肝气郁结证勃起功能障碍小鼠模型建立的实验研究

目的:建立肝气郁结证小鼠勃起功能障碍(ED)模型,检测小鼠性器官的变化,揭示ED发生的可能机制。方法:昆明种小鼠,雄性24只,雌性48只,雌雄小鼠都均分为正常组、肝郁组、肝郁加强组。采用束缚盒慢性应激法,逐渐增加束缚强度与时间,造成小鼠肝郁,再阻止雄鼠舔嗅及爬背,压抑其性活动,诱发加强肝气郁结证ED模型。结果:小鼠自主行为、性活动观察及体重均表现出明显的差异性。性器官脏器指数有递减趋势,其病理切片显示正常对照组优于肝郁组及肝郁加强组。结论:束缚盒慢性应激法可造成小鼠肝气郁结证ED,加强因素可增强ED的程度。     

高催乳素血症勃起功能障碍的临床研究

催乳素 (Ｐｒｏｌａｃｔｉｎ ,ＰＲＬ)是垂体前叶分泌的一种多肽激素 ,与人类的生殖功能和性功能关系十分密切 ,ＰＲＬ的升高可以直接或间接地影响男子的性功能和生殖功能。 1998年 8月～ 1999年 3月 ,对来我所就诊的高催乳素血症伴有阴茎勃起功能障碍(ＥＤ)的 33例患者 ,进行了治疗前后卵泡刺激素(ＦＳＨ)、黄体生成素 (ＬＨ)、睾酮 (Ｔ)和雌二醇 (Ｅ2 )的测定及临床观察。材料和方法一、材　料1.受检对象　主诉阴茎勃起不坚、勃起困难或不能性交 ,经两次测定血清ＰＲＬ值 >30ｎｇ/ｍｌ的患者 33例 ,年龄 2 5～ 4 1岁 ,婚龄 1～ 16年 ,ＥＤ…     

肝郁证勃起功能障碍大鼠模型建立的实验研究

目的建立大鼠肝郁证勃起功能障碍(ED)模型,揭示肝郁证ED的可能发病机制。方法采用束缚盒慢性应激法,逐渐增加束缚强度与时间,造模共50d,观测雄性大鼠性活动,包括嗅舔次数,首次爬背时间,爬背次数,累计爬背时间并制作性器官病理切片及检测阴茎组织一氧化氮合成酶等指标。结果大鼠性活动及体重均表现出明显的差异性。性器官病理切片显示正常对照组与模型组存在差异。一氧化氮合成酶正常对照组与模型组差异有显著性(P<0．05)。结论实验表明束缚盒慢性应激法可造成大鼠肝郁证ED,其发病机制一是肝郁大鼠阴茎组织一氧化氮合成酶降低,使介导阴茎勃起的最主要非胆碱能非肾上腺能神经递质NO产生减少,阻止海绵体平滑肌舒张;二是肝郁导致性器官组织细胞病理改变,因此无法完成正常的勃起功能。     

己酮可可碱治疗勃起功能障碍的临床研究

目的　为探讨己酮可可碱治疗勃起功能障碍 (ED)的有效性。方法　以勃起功能国际问卷 (IIEF 5 )的量表作为指标 ,对 30例ED患者进行了临床观察。结果　服用己酮可可碱后阴茎勃起功能明显改善 ,有效率为6 3.33%。结论　己酮可可碱可以用于ED的临床治疗     

西地那非对器质性勃起功能障碍的夜间勃起作用

目的 探讨西地那非对器质性ED夜间勃起的作用。方法 对28例器质性ED患者予以万艾可100mg睡前口服，用NEVA监测夜间勃起情况。结果 器质性ED患者的勃起参数有明显改善（P〈0．05）。结论无性刺激条件下万艾可增强器质性ED患者夜间勃起。     

盐酸曲唑酮治疗勃起功能障碍的临床研究(附32例报告)

观察盐酸曲唑酮对勃起功能障碍(ED)患者治疗的有效性和安全性,本组设计ED症状评分表对32例患者进行开放式多中心临床研究,结果获得59.4%的有效率,并发现在勃起时间、性交频率、性交满意度方面用药后均有明显改善,不良反应主要为头晕、嗜睡和口干、疲劳,程度均较轻微.认为在累积更多病例更长时间的观察基础上,本药有望成为治疗ED的选择性用药.     

