[Clinical efficacy of Jujing Decoction on teratospermia: An investigation based on the theory of "yin forming"].

Objective: To study the clinical efficacy of Jujing Decoction (JJD) based on the theory of "yin forming" in the treatment of teratospermia and its effects on semen parameters, sperm morphology, sperm DNA fragmentation index (DFI) and the ultrastructure of sperm mitochondria.

Methods: We randomly divided 40 patients with teratospermia into a blank control group (n = 16) and a JJD group (n = 24), the former treated by reproductive health guidance and the latter with JJD, respectively. After 12 weeks of intervention, we observed the clinical effects and changes in the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically abnormal sperm (MAS), sperm DFI and the ultrastructure of sperm mitochondria, and analyzed the data obtained based on the "yin forming" theory.

Results: The total effectiveness rate was significantly higher in the JJD than in the blank control group (87.50% vs 6.66%, P < 0.05). Compared with the baseline, the patients after treated with JJD showed significant improvement in semen volume (［3.27 ± 1.14］ vs ［4.16 ± 1.84］ ml, P < 0.05), sperm concentration (［38.85 ± 15.88］ vs ［39.35 ± 14.58］ × 10⁶/ml, P < 0.05), PMS (［37.47 ± 2.74］% vs ［42.55 ± 7.07］%, P < 0.05), MAS (［97.43 ± 1.01］% vs ［95.52 ± 0.85］%, P < 0.05), acrosomal integrity (［45.27 ± 5.14］% vs ［51.88 ± 4.48］%, P < 0.05), and DFI (［25.53 ± 6.89］% vs ［17.68 ± 2.38］%, P < 0.05), while the blank controls exhibited only slightly increased semen volume (［3.67 ± 1.77］ vs ［4.40 ± 1.78］ ml) and sperm concentration (［37.24 ± 9.31］ vs ［38.32 ± 10.54］ ×10⁶/ml), but no significant improvement in the other parameters (P> 0.05). Before treatment, folded and discontinuous sperm acrosomal membrane was observed under the transmission electron microscope in the sperm mitochondria of the two groups of patients, the mitochondria stacked and differently sized in the neck and disorderly arranged and some obviously swollen around the tail microtubule. After treated with JJD, the ultrastructure of sperm mitochondria was significantly improved, with relative continuity and integrity of the acrosomal membrane and well-arranged and relatively intact and uniform-sized mitochondria in the neck and tail.

Conclusion: Jujing Decoction can increase the semen volume, sperm concentration and percentage of progressively motile sperm, reduce the percentage of morphologically abnormal sperm and sperm DFI, improve sperm acrosomal integrity, maintain the stability of sperm ultrastructure and protect the structure of sperm mitochondria.