勃起功能障碍病机证素分布、组合及演变规律的临床研究

目的:基于病机证素理论,探讨勃起功能障碍(ED)病机证素分布、组合及演变规律。方法:采用编制的ED病机证素调查量表收集297例ED患者中医临床四诊信息,通过主成分及因子分析提取核心病机证素,同时结合患者一般资料分析ED病机证素分布、组合及演变规律。结果:通过分析共提取9个ED核心病机证素,分别为肝郁气滞、肾阴虚、湿热、肝郁化火、血瘀、肾阳虚、心脾两虚、气阴两虚、痰湿;各核心病机证素有明显分布规律,单一病机证素在本研究中仅占36.03%,51.52%ED中病机证素以2项和3项兼夹组合方式存在。结论:ED早期病机证素表现为肝郁气滞、肾阴虚、湿热、肝郁化火和血瘀。随着自然病程的发展,其病机证素逐渐转变为肾阳虚、心脾两虚、气阴两虚、痰湿和血瘀,病位在肾、心和脾,病性以虚为主、多虚实夹杂;最终演变为心脾肾阴阳俱虚,痰湿瘀血互结。

Distribution,combination, and evolution of syndromic etiologies of erectile dysfunction

Objective： To explore the distribution, combination and evolution of various syndromic etiologies of erectile dys- function （ED） based on the syndrome etiology theory. Methods： Using the ED Syndromic Etiology Scale, we collected the clinical data on the Chinese medicine diagnoses of 297 cases of ED, extracted the core syndromie etiologies by analysis of principal components and factors, and analyzed the patterns of distribution, combination, and evolution of ED syndromic etiologies according to the general information of the patients. Results ： Through analysis of principal components and factors, 9 core syndromic etiologies were extrac- ted, i.e. , liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, blood sta- sis, kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, and phlegm-damp. Each of these syndrome etiol- ogies exhibited its own specific distribution patterns. Of the total number of cases studied, 51.52% had 2 or 3 core syndromic etiolo- gies and 36.03% had only one. Conclusion： In the early stage of ED, its syndromic etiologies are usually liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, and blood stasis. With the natural progres-sion of the disease, its syndromic etiologies gradually evolve into kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, phlegm-damp, and blood stasis, and finally into yin-yang deficiency of the heart, spleen and kidneys, combined with phlegm-damp and blood stasis.