I. overviewMale infertility due to male causes. In the twenty-first Century, male infertility will become one of the three diseases that thr
Male infertility due to male causes. In the twenty-first Century, male infertility will become one of the three diseases that threaten the health of human beings. In male infertility, semen abnormality is the leading cause of male infertility (64.8%), followed by sexual dysfunction (21.1%) and other factors (14%).
Semen consists of sperm and seminal plasma. Therefore, semen abnormalities include two aspects: abnormal sperm and seminal plasma. The main sperm abnormalities were azoospermia, oligospermia, excess sperm, low sperm motility, dead sperm, abnormal sperm, sperm agglutination and so on. Seminal fluid is abnormal seminal fluid is overmuch, seminal quantity is too little, seminal fluid is not liquefied, seminal fluid is not solidified, seminal leucocyte is overmuch, etc..
Two, etiology and pathogenesis
The cause of male infertility, including congenital factors and acquired factors two aspects.
Congenital factors: mainly is congenitally deficient, weak constitution, or ferrite deficiency, decline of vital gate fire, yin and blood deficiency, reproductive essence is metaplasia or dysplasia, the kidney is not sufficient, night small or absent due to dysspermia infertility.
Acquired factors include: atrioventricular section, Laojuan, chronic emotional disorders, eating disorders, feelings of evils and injury.
Excessive sexual intercourse: frequent and uncontrolled, happy drunk, in order to enter a room, or frequent masturbation, or early marriage and childbearing, caused by the essence of internal friction, spermatogenic dysfunction caused by abnormal sperm sterility.
With a long illness, or Laojuan, too, or excessive anxiety, by heart, blood deficiency injury in two, acquired the refined source, loss of kidney essence to fully support, kidney essence deficiency caused by abnormal sperm sterility.
Emotional disorders: emotional depression, liver qi stagnation, Qi disorder caused by blood and viscera function disorder, kidney imbalance between yin and Yang, Qi Qi reservoir leakage, resulting in abnormal sperm or sexual dysfunction and infertility.
Diet: eating cold, stomach injury, hand induced blood biochemical passive, acquired essence is not sufficient, resulting in congenital kidney deficiency. On the other hand, weakness of the spleen and stomach, transportation and failure of the Department, the water is not wet, phlegm damp block, gasification disorders, semen viscous difficult. If you eat spicy food and alcohol, heat accumulation of wet phlegm, damp and hot finishing room, burning Yin Yin, damp heat loss, or block, the disorder of Qi or dampness caused them a fine fine body, abnormal sperm sterility.
Evil: vulva feculent, or feculent sexual intercourse, dirty inner product, excessive poison infection, or feel the wind heat toxin, cold evil, evil can bet, syphilis, blood, pus, drench turbid essence, Ganchuang disease, resulting in abnormal sperm, cause infertility.
Trauma: Men's genitals vein damage, injury, blood stasis, blood stasis and sperm sterility.
Three, treatment based on differentiation of symptoms and signs
1, kidney essence deficiency: see Yaoxisuanruan, forgetfulness, tinnitus, fatigue etc.. There may be a small amount of semen, or a small number of sperm, or sperm motility, or no sperm. Pathogenesis is deficiency of kidney essence. Treatment is bushentianjing. If the semen volume and less sterile, optional Shengsui Yulin Dan, Jing Wan, continued to fish pill; oligospermia, optional Wuziyanzong pill combined Qibaomeirandan Decoction; sperm motility, sperm can be modified Wuziyanzong pill; no, optional Jujing decoction. Chinese medicine believes that the kidney essence, the essence of the rise and fall of the main reproduction, is directly related to the quantity and quality of sperm, the previous "man with fine, woman with blood", so kidney asthenia is the main pathogenesis of male infertility, kidney essence is the basic law for the treatment of male infertility of abnormal sperm. In clinical application, to nourishing Yin filling kidney essence as the foundation, because the fine Yin, kidney yin, mutual dependence, and the material basis for the kidney. At the same time, TCM believes that "gas generating essence", the essence can alternate, so and to supplement the kidney. In addition, Chinese medicine also believes that blood blood homology dependent, can also participate in the Qi and blood products, blood transfer to fine.
2, kidney deficiency: visible backache, lassitude, spermatorrhea, premature ejaculation, urination urine clear long, after Yuli, pale tongue, weak pulse, etc.. There may be a lot of semen and clear dilute, or semen is not frozen, or abnormal increase in sperm, or dead sperm increased. The pathogenesis is deficiency of kidney qi, Qi and blood is not sufficient, fine customs is not solid, dysfunction of Qi, and No. Is the treatment of kidney qi. If the semen volume and thin, optional solid pills; if semen coagulation, optional Wuziyanzong pill Baoyuantang together; if too much sperm, optional Jinkuishenqiwan; if the dead sperm increased, optional spermatogenic Zhongyu decoction.
