[Effect of Shanhaidan Granules combined with tadalafil on erectile dysfunction: A multi-center clinical trial].

OBJECTIVE: To observe the clinical effect and safety of Shanhaidan Granules (SHDG) combined with tadalafil tablets (TT) in the treatment of ED. METHODS: In this open multi-center case-control clinical trial, we enrolled 247 ED patients according to the designed criteria, and treated them orally with SHDG at 10 g per time tid (n = 74), TT at 5 mg per time bid (n = 52), or SHDG + TT at the above doses (n = 121), all for 8 weeks. Before and after medication, we recorded the IIEF-6, erection hardness scores (EHS), traditional Chinese medicine syndromes (TCMS) scores, penile cavernous blood flow parameters and adverse reactions, and compared them between the 3 groups of patients. RESULTS: After 8 weeks of treatment, all the patients showed significantly increased IIEF-6, EHS and TCMS scores in comparison with the baseline (P < 0.05). The total effectiveness rates in the SHDG, TT and SHDG + TT groups were 60.8%, 67.3% and 69.4% respectively based on the IIEF-6 scores, remarkably higher in the TT and SHDG + TT groups than in the SHDG group (P < 0.05), and 40.5%, 32.7% and 63.6% respectively according to the TCMS scores, markedly higher in the SHDG and SHDG + TT groups than in the TT group (P < 0.05). Single-center data manifested significantly increased peak systolic velocity (PSV) of the penile artery in the SHDG + TT and TT groups (P < 0.05). The improvement values of relevant parameters were remarkably higher in the SHDG + TT group than in the TT and SHDG groups, so were IIEF-6 scores in the TT than in the SHDG group, and TCM syndromes in the SHDG than in the TT group. No medication-related adverse events were found in any of patients after treatment, except for some mild side effects including muscle soreness and gastrointestinal reactions in a few cases, all soon relieved, none with abnormalities in blood and urine routine tests or hepatic and renal function indicators. CONCLUSIONS: Shanhaidan Granules combined with tadalafil can significantly improve the erectile function and reduce TCM syndromes in ED patients, and therefore can be applied effectively and safely in clinical practice./.

[Short-term medication of L-carnitine before intracytoplasmic sperm injection for infertile men with oligoasthenozoospermia].

OBJECTIVE: To observe the pregnancy promoting effect of L-carnitine combined with intracytoplasmic sperm injection (ICSI) in treating male infertility with oligoasthenozoospermia. METHODS: We assigned 129 patients with oligoasthenozoospermia to receive 2 weeks of oral L-carnitine followed by ICSI (medication group, n = 42) and ICSI alone (control group, n = 87). We compared the sperm concentration and motility, the percentage of grade a + b sperm, and sperm deformity before and after L-carnitine medication, as well as the rates of fertilization, cleavage, available embryo and clinical pregnancy between the two groups. RESULTS: The percentage of grade a + b sperm was significantly increased after L-carnitine medication as compared with the baseline ([13.5 +/- 10.7] % vs [9.6 +/- 7.2] %, P<0.05), and so was the rate of available embryo in the medication group after ICSI in comparison with that of the control group (77.50% vs 69.04%, P<0.05). CONCLUSION: Short-term medication of L-carnitine can improve sperm quality and raise the success rate of ICSI.

[Clinical efficacy of combined L-carnitine and acetyl-L-carnitine on idiopathic asthenospermia].

OBJECTIVE: To evaluate the clinical efficacy of combined L-carnitine and acetyl-L-carnitine on idiopathic asthenospermia. METHODS: Thirty patients with idiopathic asthenospermia were treated by combined L-carnitine and acetyl-L-carnitine for 3 months after failure to respond to the integrated therapy of Chinese and Western medicine. Semen samples were obtained, analyzed and graded according to the WHO laboratory manual before and after the treatment. Twenty-five of the patients completed the whole study. RESULTS: Combined L-carnitine and acetyl-L-carnitine statistically improved the sperm vitality (24.89 +/- 12.28)%, grade a + b sperm motility (16.04 +/- 8.33)% and the total sperm count per ejaculate (76.79 +/- 43.14) x 10(6), with a significant difference from pre-treatment (P < 0.05). CONCLUSION: Combined L-carnitine and acetyl-L-carnitine has a supplementary effect in the treatment of idiopathic asthenospermia and improves the semen quality of the patient.

[Clinical efficacy and safety of recombinant human-growth hormone in the treatment of idiopathic asthenospermia].

OBJECTIVE: To evaluate the clinical efficacy and safety of recombinant human-growth hormone (rhGH) in the treatment of idiopathic asthenospermia. METHODS: Forty patients with idiopathic asthenospermia were recruited, randomly divided into an rhGH group and a control group and treated for 3 months. In addition to routine treatment, the rhGH group (n = 18) received rhGH, while the control group (n = 18) underwent the routine treatment only. Before and after the treatment, semen samples were obtained, analyzed and graded according to the WHO laboratory manual, and the serum sexual hormone, thyroxin, liver and kidney function, blood cholesterol and blood glucose level were detected. RESULTS: Sperm vitality was statistically increased, (28.60 +/- 32.89) % in the rhGH group and (8.42 +/- 25.87) % in the control (P < 0.01), and so was sperm (a + b) motility, (18.56 +/- 21.19) % in the rhGH group and (8.12 +/- 24.34) % in the control (P < 0.05). CONCLUSION: rhGH can be used safely as an effective supplement to medicinal treatment of idiopathic asthenospermia.

Role of Acupoint Area Collagen Fibers in Anti-Inflammation of Acupuncture Lifting and Thrusting Manipulation.

The role of the acupoint area collagen fibers in the efficacy of acupuncture lifting and thrusting (L&T) manipulation will be explored in this paper. 30 male NZW rabbits were randomly divided into 6 groups: sham operation group (Group N), model group (Group M), acupuncture without manipulation group (Group W), acupuncture L&T manipulation group (Group A), collagenase pretreatment group (Group JM), and collagenase pretreatment + acupuncture L&T manipulation group (Group JA). The bacterial endotoxin was used to generate the rabbit fever models. Acupuncture was applied at IL-11. The levels of IL-1ß, TNF-α, and IL-4 and the rectal temperature were measured at 2 h, 4 h, and 6 h after modeling and the collagen fiber morphology at acupoint area was observed after 6 hours. Results. As compared with Group N, the levels of IL-1ß and TNF-α in Group M were significantly higher; the level of IL-4 was significantly lower (P < 0.05). As compared with Group M, IL-1ß and TNF-α in Groups W and A were significantly lower and IL-4 was significantly higher (P < 0.05). As compared with Group W, IL-1ß and TNF-α in Group A were lower and IL-4 was higher (P < 0.05). The collagen fiber in Group A was slightly rough, distorted, and fractured. As shown in studies, the endotoxin-induced inflammatory response can be significantly inhibited by acupuncture whose efficacy can also be significantly improved by the manipulations. Collagenase pretreatment may be the first receptor to the mechanical force of the L&T manipulation.