苓桂术甘汤的临床应用

苓桂术甘汤源自于《伤寒论》，由茯苓、桂枝、白术、炙甘草组成。功能为通阳化气、健脾利水。笔在临床上用以治疗多种疾病，收到了较为满意的效果。     

苓桂术甘汤的临床应用

苓桂术甘汤源自干《伤寒论》,由茯苓、桂枝、白术、炙甘草组成。功能为通阳化气、健脾利水。笔者在临床上用以治疗多种疾病,收到了较为满意的效果。     

心理调理治疗心因性阳痿疗效观察

阳痿，又称阴茎勃起障碍，是多因素引起的男性功能障碍，主要表现是性交时阴茎不能勃起，或举而不坚，以致不能圆满完成性交或无法进行性交的全过程。中医学认为，凡阴阳平衡失调，出现阴茎不能勃起进行性交之称，亦称“阳事不举”、“茎痿”、“阴器不用”等。为男科疾病中的多发病，常见病。现代医学将阳痿分为器质性与功能性阳痿。功能性阳痿，由神经系统的生理改变而发生，心理因素是最主要的原因，因此又将此类称为心理性阳痿或心因性阳痿。我们采用精神心理分析和行为治疗，治疗心因性阳萎，疗效满意，现报告如下。     

阳痿也能手术

最近,有几位阳痿病人前来咨询,说某人患有阳痿,医生给动了手术,居然雄风再现,一如既往。他们是否也能手术治疗呢?于是我作了以下解释。引起阳痿的原因很多,可分为器质性和功能性两大类。功能性阳痿是由于精神或心理上的因素而造成的,而器质性阳痿则可因多     

神经衰弱、手淫与阳痿

神经衰弱手淫与阳痿文／杨高歌医学研究表明，神经衰弱是引起阳痿最常见的原因，而阳痿又可引起神经衰弱症候群。传统认为，这种由神经衰弱而引起的阳痿，属功能性阳痿。笔者多年来从众多临床病例发现，持续而严重的神经衰弱综合征，还是导致器质性阳痿的主要因素。临床常...     

肝脏与功能性阳痿

肝脏与功能性阳痿文／王学勤陈秀英阳痿是男子性功能障碍中发病率最高的一种疾病。国外资料表明，阳痿者约占男子性功能障碍的３７％以上。国内抽样调查显示，男性中约有１０％的人患有阳痿，且随年龄增长发病率有增高趋势。因阳痿导致离异者亦逐年增多。阳痿有功能性与器...     

功能性便泌的药物治疗

功能性便秘为临床最常见症状之一,便秘是指大便秘结不通,排便间隔时间延长,或欲大便而艰涩不畅的病证,称为便秘。《内经》称之大便难、后不利。《伤寒论称为阳结、阴结、脾约。《诸病源侯论》称大便不通。统称便秘。本文仅就功能性便秘病因、病理及药物治疗     

按摩可疗阳痿

统计资料表明，阳痿患者占男性性功能障碍的37％～42％，且多为功能性病变，器质性病变者较少。临床观察发现，采用按摩治疗阳痿疗效甚佳，介绍如下，有兴趣者不妨一试。     

自拟舒肝举阳散治疗功能性阳痿165例疗效观察

阳痿是最常见的男子性功能障碍 ,临床上分为功能性阳痿和器质性阳痿两种。笔者自１９９８年８月～２０００年８月收治１６５例功能性阳痿患者 ,应用自拟舒肝举阳散予以治疗 ,疗效满意 ,现报告如下。１临床资料本组１６５例患者中 ,年龄最小２０岁 ,最大５９岁。其中２０～３０岁患者６２例 ,３０～４０岁９９例 ,４０～６０岁１４例。患病时间最短６个月 ,最长８年。治疗前均长期服用补肾壮阳药而效果不佳。阳痿的诊断并不困难 ,但有时对功能性阳痿与器质性阳痿很难鉴别。因此 ,应当详细地了解发病史、进行必要的体格检查以明确诊断。以下几…     

伤寒论的五行学说思想探讨

《伤寒论》是祖国医学中为中医的辨证论治奠定基础，理、法、方药比较完备的医学专著。五行学说是《伤寒论》的哲学基础。但此前，对《伤寒论》在阴阳方面的学术思想评论较多，在五行方面则有忽略。因此，笔者想对从这方面的内容进行探讨。     

Sexual dysfunction associated with diabetes mellitus.

Sexual dysfunction associated with diabetes mellitis has been reviewed. The prevalence of impotence among diabetic males ranges between 50 and 60 percent. Duration of diabetes does not correlate with the increasing incidence of impotence, but increasing age of the male is associated. The etiology of impotence is generally assumed to be autonomic neuropathy; the role of vascular pathology is moot. Retrograde ejaculation is present in one to two percent of the cases. Nocturnal penile tumescence monitoring during periods of rapid eye movement (REM) sleep will aid in the differential diagnosis of organic vs psychogenic etiology. Penile prostheses should be considered in the treatment of organic impotence, while sex counseling is indicated for psychogenic cases. The effect of diabetes on female sexual response is conflicting. Further research in needed.     

