中醫治療男性不孕症之病例報告

A Case Report of Male Infertility Treated with Traditional Chinese Medicine

10.6516/TJTCM.202109_24(3).0008

李家甄(Chia-Chen Lee)；謝昌儒(Chang-Ju Hsieh)；李佳穎(Chia-Ying Lee)

中醫藥 ； 男性不孕 ； 射精障礙 ； Chinese Medicine ； Male Infertility ； Ejaculatory Dysfunction

中醫藥研究論叢

24卷3期（2021 / 09 / 30）

105 - 115

繁體中文

根據世界衛生組織（World Health Organization, WHO）的定義，不孕症是指一對夫妻在未進行避孕措施之前提下，有至少一年正常而規律之性生活，仍無法受孕，其中因各種環境、心理壓力、生活習慣之變化，近代男性因素而導致不孕症之比例已高達50%。此為一35歲男性，過去有過敏性鼻炎、痛風、高血脂症、原發性高血壓、泌尿道結石、脂肪肝等病史。現已結婚超過五年，與妻子平時有規律而正常之未避孕性行為，仍尚未生育，初就診之目的是為改善其痛風、高血壓、脂肪肝之病症，因預進行人工受孕而於2016-02-27接受精液檢查，檢驗結果發現有精蟲活動力不佳且形態異常之情況，伴隨平時性慾較低下，能正常勃起但容易中途痿軟，且有射精障礙的問題，經中醫辨證論治，此病例屬本虛標實，以脾腎虛損為本，兼有濕熱痰瘀之標證，主方以茵陳五苓散合小柴胡湯，疏肝化濁利濕，佐以右歸丸合加味還少丹，補腎養肝益脾，兩者搭配相輔相成，藉由標本兼治，痰濕去則三焦得通，補脾腎則精氣血足，經三個多月中藥治療下，有效改善精液實驗室參數異常：Motility由27.5%上升至52.3%，Progressing由18.7%上升至47.7%，且後續一年精液實驗室數據亦皆符合標準值以上，故整理此醫案作為中藥治療男性不孕症的臨床參考。

Based on definition in World Health Organization (WHO), infertility is defined by a couple who cannot successfully fall pregnant with regular and unprotected sexual intercourse for 12 months or longer. Nowadays, 50 % of childless couples is indicated to male infertility due to environmental and mental pressure, as well as some living habit changes. In this case, a 35-year-old male, who had allergic rhinitis, gout, hyperlipidemia, essential hypertension, urinary tract stones, and fatty liver, has been married to his wife for more than 5 years. With regular unprotected intercourse, they are still struggling to have a successful pregnancy. The original purpose of Chinese medicine treatment was for gout, hypertension, and fatty liver. After a semen test for IVF, the analysis indicated that his sperm had irregular shape and poor motility. This combined with a lower libido, he has trouble keeping his erection and has ejaculation dysfunction during intercourses. After receiving more than three months of Chinese medicine treatment, his laboratory parameters had improved effectively and the follow-up semen analysis reports for a whole year the data revealed above standard quality. Therefore, this successful case study report can be a future reference for male infertility with Chinese medicine treatment.

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