尿道外伤患者勃起功能障碍相关因素的临床研究

目的研究尿道外伤患者勃起功能障碍相关因素。方法对40例外伤所致尿道损伤患者采用IIEF-5量表、夜间阴茎勃起监测、血管活性药物注射下阴茎血流彩超检查并进行统计学分析。结果40例中,11例存在明显勃起障碍,3例有血管病变依据。所有患者受伤前后IIEF-5评分有显著性差异(P<0．05);耻骨联合有分离病人较不分离者在IIEF-5评分变化上幅度更大(P<0．05);两组患者在背深动脉收缩期流速上显示出统计学差异(P<0．05)。后尿道损伤患者在阴茎勃起长度变化、周径变化以及勃起持续时间上较前尿道损伤患者明显变小,且ED概率更高。背深静脉流速>5 cm／s患者的比率在两组人群中有显著性差异(P<0．05)。而静脉流速>5cm／s人群主要集中在30-40岁。结论尿道外伤患者发生勃起功能障碍与损伤部位尤其是耻骨联合分离与否、前后尿道损伤位置、神经受损受伤年龄相关,与心理因素也有一定关系。     

盐权曲唑酮治疗勃起功能障碍的临床研究

观察盐酸曲唑酮对勃起功能障碍（ＥＤ）患者治疗的有效性和安全性，本组设计ＥＤ症状评分表对３２例患者进行开放式多中心临床研究，结果获得５９．４％的有效率，并发现在勃起时间、性交频率、性交满意度方面用药后均有明显改善，不良反应主要为头晕、嗜睡和口干、疲劳，程度均较轻微，认为在累积更多病例更长时间的观察基础上，本药有望成为治疗ＥＤ的选择性用药。     

勃起功能障碍基因治疗的靶点研究进展

勃起功能障碍(erectile dysfunction,ED)是指阴茎不能勃起及不能维持有效的勃起而完成满意的性生活.ED已成为困扰全球男性的重要疾病之一.全球范围内大约有1.5亿的男性患有不同程度的ED,到2025年,患病人数将会翻一番[1].     

The etiology of erectile dysfunction and contributing factors in different age groups in Turkey

BACKGROUND: The aim of the present study was to determine the pathophysiological factors which cause erectile dysfunction (ED), as well as the risk factors in different age groups in Turkey. METHODS: A total of 948 patients with ED who were admitted to three andrology clinics were evaluated in terms of etiological factors. They underwent a multidisciplinary diagnostic evaluation. Erectile dysfunction was classified as primarily organic, primarily psychogenic, mixed or unknown in etiology. RESULTS: Psychogenic ED was diagnosed in 65.4% of the patients and organic ED was diagnosed in 34.6% of patients overall. In patients under 40 years, the rate of psychogenic ED was 83% and the rate of organic ED was 17%, but in the patients over 40 years, the rate of psychogenic ED was 40.7% and the rate of organic ED was 59.3%. The causes of organic ED were identified as arteriogenic ED, 40.5%; cavernosal factor (venogenic) ED, 10%; neurogenic ED, 12.5%; endocrinologic ED, 1.8%; mixed type ED, 11.8%; and drug induced ED, 4.5%. CONCLUSION: Our data represent a higher ratio of ED in patients under 40, which are mostly psychogenic, This finding potentially results from local social and cultural differences.     

Pathophysiology and treatment of diabetic erectile dysfunction

The pathophysiology of diabetes is multifactorial and no single etiology is at the forefront.The proposed mecha-nisms of erectile dysfunction(ED)in diabetic patients includes elevated advanced glycation end-products(AGEs)andincreased levels of oxygen free radicals,impaired nitric oxide(NO)synthesis,increased endothelin B receptor bindingsites and ultrastructural changes,upregulated RhoA/Rho-kinase pathway,NO-dependent selective nitrergic nervedegeneration and impaired cyclic guanosine monophosphate(cGMP)-dependent kinase-1(PKG-1).The treatment ofdiabetic ED is multimodal.Treatment of the underlying hyperglycemia and comorbidities is of utmost importance toprevent or halt the progression of the disease.The peripherally acting oral phosphodiesterase type 5(PDE5)inhibitorsare the mainstay of oral medical treatment of ED in diabetics.Vacuum erection devices are an additional treatment asa non-invasive treatment option.Local administration of vasoactive medication via urethral suppository or intracorporalinjection can be effective with minimal side-effects.Patients with irreversible damage of the erectile mechanism arecandidates for penile implantation.Future strategies in the evolution of the treatment of ED are aimed at correcting ortreating the underlying mechanisms of ED.With an appropriate vector,researchers have been able to transfectdiabetic animals with agents such as neurotrophic factors and nitric oxide synthase(NOS).Further studies in genetherapy are needed to fully ascertain its safety and utility in humans.(Asian J Androl 2006 Nov;8:675-684)     