3, kidney yang deficiency (decline of vital gate fire) syndrome: visible cold limbs, waist and knee cold, vulva and two cold, dizziness tinnitus, listlessness, impotence and premature ejaculation, night urination, or urine clear long, pale tongue with teeth marks, thready pulse and other symptoms. There may be many cold or semen volume, semen thin such as water solidification, or viscous semen liquefaction, or reduce the number of sperm, or sperm motility. Pathogenesis is the decline of vital gate fire, yangdeficiency, Xu, Yin essence, kidney essence deficiency and dysfunction of qi. Is the treatment of kidney yang, aims to restore the kidney warming and gasification function. If the semen volume and cold, or dead sperm too much, available zanyudan '; semen coagulation, optional YouguiWan megalosaur combined pill; semen liquefaction, optional Jinkuishenqiwan; oligospermia, optional Jinguishenqi pill and Qiangxinboyuan Decoction; sperm motility impaired, can be modified Yougui pill. The application of this method, the hot goods should be used not overdo sth. not too long. Traditional Chinese medicine believes that "strong fire, food, gas, less fire angry". Otherwise, however, anti Yizhi Yin depletion. Secondly, the prescription should not blindly seek to warm yang, Yang Yin based, in order to help and biochemical yin-yang was infinite. Furthermore, with nourishing qi and blood products, to help the germ of the source. In addition, if Yang cold Sheng, when heated by cold, such as Radix Linderae, fennel, corydalis etc..
4, kidney yin deficiency syndrome: visible Fanre night sweats, tinnitus, Yaoxisuanruan, insomnia, dry mouth and throat, or strong sexual desire, red tongue, little coating, thready pulse etc.. There may be a small amount of semen, or semen viscous non liquefaction, or semen, there are pus cells, white blood cells, or too much sperm, or abnormal sperm too much. The pathogenesis is kidney yin deficiency, yin deficiency, heat burn injury fine. Is the treatment of kidney yin, a fever. The semen volume is too small, optional Dabuyinwan; semen liquefaction, optional Decoction; purulent essence, optional Zhibaidihuang pill plus tuckahoe, honeysuckle, dandelion to detoxify, dampness and pus; necrozoospermia, optional dead sperm No. 1 (Anemarrhena, phellodendron, rehmannia, white peony, salvia, red peony root, angelica, honeysuckle, dandelion, licorice root, etc.); sperm deformity too much, optional Six Ingredient Rehmannia Pill Combined Wuziyanzong decoction. Jing Yin, Yin is the germ of the righteous. Yin health is heat, heat is very fire, nourishing Yin drugs quality run cold and sweet, with fire. In clinical application, should pay attention to reinforcing Yin from Yang, as a source of inexhaustible, should not blindly use greasy and tonifying kidney yin nourishing medicine products; of greasy, careful prevent stomach, spleen and stomach affect the transport of the absorption function, and ultimately affect the sperm biochemistry.
5, Qi and blood deficiency syndrome two: visible emaciation, lassitude, palpitations, shortness of breath, pale Huang Wuhua etc.. There may be less semen, or less sperm, or low sperm motility. The pathogenesis is Qi and blood two empty, the viscera function is reduced, the essence loses the source. At the same time to treatment is nourishing qi and blood, and the kidney essence. If less semen, optional Bazhen Decoction and Wuziyanzong pill; spermacrasia, optional River car seed pill; low sperm activity, can Shiquandabu decoction.
Two, 6: cardiosplenic syndrome showed palpitation and dizziness, eatless weakness, fatigue, lusterless complexion, insomnia, pale tongue, thin white fur, thready pulse etc.. Semen volume more or less, or semen is not solidified. The pathogenesis is thought too much, two empty cases, deficiency of Qi and blood, deficiency of kidney essence and acquired essence of the source, in charge loss caused by. Is the treatment of Spleen Qi, nourishing blood, optional Guipi decoction.
7, damp heat: visible yellow and turbid urine, urethral and glowing, dripping wet is not smooth, or after the urine turbid, lower abdomen, perineal pain or discomfort, scrotum wet itching, chest fullness distension, pain throat, red tongue, slippery pulse number or etc.. There may be less semen dense, or semen, semen or thick, leukocytosis, fishy or turbid, a small number of sperm or abnormally increased or low sperm motility, or increased sperm deformity. The pathogenesis is damp, voicing is not divided, even into the toxic fester, blockage of Qi, genital tract obstruction. Treatment is qingrelishi. If the semen volume less dense, and to clear the essence, optional three wonderful pills and distinguish the rhizoma solution Decoction; semen liquefaction, and nourishing Yin, Longdanxiegan Decoction and optional Zhibaidihuang Decoction; if semen white blood cells increased, and to detoxify and drain pus, optional Longdan five disinfection drink a small number of sperm; Yin, and refined, optional Longdan six Dihuang Decoction; if the sperm is too much, the optional eight are scattered; if low sperm activity, suitable for purging liver and gallbladder damp heat, can Longdan Xiegan Decoction; increased sperm deformity, and detoxification, dampness optional Yishen decoction.
