CNKI),Wanfang Data(WanFang Data)medical journal database Chinese biomedical literature database(CBM),Weipu(VIP),PubMed,EMbase,Cochrane,Library database,retrieval time was up to September 30,2017.And inquire about the Chinese clinical trial registry www.ehietr.org/site/ehinese/Index.htm,retrieval time was up to September 30,2017.2.Extracting information from literatures3.The bias risk assessment tool was used to evaluate the bias risk in the literature.4.ReviewManager5.3,a special software provided by Cochrane,is used to systematically evaluate the extracted data.Results:1.A total of 877 articles were retrieved,and finally 31 articles were included.The total sample size of the study included 5273 cases,including 3319 cases in the experimental group and 1954 cases in the control group.2.All 31 articles included mentioned "randomized controlled trial",a total of 11 studies clearly described using randomly assigned experimental group and control group.But only 1 references to blind law,the overall deviation of the literature can not be judged.In the experimental design,the kidney tonifying method has a further improvement in the treatment of oligoasthenospermia.3.Through Meta analysis,and cure rate(pregnancy rate),sperm concentration,total sperm activity rate,the percentage of grade a+b sperm(forward motility),a level sperm,the treatment of traditional Chinese medicine of tonifying kidney oligoasthenospermia significantly better than clomiphene.The heterogeneity of each study was high.4.There are 5 studies involved in the observation of adverse reactions.The safety of Chinese traditional Chinese medicine for the treatment of oligospermia and oligospermia needs further observation.Conclusion:Tonifying kidney Chinese medicine can significantly improve pregnancy rate,sperm density,total survival rate,forward motility,a level sperm is obviously better than clomiphene.However,the homogeneity of the studies is poor,and the relevant diagnosis and treatment plans need to be further standardized.