针刺治疗中老年勃起功能障碍的体会

目的:研究针刺治疗中老年男性勃起功能障碍.方法:将门诊96例中老年男性勃起功能障碍患者,根据血清总睾酮水平正常与否分为A、B两组,A组单纯行针刺治疗,B组除针刺治疗外,加服十一酸睾酮.结果:A组有效率为97.01%,B组有效率为96.55%,总有效率为96.87%.结论:针刺治疗中老年男性勃起功能障碍安全、经济,无毒副作用,不失为一种较佳选择.     

针刺治疗中老年勃起功能障碍的体会

目的 :研究针刺治疗中老年男性勃起功能障碍。方法 :将门诊 96例中老年男性勃起功能障碍患者 ,根据血清总睾酮水平正常与否分为 A、B两组 ,A组单纯行针刺治疗 ,B组除针刺治疗外 ,加服十一酸睾酮。结果 :A组有效率为 97.0 1% ,B组有效率为 96 .5 5 % ,总有效率为 96 .87%。结论 :针刺治疗中老年男性勃起功能障碍安全、经济 ,无毒副作用 ,不失为一种较佳选择。     

张氏亢痿振阳汤治疗功能性勃起功能障碍

勃起功能障碍是一种常见的男性性功能障碍疾患,在男性功能障碍中占有最为重要的地位.笔者从2010年10月至2011年7月用张氏亢痿振阳汤治疗功能性勃起功能障碍患者15例,详细介绍如下.     

丹瓜方联合枸橼酸西地那非片治疗痰瘀型2型糖尿病勃起功能障碍的临床观察

<正>勃起功能障碍是临床男性常见疾病,近年来其发病率呈逐年上升趋势发展,给患者带来较大的心理压力,影响夫妻感情生活。勃起功能障碍可作为糖尿病的一种常见并发症出现,与无糖尿病的男性相比,糖尿病男性勃起功能障碍的发病率增加了3倍。目前,以枸橼酸西地那非片为代表的5型磷酸二酯酶(PDE-5)抑制剂是勃起功能障碍的一线治疗药物,但其对糖尿病勃起功能障碍的临床疗效尚有待提高,且存在一定程度的不良反应。研究~[1]表明,中西医结合治疗勃起功能障碍具有明显优     

阴茎勃起功能障碍的药物治疗进展

勃起功能障碍(ErectileDysfunction,ED)是指阴茎不能持续达到和维持足够勃起以获得满意的性生活。勃起功能障碍是影响男性身心健康的常见疾病。近10年来,阴茎勃起功能障碍的治疗取得了长足的进展。人们力求开发新的安全、有效且对勃起功能障碍有特异性治疗作用的药物。研究热点     

十一酸睾酮联合他达拉非治疗中老年勃起障碍

目的 研究十一酸睾酮联合他达拉非治疗中老年男性勃起功能障碍的疗效.方法 对在2008年11月～2011年3月收治的114例中老年男性勃起功能障碍患者进行随机分组,观察组57例,给予十一酸睾酮、小剂量他达拉非联合治疗;对照组57例,仅给予十一酸睾酮治疗.治疗2个月后应用 IIEF问卷表和PADAM评分表评价两组患者的治疗效果.结果 治疗2个月后,观察组IIEF问卷表、PADAM评分表平均得分分别为(22.0±3.1)、(10.3±0.8);对照组为(17.9±2.2)、(13.2±1.1).结论 十一酸睾酮联合小剂量他达拉非治疗中老年男性勃起功能障碍疗效好于单纯使用十一酸睾酮治疗,值得临床推广.     

早泄与勃起功能障碍

早泄(premature ejaculation,PE)和勃起功能障碍(erectile dysfunction,ED)是成年男性中最常见的性功能障碍性疾病.其中PE的发病率为25%～40%,ED的总发病率约为40%～52%[1].两者之间在病因、发病机制、诊断及治疗等方面有共同之处,近年来随着对男性勃起机制认识的加深和新的治疗手段的出现,PE和ED的诊疗有了较大的进展.     