Medical treatment of neurogenic impotence

The present modalities available for the medical treatment of patients with neurogenic impotence include: 1) intracavernosal injection of vasoactive agents, 2) topical application of vasoactive drugs via paste or plaster, including intraurethral application and 3) oral administration of vasoactive drugs. Intracavernosal injection pharmacotherapy represents the most common form of treatment. Patients enter a pharmacologic erection program including: 1) initial office testing, during which the safety and efficacy of vasoactive drugs is established and the appropriate technique of self-injection is taught, 2) initial home use by the patient, during which safety and efficacy at home is established and 3) longterm home use and longterm follow-up by the doctor or the nurse to monitor longterm safety and efficacy. Patients with neurogenic impotence may require several special considerations when performing intracavernosal injections. In cases of upper extremity weakness or when there is a lack of upper extremity fine motor control, it may be more appropriate for the partner to perform the intracavernosal injections. Patients with neurogenic impotence must be cautioned against the complication of priapism, a frequent development in the presence of normal hemodynamic parameters. A literature review of satisfaction, complications and drop-out incidence, as well as our personal experience with 62 such patients, confirms the safety, reliability and effectiveness of the intracavernosal injection therapy. Alternative systems for the delivery of vasoactive agents to the corpora include topical application via plasters or paste and intraurethral application via ointments. Vasoactive agents utilized in alternative delivery systems have included nitroglycerin, prostaglandin E2 and minoxidil. The main advantage is the lack of invasiveness while the main disadvantage is the reduced effectiveness of the penile erection. Oral drugs, like yohimbine and trazodone, are prescribed by some urologists, but results have not been predictable. Intracavernosal injection pharmacotherapy remains the most effective and safe medical treatment available for patients with neurogenic impotence.     

Constructions of masculinity following prostatectomy-induced impotence

Large numbers of Australian men are diagnosed and treated for prostate cancer each year. The incidence is exceeding mortality, and men are living longer with prostate cancer and the common treatment[s] side effect of impotence. Despite these epidemiological trends there is little research about men's experiences of impotence following treatment. An ethnographic study of Anglo-Australian men with localized prostate cancer explored participants' experiences of impotence following prostatectomy. In-depth semi-structured interviews with 15 men were analyzed using a social constructionist gendered framework. In particular, the effect of impotence on participants' masculinity, sexuality and intimate relationships was explored. The findings show that participants rationalized forgoing potency prior to surgery as a way of living longer. However, diverse complex reactions accompanied impotence. Whilst most participants redefined masculine ideals of phallocentric sex, the way in which this occurred varied greatly. The findings disrupt essentialist constructions of male sexuality and impotence, and provide valuable insight for clinical practice.     

男性尿道损伤早期手术方式的选择

目的探索男性尿道损伤早期最佳治疗方法。方法回顾性分析60例男性尿道损伤早期处理,球部尿道部分损伤15例,留置尿管3w治愈。球部尿道完全断裂45例,20例行Ⅰ期尿道吻合术,10例膀胱造瘘,15例行尿道会师术。结果球部尿道部分损伤患者20.0%(3/15)有轻度尿道狭窄,无阳痿发生。单纯膀胱造瘘术后尿道狭窄的发生率为100.0%,阳萎的发生率为40.0%(4/10);尿道会师及牵引术后尿道狭窄的发生率为80.0%(12/15),阳萎的发生率为26.7%(4/15);早期经会阴部Ⅰ期尿道吻合术后尿道狭窄的发生率为15.0%(3/20),阳萎的发生率为35.0%(7/20)。结论尿道部分损伤患者停留尿管效果满意;球部尿道断裂Ⅰ期尿道吻合术疗效良好,尿道会师术创伤小,如病情重则可先行单纯膀胱造瘘术。     

关于桂枝平喘作用的认识

桂枝为临床常用中药,首载于《神农本草经》,味辛甘温,临床以其解肌发表,温经通阳为常用,在伤寒论中有众多组方包含桂枝,可谓仲景选方第一要药。然而,桂枝尚具有平喘降气之功,明清医家已有相关记述,而在现代使用却鲜有报道。笔者通过对文献回顾,综合现代药理研究,对桂枝的降气平喘作用作一探讨。     

The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?

