abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 36-37 of issue #3, 2007 of Hei Long Jiang Zhong Yi Yao (Heilongjiang Chinese Medicine & Pharmacology), Shao Chang-jie published an article titled “An Integrated Chinese-Western Medical Treatment of 100 Cases of Male Oligospermia Sterility.” A summary of this article is presented below

Cohort description:

All 100 cases enrolled in this cohort study were seen as outpatients. Their ages ranged from 26-40 years, with an average age of 30.8 years. Duration of conceptionless marriage had lasted from 2-12 years, with an average duration of 3.7 years. Ninety-seven of these 100 men were diagnosed with primary-onset sterility and three cases were diagnosed with secondary-onset sterility. In all these cases, sperm motility was decreased up to 60% and sperm count was less than 0.6 million per milliliter. In fact, six cases had zero sperm, 11 cases had extremely few sperm of only 1-3 sperm, 19 cases had counts of 0.05-0.1 million/ml, 18 cases had 0.15-0.2 million/ml, 34 cases had 0.25-0.3 million/ml, and 12 cases had 0.4-0.5 million/ml. In 46 cases, motility was decreased by 10%; in 28 cases, it was decreased 11-30 %; in 24 cases, it was decreased 31-55%; and in two cases, it was normal. Seminal fluid contained red blood cells (RBCs) in five cases and white blood cells (WBCs) in eight cases.

Treatment method:

Chinese medical treatment consisted of a self-composed formula to course the liver and increase progeny consisting of:

Chai Hu (Radix Bupleuri)
Fu Ling (Poria)
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Yin Yang Huo (Herba Epimedii), 12g each
Dang Gui (Radix Angelicae Sinensis)
Bai Shao (Radix Alba Paeoniae)
Fu Pen Zi (Fructus Rubii)
Shu Di (cooked Radix Rehmanniae)
stir-fried Shan Yao (Radix Dioscoreae), 15g each
Gou Qi Zi (Fructus Lycii)
Tu Si Zi (Semen Cuscutae), 30g each
Shan Zhu Yu (Fructus Corni), 10g
Gan Cao (Radix Glycyrrhizae), 6g

If there was a tendency to kidney essence insufficiency, Rou Cong Rong (Herba Cistanchis), processed He Shou Wu (Radix Polygoni Multiflori), and Zi He Che (Placenta Hominis) were added.

If there was a tendency to kidney qi insufficiency, Dang Shen (Radix Codonopsis), Huang Qi (Radix Astragali), Lu Jiao Shuang (Cornu Degelatinum Cervi), and She Chuang Zi (Semen Cnidii) were added.

If sperm motility was decreased due to yang insufficiency and decline of life-gate fire, Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti) and Ba Ji Tain (Radix Morindae Officinalis) were added.

If the rate of abnormal sperm morphology was high due to yin vacuity and fire effulgence, Huang Bai (Cortex Phellodendri), Zhi Mu (Rhizoma Anemarrhenae), Rou Cong Rong (Herba Cistanchis), and He Shou Wu (Radix Polygoni Multiflori) were added.

If the seminal fluid contained lots of RBCs and WBCs due to yin vacuity and fire effulgence accompanied by damp heat pouring downward, Huang Bai (Cortex Phellodendri), Zhi Mu (Rhizoma Anemarrhenae), Mu Tong (Caulis Akebiae), and Jin Yin Hua (Flos Lonicerae) were added.

If there was dizziness, tinnitus, low back soreness, and slippery essence, Jin Ying Zi (Fructus Rosae Laevigatae) and Qian Shi (Semen Euryalis) were added.

If the condition was accompanied by fear of cold, chilled extremities, low back soreness, and yang wilting due to kidney yang insufficiency and decline of life-gate fire, Rou Gui (Cortex Cinnamomi),

Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti), and Yang Qi Shi (Actinolium) were added.

If there was accompanying lesser abdominal chilly pain and scrotal distention and pain due to cold congealing in the liver vessel, Wu Zhu Yu (Fructus Evodiae), Xiao Hui Xiang (Fructus Foeniculi), Li He Zhi (Semen Litchi), and Ju He (Semen Citri Reticulatae) were added.

One packet of these medicinals was decocted in water and administered per day, with 15 days equalling one course of treatment.

Western medical treatment consisted of 50 milligrams of clomiphene orally administered one time per day along with 100 milligrams of vitamin E three times per day. If there were RBCs and WBCs in the seminal fluid, patients were also treated with anti-flammatories. Fifteen days also equaled one course of treatment with these Western drugs.

Study outcomes:

Cure was defined as disappearance of all clinical signs and symptoms with a return to normal of sperm counts and seminal fluid or the wife getting pregnant during treatment. Marked effect meant that the clinical symptoms disappeared and the sperm counts and seminal fluids were almost normal. Some effect meant that the clinical symptoms decreased and that the sperm counts were higher than originally. No effect meant that, after two months of treatment, there was no marked improvement in sperm counts and seminal fluid. Based on these criteria, 82 cases were cured,14 cases got a marked effect, three cases got some effect, and one case got no effect. The shortest course of treatment was 15 days and the longest was 60 days, with an average duration of treatment of 37.3 days.

Discussion:

Dr. Shao begins his discussion with a typical recounting of Chinese medical theory in terms of reproductive function. The kidneys store the essence and govern reproduction. Therefore sterility is mostly treated via the kidneys. However, if one attempts to treat male sterility simply by supplementing the kidneys and fortifying the spleen, the results are not good. This is because, in the young and strong, the kidney qi is naturally effulgent and exuberant and kidney vacuity signs and symptoms are not very obvious. On the other hand, the liver stores the blood and governs coursing and discharge. Further, the liver and kidneys together mutually transform the blood and essence. If the liver stores the blood correctly and courses and discharges normally, then the qi blood penetrate, thrust, or course harmoniously and this then leads to the ability to reproduce. Therefore, reproduction is closely associated with both the viscera of the liver and the kidneys. In fact, according to Dr. Shao’s experience, oligospermia or low sperm counts are mostly due to a combination of liver depression and kidney vacuity. Hence, within the above formula, Chai Hu, Dang Gui, Bai Shao, Fu Ling, and Shan Yao course the liver and fortify the spleen, nourish and harmonize the blood. Yin Yang Huo, Fu Pen Zi, Shu Di, Gou Qi Zi, and Shan Zhu Yu supplement the kidneys and foster the essence. When all these medicinals are used together, they treat both the root and the tip or branch at the same time. According to Dr. Shao, decreased sperm count is mostly due to kidney essence insufficiency, decreased sperm motility is due to kidney yang insufficiency, and poor morphology as well as RBCs and WBCs in the seminal fluid are due to yin vacuity with fire effulgence with or without damp heat pouring downward. The combination of the above Chinese medicinals with clomiphene and vitamin E strengthens the production and development of the sperm. Thus, when these Chinese medicinals are integrated with these Western drugs, the therapeutic effects obtained are fully satisfactory.

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