| 1.Objective Observe the clinical efficacy of Yulin 2 on varicocele-induced asthenospermia and investigate its effect on sperm motility and DNA fragment rate,so as to evaluate the efficacy of Yulin 2 on the fertility of VC-induced asthenospermia patients with kidney deficiency and blood stasis.2 Methods2.1 Theoretical research From a large number of documents retrievaled from CNKI datebase and Wanfang database,analyzing the relationship between kidney deficiency syndrome and blood stasis syndrome in patients with VC-induced asthenospermia,meanwhile summarizing the Chinese medical etiology and clincal curative effects and elaborating the theoretical foudation of invigorating blood circulation and tonifying kidney to treat VC-induced asthenospermia.2.2 Clinical Research70 patients with VC-induced asthenospermia who visited the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2017 to December 2017 were selected.All selected patients were randomly divided into treatment group and control group each for 35 cases.The control group was given Diosmin + L-carnitine treatment,on this basis,the treatment group was treated with Qilin 2 treatment.Both groups were observed for 12 weeks.Spermatic vein index and testicular volume were detected by color Doppler ultrasound.The parameters of sperm density and viability were analyzed by Bei ang sperm quality analyzer.The fragment rate is detected by sperm chromatin dispersion(SCD)method.Safety indicators,TCM syndromes,semen parameters,spermatic vein index,decreased sperm DNA fragment rate and other indicators of changes of the two groups were observed and compared before,during and after treatment to evaluate curative efficacy of Yulin 2 on patients with VC-induced asthenospermia.3 Results3.1 Theoretical research results There is a close relationship between kidney deficiency and blood stasis.For example,deficient kidney qi cannot promote blood gasification sufficiently,which would lead to abnormal blood circulation and blood stasis obstructed in collaterals.Kidney yang deficiency makes coldness obstruct,the merdians contract and generate blood stasis.The eficiency of kidney yin which leads to heat internal disturbance and Yin liquid concentration,viscosity,running sluggish,and the formation of blood stasis.Therefore,kidney deficiency is an important factor in the formation of blood stasis.The patient’s with VC-induced asthenospermia scrotum falls,or bulges or pain,even the scrotal skin can be seen in the expansion and distortion of the plexiform vascular plexus,sublingual vein engorgement,dark tongue or petechiae,etc.are all closely connected with the blood stasis.The blood stasis is an important manifestation of essence of blood stasis syndrome in TCM.And the blood stasis syndrome runs through the course of VC-induced asthenospermia.VC-induced asthenozoospermia is prolonged,and the condition is repeatedly lingering,blood stasis in the testes and subacts collaterals and become poisonous.If blood stasis and poison intertwine,it will damage the internal organs,and it will lead to kidney deficiency,aggravate blood stasis and the vicious spiral,Therefore,kidney deficiency and blood stasis is an important pathological mechanism of VC-induced asthenozoospermia.So,for the treatment of VC-induced asthenospermia,the application of invigorating blood circulation and tonifying kidney is very important.3.2 Clinical research results3.2.1 The overall clinical efficacy of Yulin 2 in the treatment of patients with VC-induced asthenospermia After treatment,the two groups had different degrees of improvement.The total effective rate of the treatment group was 91.42%,which was higher than that of the control group(71.42%).The difference was significant(p-value of chi-square test was < 0.05),indicating that the treatment group had more advantages in thetreatment of the disease.3.2.2 Effect of Yulin 2 on symptoms and signs of kidney deficiency in patients with VC-induced asthenospermia After 12 weeks of treatment,compared with that before treatment,the symptoms and signs of sperm motility,loss of libido,waist weakness,lassitude,tinnitus,impotence,forgetfulness,and hair loss were significantly improved in the treatment group after treatment,and the difference was significant(P<0.01).In the control group,sperm motility,waist weakness,and lassitude were also improved,and the difference was also significant(P<0.05).In premature ejaculation and spermatorrhea,there were no significant difference between the two groups before and after treatment(P>0.05).Comparison between groups,the improvement of sperm motility,loss of