Objective: To investigate the mechanism of Yishen Qiangjing Decoction in treating male infertility associated with Yang deficiency, based on the ""kidney - governing reproduction"" theory of traditional Chinese medicine (TCM), and to further validate and refine the application of this theory in addressing male infertility, thereby providing substantial support for the inheritance and development of TCM theory.Methods: A total of 78 male infertility patients who were treated at our hospital between March 2021 and March 2023 were recruited and randomly assigned to either a control group or an experimental group using the random number table method, with 39 participants in each group. The control group received conventional treatment, while the experimental group was administered Yishen Qiangjing Decoction based on the theoretical framework of ""kidney governing reproduction"" in addition to the conventional treatment. Compare the clinical therapeutic efficacy (including TCM syndrome scores), sperm quality, and sex hormone levels between the two groups. Conduct a 24 - month follow - up to document fertility outcomes and analyze overall effectiveness.Results: The total clinical efficacy rate in the experimental group was 92.31%, which was significantly higher than the 74.36% observed in the control group (P <0.05). Following treatment, significant improvements were noted in sperm liquefaction time, normal sperm morphology rate, semen volume, sperm concentration, and progressive motility plus non - progressive motility (PR + NP) compared to pre - treatment values in both groups, with greater improvement in the experimental group compared to the control group (P < 0.05). Post - treatment serum levels of follicle - stimulating hormone (FSH) and luteinizing hormone (LH) were markedly reduced in both groups compared to baseline, with a more pronounced decrease in the experimental group relative to the control group (P < 0.05). Conversely, serum testosterone (T) and free testosterone (FT) levels increased significantly post - treatment in both groups compared to baseline, with higher levels achieved in the experimental group compared to the control group (P <0.05). The cumulative pregnancy rate at 24 months was significantly higher in spouses of the experimental group than in the control group (P < 0.05). The median time - to - pregnancy was significantly shorter among spouses of the experimental group compared to the control group (P < 0.05). No statistically significant differences were observed between groups regarding live birth rates or spontaneous abortion rates among patients' spouses (P >0.05).Conclusion: Yishen Qiangjing Decoction, grounded in the theoretical framework of ""kidney - governing reproduction,"" significantly enhances the semen quality and reproductive endocrine function in male infertility patients with Yang deficiency. Through its integrated effects of ""regulating kidney - yang, promoting spermatogenesis, and assisting pregnancy,"" it also increases the natural pregnancy rate of their partners, demonstrating substantial clinical application value.

Theory of "Kidney Governing Reproduction"  /  Yishen Qiangjing Decoction  /  Male infertility of Yang deficiency type  /  Sperm quality  /  Fertility outcomes