心房颤动与勃起功能障碍的关系

尽管医疗卫生技术的进步使心血管疾病死亡率逐年降低,但心血管事件仍然是导致全球人口寿命缩短的重要原因,其中男性患病年龄多早于女性。识别及减少心血管疾病危险因素,在改善心血管疾病预后中占有重要地位。良好的性生活也是健康的重要组成部分。性功能障碍,特别是男性勃起功能障碍,在人群中具有高患病率,并随年龄增长而逐渐增加。心房颤动与勃起功能障碍2种疾病常合并存在,二者不仅有诸多相似的危险因素,也有众多共同的病理生理途径。勃起功能障碍作为心血管疾病的独立危险因素,在预测心房颤动发生及进展中也有一定的价值。同时,勃起功能障碍也是导致心血管疾病治疗中断或依从性差的一个重要原因。筛查和诊断勃起功能障碍,可为评估心房颤动预后提供一种简单且实用的工具。已有研究证实,勃起功能障碍相关药物治疗在改善血管内皮功能时,也可改善心房肌血供、降低炎症水平,其中,睾酮可作用于心房肌膜离子通道,减少心房肌异常自发触发电位,进而降低房颤发生风险。越来越多的研究致力于明确勃起功能障碍与心房颤动间的关系,内皮功能障碍、炎症及睾酮缺乏在二者的发病中均占有重要地位,但具体机制仍未完全清楚,本文就勃起功能障碍及相关治疗对心房颤动的影响作一综述。      

哪些病容易导致ED

在男性性功能障碍谈论最多的是印，常表现为勃起功能障碍。在40～70岁的男性中，勃起功能障碍发病率达52％。年龄是与勃起功能障碍关系密切的间接因素，随年龄增长，发生勃起功能障碍的可能性增大。     

糖尿病性勃起功能障碍的基因治疗

近10年来,男性勃起功能障碍(ED)的基因治疗已在动物试验中取得理想的效果,并在人体临床试验中取得初步尝试.糖尿病性勃起功能障碍(DMED)对现有的治疗方法总体效果不理想,也成为基因治疗的一个主要研究对象.本文在分析DMED的发病机制、治疗现状的基础上,首先阐述了ED基因治疗的研究现状及在阴茎海绵体进行转基因操作的优势,然后就DMED的基因治疗研究进展进行综述.     

Evaluation and treatment of sexual dysfunction in men with diabetes mellitus.

Sexual dysfunction is common among men with Type I and Type II diabetes. Tests of nocturnal penile tumescence (NPT) combined with waking tumescence and questionnaires can more accurately differentiate between primary organic and primary psychogenic impotence. This ability to differentiate the etiology of erectile dysfunction avoids the inappropriate use of penile injections and costly surgical procedures which are unnecessary in treatment of diabetic patients with primary psychogenic impotence. In patients with primary organic impotence, several new treatments are available which result in high patient satisfaction.     

Erectile impotence precipitated by organic factors and perpetuated by performance anxiety.

A survey of 72 men with erectile impotence showed that for 14 the onset had been concurrent with the start of a temporary physical disability (in 8), temporary exposure to a chemical agent in doses thought to be significant (in 4) or the return of sexual opportunity after a long period of celibacy or near-celibacy (in 2 older men). After elimination of that possible cause the impotence had persisted owing to anxiety about sexual performance. In another 6 of the 72 there were persistent nonpsychic causes for the impotence. Thus, in 28% of the men surveyed the precipitating cause of erectile impotence was organic. A large proportion of the cases of erectile impotence participated by a temporary nonpsychic factor could probably have been prevented with appropriate professional advice--for example, at the time an antihypertensive drug capable of causing the dysfunction was first prescribed.     

伐地那非联合心理疗法治疗老年男性肾移植受者勃起功能障碍的疗效评价

目的：评估伐地那非联合心理疗法治疗老年男性肾移植受者勃起功能障碍（ED）的有效性及安全性。方法：随机选取50岁及以上、肾移植术后1年及以上和血肌酐150 μmol?L-1的肾移植受者120例，应用国际勃起功能指数（IIEF）进行肾移植术后性功能状况评分，存在ED者给予伐地那非联合心理治疗6个月，重新采用IIEF来评估其有效性。监测患者血清肌酐值、肌酐清除率、肝功能及免疫抑制剂（环孢素及普乐可复）浓度以评估伐地那非的安全性。结果：120例肾移植受者中78例存在ED。78例ED患者采用伐地那非联合心理治疗6个月后，IIEF评分由11.2±4.2升至23.3±4.6（P<0.05）；肾功能、肝功能及免疫抑制剂浓度在治疗前后无明显改变，无严重不良反应。结论：伐地那非联合心理疗法治疗老年男性肾移植术后ED有效且安全。     

Successful non-invasive management of erectile impotence in diabetic men

The effectiveness of a device designed to overcome erectile impotence was assessed in 10 insulin dependent diabetics with no other cause for their erectile impotence. The 10 men and their partners were instructed how to use the device, which uses suction to induce penile engorgement and maintains erection with a constriction band. After three months they answered a questionnaire about its effectiveness and acceptability, assessing these by visual analogue scales. All the patients achieved lasting erections with the device and gave high mean scores for ease of use, effectiveness, and satisfaction, but three partners refused to complete the questionnaire having failed to come to terms with using the device. One couple stopped using it because of marital disharmony. This device provides a practical alternative for the treatment of erectile impotence in diabetic men. Unlike invasive treatments, it does not necessitate lengthy assessments of autonomic, endocrine, and erectile function and is safe to use and relatively cheap.     

