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OBJECTIVE： To systematically evaluate the efficacy of Compound xuanju capsules combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， in order to provide evidence-based medicine guidelines for clinical medication. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， VIP， CJFD and Wanfang database from database establishment to Apr. 5， 2019， randomized controlled trials （RCTs） about therapeutic efficacy （total response rate， ovulation rate， pregnancy rate， FSH level， LH level， testosterone level， degree of endometrial thickening） of Compound xuanju capsules combined with chemical medicine （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation of included studies with modified Jadad scale， Meta-analysis was conducted by using STATA 14.0 software. Trial sequential analysis （TSA） was conducted by using TSA 0.9 software. RESULTS： A total of 15 RCTs were included， involving 1 259 patients. The results of Meta-analysis showed that the total response rate [RR＝1.27，95％CI（1.13，1.44），P＜0.001]， ovulation rate [RR＝1.18，95％CI（1.03，1.37），P＜0.001]， pregnancy rate [RR＝1.34，95％CI（1.11，1.61），P＜0.001]， serum hormone level {FSH [SMD＝－0.66，95％CI （－0.51， －0.82），P＜0.001]， 95％CI（－1.76，－1.41），P＜0.001]， LH [SMD＝－1.24，95％CI（－1.39， －1.08），P＜0.001]， testosterone [SMD＝－1.59，95％CI（－1.76，－1.41），P＜0.001]} and endometrial thickness [SMD＝1.20，95％CI（1.04，1.37），P＜0.001] of the trial group were better than those of the control group， with statistical significance. The results of TSA were reliable. CONCLUSIONS： In the treatment of PCOS， Compound xuanju capsules combined with chemical medicine is better than chemical medicine alone in improving total response rate， pregnancy rate， ovulation rate and endometrial thickness， and reducing serum hormone levels.
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Objective@#To observe the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in treating infertility caused by varicocele.@*Methods@#Retrospective analysis of 49 cases of infertility caused by varicocele admitted to the Affiliated Hospital Xuzhou Medical University from February 2015 to November 2016, average age was 27.5 years, aged 20-50 years; according to simple random method divided into experimental group (n=20) and control group (n=29). Patients in the experimental group were treated with laparoscopic high ligation of spermatic vein and compound xuanju capsule. Patients in the control group were treated with high ligation of spermatic vein. Semen quality (sperm concentration, forward motor sperm rate, sperm survival rate), peripheral blood sex hormone (follicle stimulating hormone, luteinizing hormone testosterone) were compared between the two groups before and 3 months after surgery. Pregnancy rate of the spouse 1 year after surgery were compared between the two groups. Measurement data were expressed as mean± standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test.@*Results@#Preoperative sperm concentration [(14.95±2.35) million/ml vs (15.69±3.35) million/ml, P=0.118], forward motor sperm rate [(24.35±3.72)% vs (25.10±3.89)%, P=0.221], sperm survival rate [(27.90±2.59)% vs (26.93±3.20)%, P=0.122]was not statistically significant between experimental group and control group. 3 months after operation, sperm concentration [(23.45±4.39) million/ml vs (20.07±2.91) million/ml, P=0.001], forward motor sperm rate [(34.80±3.56)% vs (31.62±3.75)%, P=0.001], sperm survival rate [(44.55±4.29)% vs (39.52±4.49)%, P=0.001] was statistically significant between experimental group and control group. Preoperative follicle stimulating hormone [(8.97±0.64) IU/L vs (9.17±0.96) IU/L, P=0.238] and luteinizing hormone [(6.75±0.49) IU/L vs (6.64±0.37) IU/L, P=0.744], testosterone [(10.87±1.66) nmol/L vs (9.98±1.17) nmol/L, P=0.064] was not statistical significance between experimental group and control group. 3 months after operation, Follicle stimulation. [(6.96±0.66) IU/L vs (7.34±0.77) IU/L, P=0.043], luteinizing hormone [(6.04±0.39) IU/L vs (6.15±0.38) IU/L, P=0.038], testosterone [(14.46±1.30) nmol/L vs (12.23±2.23) nmol/L, P=0.001] was statistically significant between experimental group and control group. Pregnancy rate of the spouse 1 year of the experimental group was higher than the control group [65.0% (13/20) vs 48.3% (14/29)], but it was not statistically significant between two groups (χ2=1.34, P=0.247).@*Conclusions@#Laparoscopic high ligation of spermatic vein combined with compound Xuanju capsule in the treatment of infertility caused by varicocele can significantly improve semen quality and sex hormone levels. From visual data, the natural pregnancy rate is also improved compared with the simple operation group. It is worthy of clinical recommendation.
