广西桂北地区勃起功能障碍患者中医证型流行病学调查
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摘要
目的了解广西桂北地区勃起功能障碍(erectile dysfunction,ED)患者中医证型分布,探讨勃起功能障碍中医证型相关危险因素。方法选择2015年1月至2016年12月在桂林市妇幼保健院辅助生殖中心门诊就诊或住院治疗的188例ED患者为研究对象。采用问卷调查方式,记录患者一般情况、中医证型,并同时进行危险因素调查。结果经过中医证型分析,纳入本研究的188例患者中,多数患者中医证型为复合型,5种中医证型出现的频率分别为:肝郁气滞型111例(59.0%),肝胆湿热型75例(39.9%),肾阳微衰型73例(38.8%),肝肾阴虚型98例(52.1%)、心脾两虚型35例(18.6%);肝郁气滞型、肾阳微衰型、肝肾阴虚型在各年龄段的分布差异均具有统计学意义(均P<0.05);肝胆湿热型、肝肾阴虚型病程上的差异具有统计学意义(P<0.05),其中肝胆湿热型病程较长,而肝肾阴虚型病程相对较短;肝郁气滞型、肾阳微衰型和心脾两虚型在原发性高血压上的差异均具有统计学意义(均P<0.05),肝胆湿热型在吸烟上的差异具有统计学意义(P<0.05),肝胆湿热型、肾阳微衰型、心脾两虚型在发病季节上的差异均具有统计学意义(均P<0.05)。结论广西桂北地区勃起功能障碍患者的中医证型以肝肾阴虚和肝郁气滞型分布较多,这2种证型患者年龄明显偏小,病程也比较短,其与心理压力、吸烟、饮酒、季节等因素相关。
Objective To investigate the distribution of Traditional Chinese Medicine(TCM) syndromes in patients with erectile dysfunction(ED) in Northern Guangxi, and to explore the related risk factors. Methods 188 patients with ED were selected from Reproductive Center of Guilin Maternal and Child Health Care Hospital between January 2015 and December 2016. Questionnaire survey was applied to collect information including the general situation of patients, TCM syndromes, and risk factors. Results Of the 188 patients with ED, the majority of TCM syndromes was complex type, and there were 111 cases(59.0%) of liver-qi stagnation type, 75 cases(39.9%) of liver-gallbladder dampness-heat type, 73 cases(38.8%) of kidney-yang deficiency type, 98 cases(52.1%) of deficiency of liver-yin and kidney-yin type and 35 cases(18.6%) of heart-spleen deficiency type. There were statistically significant differences in the liver-qi stagnation type, kidney-yang deficiency type and liver-yin and kidney-yin type among different age groups(all P<0.05). There were statistically significant differences in the course of disease between liver-gallbladder dampness-heat type and liver-yin and kidney-yin type(P<0.05), where the course of disease of liver-gallbladder dampness-heat type was much longer. There were statistically significant differences in the incidence of primary hypertension among the liver-qi stagnation type, kidney-yang deficiency type and heart-spleen deficiency type(all P<0.05). There were statistically significant differences in the onset seasons among the liver-gallbladder dampness-heat type, kidney-yang deficiency type and heart-spleen deficiency type(all P<0.05). Conclusions TCM syndrome types of patients with ED in Northern Guangxi were mainly the liver-yin and kidney-yin deficiency type and liver qi stagnation type, which was related to psychological pressure, smoking, drinking, season and other factors, with significantly younger age of patients and shorter course of disease.
Objective To investigate the distribution of Traditional Chinese Medicine(TCM) syndromes in patients with erectile dysfunction(ED) in Northern Guangxi, and to explore the related risk factors. Methods 188 patients with ED were selected from Reproductive Center of Guilin Maternal and Child Health Care Hospital between January 2015 and December 2016. Questionnaire survey was applied to collect information including the general situation of patients, TCM syndromes, and risk factors. Results Of the 188 patients with ED, the majority of TCM syndromes was complex type, and there were 111 cases(59.0%) of liver-qi stagnation type, 75 cases(39.9%) of liver-gallbladder dampness-heat type, 73 cases(38.8%) of kidney-yang deficiency type, 98 cases(52.1%) of deficiency of liver-yin and kidney-yin type and 35 cases(18.6%) of heart-spleen deficiency type. There were statistically significant differences in the liver-qi stagnation type, kidney-yang deficiency type and liver-yin and kidney-yin type among different age groups(all P<0.05). There were statistically significant differences in the course of disease between liver-gallbladder dampness-heat type and liver-yin and kidney-yin type(P<0.05), where the course of disease of liver-gallbladder dampness-heat type was much longer. There were statistically significant differences in the incidence of primary hypertension among the liver-qi stagnation type, kidney-yang deficiency type and heart-spleen deficiency type(all P<0.05). There were statistically significant differences in the onset seasons among the liver-gallbladder dampness-heat type, kidney-yang deficiency type and heart-spleen deficiency type(all P<0.05). Conclusions TCM syndrome types of patients with ED in Northern Guangxi were mainly the liver-yin and kidney-yin deficiency type and liver qi stagnation type, which was related to psychological pressure, smoking, drinking, season and other factors, with significantly younger age of patients and shorter course of disease.