libido,waist weakness,tinnitus,impotence,forgetfulness,hair loss and loosening of teeth after treatment was better in the treatment group than in the control group,with the difference was significant(P<0.01 or P<0.05).Therefore,the treatment group is better at improving the symptoms of kidney deficiency in patients.3.2.3 Effect of Yulin 2 on the symptoms of blood stasis and physical signs of patients with VC-induced asthenospermia After 12 weeks of treatment,compared with before treatment,the treatment group had significantly improved in aspects of testicular pain or bulge,lip color,tongue,sublingual collaterals,pulse symptoms and physical signs(P<0.05 or P<0.01).There was no significant difference in scrotal moisture(P>0.05).In the control group,the testicular pain or bulge,lip color,tongue and sublingual collaterals is also improved,with statistical significance(P<0.05 or P<0.01).There was no difference in pulse and scrotal moisture(P>0.05).Compared with the control group,the scores of the treatment group were significantly lower in testicular pain or bulge,tongue,and sublingual collaterals(P<0.05 or P<0.01),indicating that Yulin 2 has more advantages in improving the symptoms of blood stasis.3.2.4 Effect of Yulin 2 on the curative effect of TCM Symptoms in patients with VC-induced asthenospermia After 12 weeks of treatment,the conditions of the two groups have been improved at different levels.Among them,the TCM symptoms in the treatment group improved markedly with a total effective rate of 88.57%.The TCM symptoms in the control group were relatively low,and the total effective rate was 65.71%.By chi-square test,P<0.01,indicating significant difference between the two groups.3.2.5 Effect of Yulin 2 on the semen routine parameters in patients with VC-induced asthenospermia Compared with before treatment,there was no significant difference in sperm progressive motility(PR)and sperm density between the two groups at the 4th week of treatment,PR was significantly increased at the 8th and 12 th week of treatment,and the difference was statistically significant(P<0.01).PR+NP grade sperm were significantly different at the 4th,8th,and 12 th weeks of treatment(P<0.01),sperm density,the treatment group was statistically different at the 8th week(P<0.05).At the 12 th week,the difference was also significant(P<0.01).The sperm density of the control group was still not significant at the 8th and 12 th week(P>0.05).Comparison between groups,after 12 weeks of treatment,the PR and sperm density increased significantly in the treatment group,which was better than that in the control group(P<0.01),indicating that the difference in PR level and sperm density between the two groups was statistically significant.3.2.6Effect of Yulin 2 on the DNA fragment in patients with VC-induced asthenospermia Compared with before treatment,there was a difference in the treatment group after 4 weeks of treatment(P<0.05),after 8 and 12 weeks,the sperm DNA fragment rate in both groups showed significant improvement,with significant differences(P<0.01).Comparison between groups,it was found that at the end of the 12-week treatment period,the sperm DNA fragment rate in the treatment group decreased even more significantly(P<0.01),indicating that there was a statistically significant difference between the two groups after treatment,treatment group had better curative effect.3.2.7 Effect of Yulin 2 on testicular spermatic color Doppler ultrasound in patients with VC-induced asthenospermia Compared with before treatment,there was no significant difference in DR and DV after treatment between the two groups(P>0.05);there was a change in Vmax and TR(P<0.01 or P<0.05).Volume also improved(P<0.05).Among the groups,the Vmax and TR in the treatment group were significantly higher than those in the control group(P <0.01),but there was no significant change in the testicular volume(P > 0.01).4 Conclusion4.1Yulin 2 can significantly improve the clinical symptoms of VC-induced asthenospermia patients.4.2There is blood stasis in the patients with VC-induced asthenozoospermia,which is manifested by the increase in the integral value of blood stasis symptoms.4.3 Yulin 2 can improve sperm viability and sperm DNA fragment rate in the patients with VC-induced asthenozoospermia and promote fertility restoration.At the same time,it can also shorten the maintenance time of varicocele regurgitation and significantly improve the state of blood stasis in patients with VC-induced asthenozoospermia,Improve the total efficiency of the disease treatment,the effect is better than the control group. |
