Article 59: Diagnosis, Differential Diagnosis, and Western Medical Treatment of Low Sperm Motility
◇A Guide to Caring for Your Husband's Health as a Good Wife◇
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Treatment and recuperation of common diseases
What tests should be done?
1. Routine semen analysis: Sperm motility is below grade 2 in three consecutive tests, or the motility rate of grade 3 or 4 sperm is less than 50%.
2. Routine examination of prostatic fluid: lecithin bodies are unevenly distributed, reduced in number or absent, and white blood cells are increased, with more than 10 per high-power field.
Which diseases should it be differentiated from?
1. Polyspermia: Increased number of dead sperm, reduced sperm survival rate, with more than 40% of sperm being dead; however, this disease refers to low sperm motility, including inactive sperm, which are not necessarily dead sperm.
2. Oligospermia: refers to a decrease in sperm density and total sperm count, which may be accompanied by decreased sperm motility; in cases of simple decreased sperm motility, sperm density is generally normal.
3. Decreased sperm motility: This refers to a decrease in the ratio of surviving sperm to the total number of sperm (surviving to dead sperm) per unit volume. When sperm motility decreases, sperm vitality also decreases; however, decreased sperm vitality does not necessarily mean decreased sperm motility.
How does Western medicine treat this?
Treatment of low sperm motility should focus on identifying the underlying cause and treating any genital lesions causing the low sperm motility. Medications are typically used to increase the energy necessary for sperm motility and participate in sperm metabolism, thereby stimulating sperm activity. Commonly used medications include:
1. Adenosine triphosphate (ATP): 20 mg intramuscular injection, once daily. It is more effective in cases with chronic genital inflammation and can significantly improve sperm motility.
2. Pentoxothecoside: 200-600 mg each time, 3 times a day, for 3-6 months, which has a significant effect on the forward motility of sperm.
3. Vitamin A: Cod liver oil capsules, 2-3 capsules each time, 3 times a day, for 3 consecutive months. Vitamin A is an essential substance for promoting sperm production.
4. Vitamin E: 50 mg once a day for 3 months.
How does Traditional Chinese Medicine differentiate syndromes and treat diseases?
1. Kidney Yang Deficiency Type: Symptoms include decreased sperm motility, impotence, seminal emission, low libido, infertility after prolonged marriage, weak ejaculation, cold limbs, soreness and weakness of the lower back and knees, frequent urination at night or frequent urination, loose stools, pale and swollen tongue with thin white coating, and deep, thready and slow pulse.
Treatment principle: warm the kidneys and strengthen yang, replenish qi and consolidate essence.
Prescription: Ginseng (decocted separately) 6g, Atractylodes macrocephala 6g, Poria cocos 10g, Angelica sinensis 10g, Rehmannia glutinosa (processed) 12g, Astragalus membranaceus 15g, Rehmannia glutinosa (raw) 12g, Ophiopogon japonicus 10g, Eucommia ulmoides 10g, Dioscorea opposita 30g, Lycium barbarum 10g, Cuscuta chinensis 15g, Schisandra chinensis 5g, Rubus idaeus 10g, Trigonella foenum-graecum 10g, Psoralea corylifolia 10g, Euryale ferox 15g, Cynomorium songaricum 10g, Morinda officinalis 10g, Cistanche deserticola 20g, Aconitum carmichaelii (decocted first) 6g, Cinnamomum cassia 6g.
2. Kidney Yin Deficiency Type: Symptoms include seminal emission and premature ejaculation, decreased sperm motility, hot flashes in the palms, soles, and chest, hypersexuality, restlessness and insomnia, soreness and weakness of the lower back and knees, dizziness and tinnitus, red tongue with little coating, and thready and rapid pulse.
Treatment principle: Nourish Yin and tonify the kidneys.
Prescription: 6-10g of Phellodendron bark, 6-10g of Anemarrhena rhizome, 12g of Rehmannia root, 15g of roasted tortoise shell, 15g of Dioscorea rhizome, 10g of Cornus fruit, 15g of deer antler glue (melted), 10g of wolfberry fruit, 15g of Cuscuta seed, 10g of Achyranthes root, and 10g of pig bone marrow.
3. Qi and Blood Deficiency Type: Symptoms include thin and weak semen, or reduced sperm count, decreased sperm motility, decreased libido, pale or sallow complexion, fatigue, dizziness, shortness of breath, pale lips and nails, pale tongue, and weak pulse.
Treatment principle: Nourish Qi and Blood.
Prescription: Red ginseng (decocted separately) 10g, Astragalus membranaceus 15g, Angelica sinensis 10g, Paeonia lactiflora 10g, Polygonatum sibiricum 10g, Dioscorea opposita 15g, Placenta hominis 10g, Rehmannia glutinosa 10g, Colla corii asini (melted) 10g, Fish maw gelatin (melted) 10g, Glycyrrhiza uralensis 3g.
4. Damp-heat accumulation type: Symptoms include decreased sperm motility, thick semen, slightly yellow color, containing a large number of white blood cells or pus cells, scanty and dark urine with incomplete emptying, white discharge after defecation, bitter taste in the mouth and dry throat, damp scrotum, red tongue with yellow and greasy coating, and slippery and rapid pulse.
Treatment principle: Clear heat and promote diuresis.
Prescription: Gentian root 10g, Phellodendron bark 10g, Scutellaria root 10g, Plantago seed (wrapped) 10g, Talc 20g, Smilax glabra 15g, Coix seed 20g, Moutan bark 10g, Red peony root 10g, Alisma rhizome 10g, Akebia stem 10g, Bupleurum root 10g, Licorice root 3g.