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Objective To observe the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in treating infertility caused by varicocele.Methods Retrospective analysis of 49 cases of infertility caused by varicocele admitted to the Affiliated Hospital Xuzhou Medical University from February 2015 to November 2016,average age was 27.5 years,aged 20-50 years;according to simple random method divided into experimental group (n =20) and control group (n =29).Patients in the experimental group were treated with laparoscopic high ligation of spermatic vein and compound xuanju capsule.Patients in the control group were treated with high ligation of spermatic vein.Semen quality (sperm concentration,forward motor sperm rate,sperm survival rate),peripheral blood sex hormone (follicle stimulating hormone,luteinizing hormone testosterone) were compared between the two groups before and 3 months after surgery.Pregnancy rate of the spouse 1 year after surgery were compared between the two groups.Measurement data were expressed as mean ± standard deviation (Mean ± SD),and t-test was used for comparison between groups;count data were compared by Chisquare test.Results Preoperative sperm concentration [(14.95 ± 2.35) million/ml vs (15.69 ± 3.35) million/ml,P=0.118],forward motor sperm rate [(24.35 ± 3.72)％ vs (25.10 ± 3.89)％,P =0.221],sperm survival rate [(27.90 ± 2.59) ％ vs (26.93 ± 3.20) ％,P =0.122] was not statistically significant between experimental group and control group.3 months after operation,sperm concentration [(23.45 ± 4.39) million/ml vs (20.07 ± 2.91) million/ml,P =0.001],forward motor sperm rate [(34.80 ± 3.56) ％ vs (31.62 ± 3.75) ％,P=0.001],sperm survival rate [(44.55 ± 4.29)％ vs (39.52 ± 4.49)％,P =0.001] was statistically significant between experimental group and control group.Preoperative follicle stimulating hormone [(8.97 ±0.64) IU/L vs (9.17 ± 0.96) IU/L,P =0.238] and luteinizing hormone [(6.75 ± 0.49) IU/L vs (6.64 ±0.37) IU/L,P =0.744],testosterone [(10.87 ± 1.66) nmol/L vs (9.98 ± 1.17) nmol/L,P =0.064] was not statistical significance between experimental group and control group.3 months after operation,Follicle stimulation.[(6.96 ± 0.66) IU/L vs (7.34 ± 0.77) IU/L,P =0.043],luteinizing hormone [(6.04 ± 0.39) IU/L vs (6.15 ± 0.38) IU/L,P =0.038],testosterone [(14.46 ± 1.30) nmol/L vs (12.23 ± 2.23) nmol/L,P =0.001] was statistically significant between experimental group and control group.Pregnancy rate of the spouse 1 year of the experimental group was higher than the control group [65.0％ (13/20) vs 48.3％ (14/29)],but it was not statistically significant between two groups (x2 =1.34,P =0.247).Conclusions Laparoscopic high ligation of spermatic vein combined with compound Xuanju capsule in the treatment of infertility caused by varicocele can significantly improve semen quality and sex hormone levels.From visual data,the natural pregnancy rate is also improved compared with the simple operation group.It is worthy of clinical recommendation.
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Objective To assess the clinical effect of Wuzi-Yanzong pill combined with compound Xuanju capsule for treatment of male infertility oligoasthenozoospermia. Methods 136 cases of infertility with less, weak spermatozoa patients who meet the inclusion criteria were divided into two groups using random number table, 68 cases in each group. The control group was treated with Wuzi-Yanzong Pills and Vitamin E orally, and the study group was treated with compound Xuanju capsules on the basis of the control group. Both groups were treated for 3 months. The changes of semen quality and male hormone were observed before and after treatment, and the clinical curative effect was evaluated. Results The total effective rate of the study group was 89.7% (61/68), the control group was 73.5% (50/68), there was significant difference between two groups (χ2=5.930, P=0.015). After treatment, in study group, the sperm of a grade and b grade were (68.5% ± 15.5 % vs. 52.5% ± 15.6 %, t=2.607), the sperm of a grade was (35.3% ± 15.3% vs. 26.5% ± 13.4%, t=2.688), sperm motility rate was (73.3% ± 22.5% vs. 56.8% ± 20.5%, t=2.780), sperm density was [(28.7 ± 15.5)×107/ml vs. (20.5 ± 13.2)×107/ml, t=2.612], and the sperm volume was (2.9 ± 1.7 ml vs. 2.2 ± 1.3 ml, t=2.667), higher than those of the control group (P<0.05 or P<0.01). The level of testosterone in study group (816.5 ± 135.6 ng/dl vs. 768.5 ± 118.5 ng/dl, t=2.728). Conclusions Wuzi-Yanzong pills combined with compound Xuanju capsule can effectively improve the quality of spermatozoa for patients with oligospermia, and improve the clinical efficacy.
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Objective To observe the curative effect of the combined action of Compound Xuanju Capsule and Prednisone on oligospermatism and antisperm antibody due to yang deficiency of kidney. Methods 136 patients were randomly divided into two groups: a treated group, which was taken Compound Xuanju Capsule and Prednisone, and a control group, which was taken Prednisone and Tamoxifen Citrate Tablet. Both groups received a 3-month therapy. The conditions of semen and antisperm antibody between the two groups were observed before and after the treatment. Results The total effective rate of the treated group was 90.94% (61 in 67 cases), and in which 11 cases were pregnant (16.41%). While the total effective rate of the control group was 63.07% (41 in 65 cases), and in which 2 cases were pregnant (3.08%).The clinical efficacy of the treated group was better than that of the control group. (P＜0.05) After the treatment, sperm density and motility of two groups were both evidently increased, (P＜0.05, P＜0.01) and the treated group increased much more obviously (P＜0.05). Conclusion The combined action of Compound Xuanju Capsule and Prednisone can improve the curative effect on the treatment for male infertility from oligospermatism and antisperm antibody due to yang deficiency of kidney.