Traditional Chinese Medicine (TCM) holds that the kidney is the foundation of congenital essence and the root of life. Kidney Yang plays a vital role in warming and nourishing various organs in the body. The kidney is associated with water and is crucial for maintaining the balance of Yin and Yang, nourishing the body, and eliminating metabolic waste. It is closely related to growth and aging. The kidney stores essence and governs reproduction, and the vitality of kidney essence is closely linked to reproductive function. Among these, Kidney Yang deficiency is the primary cause of impotence (阳痿), premature ejaculation (早泄), and oligospermia (少弱精子症).
Kidney Yang deficiency can manifest in various symptoms, the most notable being impotence, premature ejaculation, oligospermia, cold extremities, aversion to cold, a pale tongue with little thirst, preference for warm drinks, spontaneous sweating, clear and prolonged urination, loose stools, a pale complexion, and a weak, slow pulse. From a Western medical perspective, Kidney Yang deficiency can reflect the decline and disorder of thyroid, adrenal function, and autonomic nervous system function. Clinically, formulas such as Canrong Zhutiangao (蚕茸柱天胶囊), Shengjing Jiaonang (生精胶囊), and Yihechun Jiaonang (颐和春胶囊) can be used to improve impotence, premature ejaculation, and oligospermia caused by Kidney Yang deficiency.
1. Canrong Zhutiangao (蚕茸柱天胶囊)
The formula for Canrong Zhutiangao is derived from Zhang Zhongjing’s Jingyue Quanshu, combining the warming and tonifying Kidney Yang formula Yougui Wan (右归丸) and Zanyudan (赞育丹). It integrates the warming and tonifying effects on Kidney Yang and replenishing essence and marrow, specifically developed for male impotence, premature ejaculation, and infertility. It consists of 17 pure Chinese herbs. Clinically, it warms and tonifies Kidney Yang and replenishes essence and blood. It is used for patients with chronic illness, fatigue, poor appetite, loose stools, aversion to cold, weak lower back and knees, and impotence.
The chief herbs include unmated male silkworm moths and Yinyanghuo (淫羊藿). Silkworm pupae have been regarded as a precious tonic by the royal family since the Tang and Song dynasties, known as the “national treasure of divine insects.” Male silkworm moths are warm in nature and function to tonify the kidney, nourish the liver, and stabilize essence and strengthen Yang; Yinyanghuo is also warm, sweet, and pungent, capable of tonifying the kidney and strengthening Yang, and replenishing essence.
The ministerial herbs include Lu Rong (鹿茸), Lu Bian (鹿鞭), Ba Jitian (巴戟天), Shan Zhu Yu (山茱萸), Tu Si Zi (菟丝子), Du Zhong (杜仲), Rou Gui (肉桂), Fu Zi (附子), Shu Di Huang (熟地), Shan Yao (山药), Dang Gui (当归), and Gou Qi Zi (枸杞子). Lu Rong and Lu Bian are rich in essence and blood, assisting the silkworm moth in warming and tonifying Kidney Yang and replenishing essence and marrow; Ba Jitian, Shan Zhu Yu, Tu Si Zi, Du Zhong, Rou Gui, and Fu Zi help the silkworm moth and Yinyanghuo in warming and tonifying Kidney Yang; Shu Di Huang, Shan Yao, Dang Gui, and Gou Qi Zi nourish essence and blood, stabilize essence, and prevent leakage.
Ren Shen (人参) and Wu Gong (蜈蚣) serve as assistant herbs. Ren Shen greatly tonifies Yuan Qi, benefits Qi, and assists Yang, nourishing Spleen Qi, and is indicated for symptoms of Qi deficiency, fatigue, and poor appetite. Wu Gong is a pure Yang substance, its nature is active, regulating Qi and blood, unblocking meridians, and promoting Yin pathways, used in small amounts to assist the other herbs in their Yang-boosting effects. The guiding herb Tian Ma (天麻) enters the Jueyin Liver meridian, which runs to the Yin organs and the lower abdomen, facilitating the entry of the other herbs into the Yin organs.
Modern pharmacological studies indicate that the aforementioned Chinese herbs can regulate the nervous, endocrine, and immune systems, stimulate the secretion of sex hormones and gonadotropins, and positively affect accessory organs such as the prostate, testicles, and seminal vesicles. Research has also found that Canrong Zhutiangao can increase semen volume, sperm density, and improve sperm motility percentage, suggesting that it can improve impotence, premature ejaculation, and oligospermia.
2. Shengjing Jiaonang (生精胶囊)
TCM believes that erectile dysfunction is caused by emotional distress, liver and kidney deficiency, and other factors leading to impotence. Patients with erectile dysfunction often suffer from prolonged worry and depression, causing Qi stagnation, unsettled spirit, liver dysfunction, and Spleen impairment, which affects the Yangming Chong meridian, resulting in Qi and blood deficiency and weak Yang.