Radiation-associated impotence. A clinical study of its mechanism

External beam pelvic irradiation in men is frequently complicated by erectile dysfunction. We tested the erectile function in 23 patients (mean age, 65 years) who received radiation therapy for prostate cancer. Fifteen patients experienced changes in erectile potency following radiotherapy. Neurological, endocrine, and vascular testing revealed abnormalities in 0, 5, and 15 of these patients, respectively. In two, arteriography revealed bilateral occlusive disease in the distal internal pudendal and penile arteries overlying the pelvic radiation field. A significant difference with cigarette smoking was found among the 15 patients whose erectile capacity decreased and the four patients whose capacity remained unchanged. Vasculogenic impotence is the most consistent organic erectile abnormality in RAI.     

Erectile impotence treated with an implantable, inflatable prosthesis. Five years of clinical experience.

Erectile impotence can now be treated with a device that mimics a natural erection. Between 1973 and 1977, we implanted an inflatable prosthesis in 245 men (235 with organic impotence and ten with psychogenic impotence). Of these, 234 are able to use the device to their satisfaction; no failures have occurred in the 152 cases treated in 1976 and 1977. The success of this treatment rests in part on the careful selection of patients by a team--a urologist, a sleep researcher, a psychologist, and a psychiatrist--each evaluating the patient independently. Our experience suggest that erectile impotence may be more common than generally believed and that impotence from organic causes may account for a greater percentage of cases than formerly thought.     

基于王祖龙教授“督统宗筋”理论谈从督脉论治阳痿

本文立足于阳痿患者“督脉寒凉、督脉不通”的红外热图特点，通过对督脉功能、督脉与阳痿关系的阐释，论述了督脉在温养宗筋、促进性欲、维持勃起中的重要作用，提出阳痿的核心病因病机是以督脉阳虚为本、寒凝为标，经脉阻滞为结果，制定了“温阳通督”的治法治则及方药，初步形成了理法方药完备的“督统宗筋”学术观点，为治疗阳痿提供了新的思路。     

手术加用西地那非治疗静脉性阳痿的探讨

目的:探讨静脉性阳痿手术加用西地那非治疗方法。方法:将59例患者随机分为2组,对照组对阴茎背深静脉漏者作阴茎背深静脉剥脱术,背深静脉+脚静脉漏者作背深静脉剥脱和阴茎海绵体脚静脉结扎术;治疗组手术后1 mon加用西地那非治疗。结果:单一手术治疗组,手术后有21例第12 mon出现中度勃起功能障碍,手术后12例第18 mon,24例第24 mon出现重度勃起功能障碍。手术后加用西地那非组,手术后1例第18 mon,5例第24mon为中度勃起功能障碍或者轻、中度勃起功能障碍。两组患者治疗后不同时点的IIEF5评分经统计学分析差异有显著性。结论:对静脉性阳痿手术后加用西地那非疗效优于单纯手术治疗。     

Sildenafil: from the bench to the bedside

Erectile dysfunction affects a large segment of the male population, and in most cases impaired relaxation of the smooth muscle cells in the corpus cavernosum and the penile arteries is a factor. Sildenafil, a relatively specific vasodilator of the penile circulation, has revolutionized the treatment of impotence. This article describes the biochemistry of erection, outlines the problems that can lead to erectile dysfunction and explains how sildenafil acts to relieve these problems at the cellular and molecular level. Other aspects of therapy, such as potential side effects and absolute and relative contraindications, are also discussed.     

阳痿辨证分型古今演变探讨

古代对阳痿的病因病机、分型等论述有相当丰富的记载，从较早的“气不至”认识，到晋隋唐宋时代医家对阳痿的发生多责之劳伤、肾虚。明代医家首次以“阳痿”命名，阳痿的认识已臻完善，认为命门火衰、七情劳倦、湿热炽盛，甚至思虑、焦劳、忧郁、惊恐等，皆可致痿。清代医家开拓扩展，认为除上述外还有忍房事、失志、瘀血、心气不足、脾虚等。现代中医对阳痿的认识，仍有所发展创新，思路更加丰富，许多医家也提出各自的学术理论。课题组通过总结整理文献，为方便临床辨证及应用，将阳痿概括为肝气郁结证、湿热下注证、瘀血阻滞证、心脾两虚证、肾阳虚衰证、肾阴亏虚证六个基本证型。然临床诊治并不拘泥于此，概而言之不外虚实两端。辨证论治是中医学的特色优势，随着环境等因素改变，仍需不断思考与探索。