The aims of this prospective study were to compare sexual functioning between women with male partners who have erectile dysfunction (ED) and women without partners with ED and also to investigate the effect of the treatment of male ED on female partner's sexual function. The study included 87 women and their male partners. We divided the women into two groups: 38 women with male partners complaining of ED (ED group) and 49 women with male partners who have no ED (control group). Of the men with ED, 30 were treated with penile prosthesis implantation (n = 17) or oral sildenafil citrate (n = 13). We evaluated all the men with the International Index of Erectile Function (IIEF; Rosen, Cappelleri, Smith, Lipsky, & Pena, 1999), physical examination, and color penile Doppler ultrasound. We evaluated female sexual function with the Female Sexual Function Index (FSFI; Rosen et al., 2000) to assess sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. We compared female sexual function scores between the women of the male partners with and without ED and also compared before both groups and after the treatment of male partners in the ED group. Additionally, we compare the scores according to the type of treatment given to the male partners. Sexual arousal (p = 0.009), lubrication (p = 0.001), orgasm (p = 0.006), satisfaction (p = 0.000), pain (p = 0.039), and total score (p = 0.003) were highly significantly lower in the ED group than in the control group, although sexual desire did not differ between the two groups (p = 0.515). We investigated the effect of male ED on female sexual functions and found no statistically significant differences in the presence of organic type impotence, older age, and lower erection scores on the IIEF (p = 0.53, p = 0.15, and p = 0.1, respectively). After the treatment of male ED, we observed significant improvement in sexual arousal (p = 0.001), lubrication (p = 0.002), orgasm (p = 0.000), satisfaction (p = 0.000), and pain (p = 0.002) in the women. These findings suggest that female sexual function is affected by male erection status and may improve after the treatment of male sexual dysfunction.     

Clinical and Radiological Evaluation of Ejaculatory Duct Obstruction

Ejaculatory duct obstruction (EDO) is a rare but surgically correctable cause of male infertility. With the advent and increased use of transrectal ultrasonography and magnetic resonance imaging, abnormalities of the ejaculatory duct (ED) related to infertility have been diagnosed more frequently. Recently, with the increased awareness of functional obstruction of ED, reports have been focusing on the diagnosis of partial or functional EDO. We present 2 review of the ED pathologies, imaging modalities and treatment options.     

北京市大兴区2006—2010年手足口病分析及2011年发病趋势预测

目的了解北京市大兴区手足口病的发病规律,对2011年发病趋势做出预测,找出工作重点。方法利用SPSS及Excel软件,对经国家疾病监测信息报告管理系统报告的数据进行描述性统计。结果流动人口聚集程度越高,发病率越高（χ2=1740.82,P〈0.01）;外省户籍病例比例逐年增高,病例数涨幅高于该市病例;发病时间范围跨度增大,高峰提前,持续时间更长;EV71成为流行的病原。结论加强流动人口管理,开展健康教育与环境整治,持续监测病原,提高诊疗能力,是应对手足口病流行的重点工作。     

2008 - 2017年湖北省水痘流行病学分析

目的 全面分析湖北省2008 - 2017年水痘流行病学特征,为控制水痘的暴发和流行提供科学依据。方法 通过中国疾病控制信息系统,收集水痘个案和暴发疫情信息,运用描述性流行病学方法对湖北省10年间水痘报告病例进行分析。结果 10年间湖北省共报告水痘病例218 426例,年平均发病率为37.83/10万,水痘发病时间高峰期分别为5 - 6月,11 - 12月至次年的1月。湖北省各地市以神农架林区发病最高,年平均发病率为200.84/10万、其次是恩施州（71.92/10万)、十堰市（67.63/10万）,水痘报告病例中男女比例为1.34∶1,主要发病年龄为20岁以下的人群,其中3～14岁发病率较高,职业分布主要为学生、幼托儿童、散居儿童;暴发疫情以小学为主,占80.93%。结论 发病人群主体是学生,发病地区以山区发病率较高,应加强山区经济欠发达地区人群的健康教育及疾病监测和处置。发病主要场所是学校,应提高学校监测的敏感性,做到早发现、早诊疗、早隔离。     

濉溪县2008—2010年手足口病流行特征分析

目的分析安徽省濉溪县2008—2010年手足口病的流行特征,为制订科学有效的防控措施提供依据。方法采用描述性流行病学方法,用Excel2003对手足口病疫情资料进行整理统计分析。结果安徽省濉溪县2008—2010年共报告手足口病2207例,年均报告发病率为61.76/10万,呈逐年上升趋势,其中重症病例12例,占发病总数的0.54%,无死亡病例报告。各乡镇均有发病报告;发病时间主要集中在每年3—8月份,占发病总数的89.81%;发病人群以散居儿童为主,占发病总数的94.06%;年龄集中在4岁以下,占发病总数的95.38%;男性、女性发病之比为2.14:1(χ2=245.83,P﹤0.01)。病原学监测显示,EV71型和CoxA16型是引起我县手足口病的主要毒株,EV71是重症的危险因素。结论濉溪县手足口病的流行形势较为严峻,应关注3—8月份春夏季节的疫情动态,4岁以下的散居儿童是防控工作的重点对象。实施手足口病监测的关口前移,采取及时的医学隔离治疗、重点人群的健康教育等综合防控措施,早发现、早报告、早隔离和早治疗是防控手足口病的关键。