8, qi stagnation and blood stasis: visible abdominal or perineal pain, testicular discomfort, pain or painful, or ejaculation painful, dark red tongue or petechiae, ecchymoses, thready pulse astringent. There may be a small amount of semen and thick, semen is not liquefied, or semen is not solidified, or too much sperm. Pathogenesis of Qi and blood stasis is the essence of the road, fine diarrhea. Is the treatment of Qi and blood circulation. If the semen volume and less dense, less sperm, and appropriate to Bushenshengjing, optional Xuefuzhuyu Decoction and Wuziyanzong pill; if the semen liquefaction on promoting blood circulation and viscous, mainly fine, optional Shaofuzhuyu Decoction; if semen coagulation due to blood stasis due to cold, should be warm and cold, promoting blood circulation and removing blood stasis optional, Shaofuzhuyu Decoction; if sperm is overmuch, optional Xuefuzhuyu decoction.
9, qi stagnation: visible emotional depression, Xiongxie pain, lower abdominal discomfort, or when ejaculation stems or pain, testicular pain etc.. There may be too many dead sperm, dark red tongue or petechiae, pulse string etc.. The pathogenesis is stagnation of liver qi, Qi. Treatment is shuganjieyu. With Xiaoyaosan, ChaiHuShuGan decoction, Da Yu Decoction, four inverse scattered etc..
Four, the treatment of heart
The semen volume too much: the rare clinical, mainly from kidney qi and decline of vital gate fire on the treatment of kidney essence and emphasize perturbation Yang gas.
Semen volume is too small: Traditional Chinese medicine known as less refined. It is not because of the deficiency of the kidney essence, but because of the obstruction of the essence. Treatment of kidney tonifying essence, dredging the essence of the road for the treatment of principles. Supplemented with tonifying kidney and replenishing qi and blood, clearing and activating the other generic.
Semen liquefaction: semen liquefaction depends on the gasification effect of Yang, semen liquefaction is caused by various reasons due to dysfunction of kidney gasification. The key lies in the treatment of Fuzhengquxie, the kidney yin and yang balance, restore the function of gasification.
Semen coagulation: disease in kidney disease with deficiency of spleen heart, mainly have deficiency relying on the main pathogenesis is deficiency, loss of temperature, the key to treatment of warming kidney yang, Yin Han powder.
Sepsis syndrome: the main cause of genital infection, wet, hot, toxic is the main cause of. The key is the pathogenesis of damp heat accumulate poison, intrinsic essence room, suppuration. Treatment should be clearing heat and removing dampness, detoxification of pus. In the treatment of the same time, it is appropriate to add one or two taste of kidney essence.
Oligospermia: the most common. The etiology, pathogenesis and treatment of similar small amount of semen. Nourishing kidney and spleen and stomach of congenital attention. Pay attention to damp heat and blood stasis through fine.
Too much sperm: spermatogenic function pathological hyperfunction, sperm growth and maturation function is declining. Traditional Chinese medicine believes that yin and Yang, Yang Sheng Yin decline, kidney deficiency caused by evil. Belong to the virtual standard. In the treatment of nourishing yin and suppressing yang, Fuzhengquxie. Extremely rare clinical.
Low sperm activity: the key lies in the lack of reproductive essence promote kidney yang, lack of energy, low sperm vitality. Kidney yang deficiency is the main pathogenesis of Yang Qi is the main therapy.
Necrospermia: does the etiology, due to kidney deficiency, ultimately can lead to reproductive essence dystrophy. The key to the treatment is to invigorate the kidney and replenish the essence, and to clear the air machine. The purpose is to restore the normal life and length of the essence of reproduction.
Abnormal sperm: poor sperm quality. The pathogenesis is mainly due to the deficiency of the kidney essence or the lack of sperm, and the loss of the essence of reproduction. But, from renal differentiation, with Bushengyijing, real persons, due to damp heat cause genital tract is not smooth, with heat and dampness, Tongli genital tract.
One is the cause of azoospermia: spermatogenic failure, two vas deferens obstruction, TCM believes that the pathogenesis is deficiency of kidney essence, the essence of reproductive tract obstruction or difficult, fine, fine them out. Clinical divided into two types of kidney deficiency and blood stasis syndrome. Idiopathic azoospermia with Bushentianjing, obstructive azoospermia should be treated with heat and dampness, blood stasis and kidney.
Sperm agglutination: the disease mainly in the liver and kidney, followed by the lung and spleen. The pathogenesis of the disease is the deficiency of Qi and the deficiency of nature. To uphold the principle of treatment.