Shengjing Jiaonang can target the pathological characteristics of liver stagnation and kidney deficiency, Qi stagnation, and blood stasis, using Chinese herbs with the effects of tonifying the kidney, strengthening Yang, and replenishing essence and marrow for treatment, showing significant effects in improving the above symptoms. The formula includes Lu Rong, Gou Qi Zi, Ren Shen, Dong Chong Xia Cao (冬虫夏草), Tu Si Zi, Sha Yuan Zi (沙苑子), Yinyanghuo, Huang Jing (黄精), He Shou Wu (何首乌), Bu Guo Zhi (补骨脂), Guo Sui Bu (骨碎补), Xian Mao (仙茅), Jin Ying Zi (金樱子), Fu Pen Zi (覆盆子), Du Zhong, and Da Xue Teng (大血藤), which collectively tonify the kidney, strengthen Yang, replenish essence and marrow, benefit the Spleen and Lung, calm the spirit, enhance intelligence, stabilize essence, and reduce urination, effectively improving symptoms of impotence, premature ejaculation, nocturnal emissions, deficiency of essence, weakness of muscles and bones, dizziness, tinnitus, and unsettled spirit in patients with erectile dysfunction.
Modern pharmacological studies indicate that Lu Rong, Gou Qi Zi, and Yinyanghuo can elevate testosterone levels, which may help improve erectile function in patients with erectile dysfunction. Additionally, Lu Rong, Gou Qi Zi, and Ren Shen are rich in vitamins B, B2, glycosides, plant sterols, and trace elements such as calcium and phosphorus, which have good kidney-tonifying and Yang-strengthening effects.
Clinical studies show that patients in the research group treated with Shengjing Jiaonang combined with tadalafil exhibited better improvements in sexual function, penile hemodynamic parameters, quality of sexual life, and TCM symptom scores compared to the control group treated with tadalafil alone. This indicates that the combination of Shengjing Jiaonang can further improve the smooth muscle relaxation function of the corpora cavernosa in patients with erectile dysfunction, increase blood perfusion to enhance penile erection hardness, and alleviate symptoms of deficiency of essence and weakness of muscles and bones.
3. Yihechun Jiaonang (颐和春胶囊)
Yihechun Jiaonang consists of Ren Shen, Chuan Niu Xi (川牛膝), Gou Shen (狗肾, processed), Suo Yang (锁阳), Lu Rong (去毛), Yinyanghuo, Lu Bian (制), Sha Shen (沙参), Bing Pian (冰片), She Chuang Zi (蛇床子), Shu Di Huang, Jiu Cai Zi (韭菜子, roasted), Fu Pen Zi, Fu Zi (制), and Lu Lu Tong (路路通). It tonifies the kidney and strengthens Yang, benefiting the brain and heart. It is used for impotence, nocturnal emissions, and infertility due to Kidney Yang deficiency, as well as weak lower back and knees.
The formula contains various kidney-tonifying and essence-stabilizing herbs, which have the effects of warming and tonifying Kidney Yang, promoting Qi and water movement, supporting the body’s foundation, and nourishing blood and muscles. It effectively improves symptoms of Kidney Yang deficiency in patients, thus providing good therapeutic value for impotence, premature ejaculation, and oligospermia.
Modern pharmacological studies indicate that Yihechun Jiaonang can promote the differentiation, development, and maturation of reproductive cells at various levels, enhance the antioxidant capacity of testicular tissue, and improve the secretion capacity of testosterone, showing significant protective effects on kidney function, and improving reproductive ability and libido. After taking Yihechun Jiaonang, patients can significantly improve symptoms of impotence and premature ejaculation, and it can increase sperm density, A-grade sperm density, and A+B-grade sperm density, indicating that Yihechun Jiaonang has significant advantages in increasing sperm quantity and fertilization ability, thereby enhancing the possibility of conception. It can also improve testosterone, prolactin, luteinizing hormone, and follicle-stimulating hormone levels, indicating its advantages in regulating reproductive hormone levels.
Research also shows that kidney-tonifying herbs can improve the neurofunctional conduction of the hypothalamic-pituitary-target gland axis, while also activating and promoting the secretion of androgens from testicular interstitial cells, thereby enhancing spermatogenic function. Yinyanghuo in Yihechun Jiaonang has been found in studies to increase the weight of testicular seminal vesicles in rats and promote the secretion of testosterone from testicular interstitial cells. Other studies have found that Yinyanghuo can improve endocrine function by regulating the hypothalamic-pituitary-gonadal axis, thus promoting sperm formation, improving sperm concentration and motility in patients with oligospermia, asthenospermia, and oligospermia.
