Yang Yang, Xue Xinyu, Zhou Jun, Qiu Zerui, Wang Biao, Yin Ziwei, Ou Guangyang, Zhou Qing
The First Clinical College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China.
Hunan University of Chinese Medicine, Changsha, China.
Heliyon. 2024 Aug 24;10(17):e36680. doi: 10.1016/j.heliyon.2024.e36680. eCollection 2024 Sep 15.
Fertility rates are declining globally, and male infertility is increasingly recognized as a significant challenge. This study aims to present the latest findings on the effectiveness and safety of combining traditional Chinese medicine (TCM) with L-carnitine (LC) for treating male infertility.
We searched 8 databases. Randomized controlled trials of TCM combined with LC therapy versus LC alone in the treatment of male infertility. The outcome included: pregnancy rate, sperm motility, concentration, volume, viability and liquefaction time. Subgroup analyses were also performed according to type of TCM, type of dosage form, and different TCM treatments, and the source of the high heterogeneity was explored. The study is registered on PROSPERO (CRD42023421497).
1129 subjects from 12 of the 1833 eligible studies fulfilled the criteria. Compared with LC treatment alone, the combination of TCM and LC significantly improved pregnancy rate [RR = 1.65, 95 % CI (1.37-2.00)], grade (a+b) sperm motility [SMD = 1.56, 95 % CI (1.12, 2.01)], grade (a) sperm motility [SMD = 1.04, 95 % CI (0.69, 1.38)], sperm concentration [SMD = 1.39, 95 % CI (0.91, 1.86)], and sperm viability [SMD = 1.72, 95 % CI (0.83, 2.60)]. Subgroup analyses indicated that Compound Xuanju Capsule and Yougui Capsule demonstrated better efficacy. And the decoction and not-decoction each had their own advantages.
The combination of TCM with LC can have a dual effect: increasing pregnancy rates and sperm quality. Therefore, this combination is a recommended therapeutic strategy and a more appropriate type of TCM can be selected according to the patient's own characteristics.
全球生育率正在下降，男性不育越来越被视为一项重大挑战。本研究旨在介绍将中药与左旋肉碱（LC）联合用于治疗男性不育的有效性和安全性的最新研究结果。
我们检索了8个数据库。关于中药联合LC疗法与单独使用LC治疗男性不育的随机对照试验。结局指标包括：妊娠率、精子活力、浓度、体积、存活率和液化时间。还根据中药类型、剂型类型、不同的中药治疗方法进行了亚组分析，并探讨了高异质性的来源。该研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023421497）注册。
1833项符合条件的研究中有12项的1129名受试者符合标准。与单独使用LC治疗相比，中药与LC联合使用显著提高了妊娠率[风险比（RR）=1.65，95%置信区间（CI）（1.37 - 2.00）]、（a + b）级精子活力[标准化均数差（SMD）=1.56，95%CI（1.12，2.01）]、a级精子活力[SMD = 1.04，95%CI（0.69，1.38）]、精子浓度[SMD = 1.39，95%CI（0.91，1.86）]和精子存活率[SMD = 1.72，95%CI（0.83，2.60）]。亚组分析表明，复方玄驹胶囊和右归丸疗效更佳。且汤剂和非汤剂各有优势。
中药与LC联合使用可产生双重效果：提高妊娠率和精子质量。因此，这种联合是一种推荐的治疗策略，可根据患者自身特点选择更合适的中药类型。