1160例阴茎勃起功能障碍的病因分析

目的探讨成年男性阴茎勃起功能障碍(ED)的病因。方法对年龄在19—69岁之间的ED患者1160例进行了详细的病史询问、IIEF-5评分表评估、阴茎勃起硬度监测(NEVA，Rigiscan)、性激素全套测定、彩色多普勒检查(Knoll)等，综合分析其病因和临床特点。结果单纯心因性ED者726例(62．6％)，单纯器质性ED者84例(7．2％)，心因性和器质性并存者350例(30．2％)。在后两者中，血管性ED有297例(68．4％)，其中静脉性175例，动脉性122例。内分泌异常引起的ED55例，药源性16例，神经源性21例，多种因素混杂的45例。结论1160例ED患者中心因性ED仍占多数，器质性ED中血管性ED最常见。随年龄增加，其器质性病因增多，ED程度加重。     

重视轻症勃起功能障碍的诊治

轻症勃起功能障碍(MSED)在临床实践中常见,但临床医生和患者均对其认识不足,导致就诊率较低。越来越多的研究表明,MSED不仅与不良生活方式和精神心理因素有关,更与血管内皮、代谢、内分泌等器质性病变的早期进展具有相关性。MSED的诊治应参考ED的相关指南,但要注意其自身的特点,充分考虑共病的情况;MSED的治疗原则是整体治疗、防治并行与针对病因的个性化方案相结合;心理治疗无效时需要及时进行药物干预。延误MSED的诊治不仅影响生活质量,而且可能延误对潜在重大疾病的诊治。重视MSED的早期诊治,有利于提高对ED发病机制的认识水平,以及预防心血管、代谢等重大相关疾病,对改善男性整体健康具有重要意义。     

ED诊疗过程中心理因素的作用

勃起功能障碍(ED)是受生理和心理因素共同作用的性功能障碍疾病.生理上ED的发生与血管内皮的功能退化和性兴奋反射调节机制的紊乱紧密相关,而心理上性欲低下,焦虑和抑郁心理会直接导致ED的发生.心理因素在ED诊断和治疗中的作用近年来日益受到重视,各项对ED患者性心理进行评估的问卷为我们提供了评估心理因素对患者影响的工具.基...     

生长因子与勃起功能障碍的基因治疗

生长因子具有广泛的生物学作用。勃起功能障碍(ED)的基因治疗是ED治疗的新探索,本文就生长因子,尤其是血管内皮生长因子(VEGF)和胰岛素样生长因子1(IGF-1)在ED基因治疗中的作用和价值作一综述。     

Prevalence of erectile dysfunction in Thailand

A study of the prevalence rate of erectile dysfunction (ED) in the Thai population has never been done previously, except for a small study in the hospital. The project was carried out across the whole country, including in the north, south, eastern and central plains, and there were representatives from one small and one large province and the Bangkok metropolitan area. There were 250 males in each area, giving as total of 1250 males. The interviews were carried out in urban areas, so that the questions and answers could produce good data. The interviewer was trained by one of our EDACTT members, before going to the interview locations, and the supervisor were also onsite to clarify any the questions that might occur. The questions and pretest were carried out stringently, to help in term of statistics.
All the health questions were asked taking care to accommodate the interviewee's feelings, so as not to cause embarrassment. The interviews were held individually and strictly privately, so that the interviewees could speak freely The interviewees were between 40 and 70-years old, to match with MMAS. The rate of ED in this age group is increasing gradually, and the relationship between ED and hypertension, diabetics or heart disease, and lifestyle factors, including smoking habits, alcohol consumption, caffeine and risk factors is of interest.¹     

性自慰行为与静脉性勃起功能障碍的相关性分析

目的探讨性自慰行为与静脉性勃起功能障碍的相关性。方法对173例确诊为静脉性勃起功能障碍患者的性自慰行为资料进行logistic回归分析,以初次性自慰年龄、频率、性自慰病程、性自慰时是否伴有阴茎不适症状,以及性自慰时期是否有性伴侣等5项因素为变量指标。结果性自慰频率、性自慰病程和性自慰时是否伴有阴茎不适症状与静脉性勃起功能障碍依次相关,P值分别为0.0069、0.0108、0.0195,标准化回归系数分别为0.4925、0.3687、0.2943;而性自慰时期是否有性伴侣和初次性自慰年龄与静脉性勃起功能障碍无显著相关性(P0.05)。结论性自慰频率、性自慰病程以及是否伴有阴茎不适症状与静脉性勃起功能障碍的发生有密切关系。     

难治性勃起功能障碍的研究进展

勃起功能障碍(ED)是一种常见病、多发病。目前主要是首选PDE5抑制剂(PDE5I)治疗,总有效率可达80%,部分患者尤其是伴有糖尿病﹑心血管疾病及前列腺癌根治术后者,单独应用PDE5I效果不佳,称为难治性ED。除了NO-cGMP通路外,勃起与ED的发生过程还涉及多条信号通路(RhoA/Rho激酶、H2S、CO等),复杂的信号网络构成了难治性ED发生的基础,以PDE5I为主的交替治疗、联合治疗等可提高对难治性ED治疗成功率。本文就对PDE5I治疗无效的难治性ED的研究进展作一综述。