引文
[1] 中国中西医结合学会男科专业委员会.勃起功能障碍中西医结合诊疗指南(试行版)[J].中华男科学杂志,2016,22(8):751-757.
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[11] 陈文英,李广森,张朝德,等.勃起功能障碍患者体质类型及相关因素调查分析[J].中国中医基础医学杂志,2013,19(5):576-578.
[12] 孙松,李玉锋,鲍双君,等.慢性前列腺炎合并勃起功能障碍中医证型分布规律初探[J].中华中医药杂志,2015,30(7):2626-2628.
[13] 周少虎,谢建兴.勃起功能障碍的中医证治新观念[J].广东医学,2009,30(6):837-838.
[14] 李海松,李曰庆.勃起功能障碍中医病因病机探析[J].中国性科学,2005,14(4):13-14,17.
[15] 寇乐乐,王禾,杨晓剑,等.勃起功能障碍患者155例中医证型流行病学特征调查[J].中国临床康复,2006,10(39):12-15.
[16] 杨振辉,陈祥.肝肾同源理论在男性勃起功能障碍中的应用[J].中医临床研究,2017,9(14):24-25.
[17] 贺宏波,成海生,张韬,等.阳痿中医诊治述评[J].中国性科学,2016,25(11):85-87.
[2] 张庆江,朱积川,许清泉,等.三城市2226例男性勃起功能流行病学调查[J].中国男科学杂志,2003,17 (3):191-193.
[3] 张凯,刘德风,姜辉,等.不同年龄勃起功能障碍患者勃起功能的调查[J].中国性科学,2014,23(2):21-23.
[4] 张连栋,高明,李和程,等.青年男性勃起功能障碍患者精神心理状态特点分析[J].现代泌尿外科杂志,2016,21(3):187-189.
[5] 王继升,代恒恒,王彬,等.勃起功能障碍中医与西医诊治策略的对比[J].中国性科学,2017,26(8):23-26.
[6] 杜强,耿强,李湛民,等.东北地区勃起功能障碍患者中医体质特征初探[J].中华中医药杂志,2016,31 (12):5360-5362.
[7] 王晓峰,朱积川,邓春华,等.中国男科疾病诊断治疗指南(2013 版)[M].北京:人民卫生出版社,2013:57,71,78.
[8] 李宏军.勃起功能障碍的诊治进展与共识[J].中国性科学,2011,20(1):4-6,22.
[9] 赵冰,莫旭威,王彬,等.运用风药治疗阳痿经验[J].中医杂志,2014,55(21):1877-1878,1887.
[10] 高五芝,马永,王祖龙,等.督灸疗法联合心理康复治疗阳痿[J].中国中医药现代远程教育,2014,12(9):61-62.
[11] 陈文英,李广森,张朝德,等.勃起功能障碍患者体质类型及相关因素调查分析[J].中国中医基础医学杂志,2013,19(5):576-578.
[12] 孙松,李玉锋,鲍双君,等.慢性前列腺炎合并勃起功能障碍中医证型分布规律初探[J].中华中医药杂志,2015,30(7):2626-2628.
[13] 周少虎,谢建兴.勃起功能障碍的中医证治新观念[J].广东医学,2009,30(6):837-838.
[14] 李海松,李曰庆.勃起功能障碍中医病因病机探析[J].中国性科学,2005,14(4):13-14,17.
[15] 寇乐乐,王禾,杨晓剑,等.勃起功能障碍患者155例中医证型流行病学特征调查[J].中国临床康复,2006,10(39):12-15.
[16] 杨振辉,陈祥.肝肾同源理论在男性勃起功能障碍中的应用[J].中医临床研究,2017,9(14):24-25.
[17] 贺宏波,成海生,张韬,等.阳痿中医诊治述评[J].中国性科学,2016,25(11):85-87.