中医药防治勃起功能障碍研究进展述评
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摘要
勃起功能障碍(ED)是男科常见性功能障碍疾病之一,严重影响家庭和谐,破坏社会稳定。近年来,勃起功能障碍发病率迅猛增长,呈年轻化趋势。中医药防治勃起功能障碍历史悠久,能充分发挥其整体治疗优势,且治疗手段丰富。目前中医药治疗勃起功能障碍的机制主要集中在促进一氧化氮(NO)释放,提高一氧化氮合酶(NOS)活性及环磷酸鸟苷(cGMP)、环磷酸腺苷(cAMP)含量,抑制5型磷酸二酯酶(PDE5)活性,改变海绵体平滑肌离子通道,抗氧化及器官保护作用。分子生物学研究大多数集中在中药单体对一氧化氮-环磷酸鸟苷信号通路(NO-cGMP)信号转导途径的影响,努力阐明复方中药对勃起功能障碍分子机制的调控,挖掘和阐明新的分子调控通路,可能是今后的研究重点。在治疗手段方面,除内服中药外,还包括针灸导引等外治术。基于循证医学证据的针灸治疗ED的疗效正逐步得到国际认可,已成为中医治疗本病的重要组成部分。
引文
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[33]ZHANG Y,CHEN J,JI H,et al.Protective effects of Danshen injection against erectile dysfunction via suppression of endoplasmic reticulum stress activation in a streptozotocin-induced diabetic rat model[J].BMC Complement Altern Med,2018,18(1):343.
[34]LI Y X,JIANG J,HE Y Z,et al.Icariin combined with breviscapine improves the erectile function of spontaneously hypertensive rats[J].J Sex Med,2014,11(9):2143.
[35]杨绪斌,魏巍.辨证针刺治疗阳痿187例[J].中国针灸,1999,19(2):108.
[36]代敏,卢小容,蔡宜生,等.八髎穴温针灸治疗阳痿32例[J].河南中医,2017,37(1):162.
[37]葛来安,彭莉莉,杨保东,等.蜂针调节性激素水平治疗阳痿120例临床研究[J].实用中西医结合临床,2014,14(10):29.
[38]江立军,杨德华.外敷壮阳散配合内服振威汤治疗阳痿49例[J].中国实验方剂学杂志,2013,19(4):295.
[2]JAY P P,ERIC H L,CARLOS,et al.Evaluation and management of erectile dysfunction in the hypertensive patient[j].Curr Cardiol Rep,2017,19(89):1.
[3]GANDAGLIA G.A systematic review of the association between erectile dysfunction and cardiovascular disease[J].Eur Urol,2014,65(5):968.
[4]OYELADE B O,JEMILOHUN A C,ADERIBIGBE S A.Prevalence of erectile dysfunction and possible risk factors among men of south-western nigeria:a population based study[J].Pan Afr Med J,2016,24:124.
[5]DERBY C A,ARAUJO A B,JOHANNES C B,et al.Measurement of erectile dysfunction in population-based studies:the use of a single question self-assessment in the massachusetts maleaging study[J].Int J Impot Res,2000,12:197.
[6]JOHANNES C B,ARAUJO A B,FELDMAN H A,et al.Incidence of erectile dysfunction in men 40 to 69 years old:longitudinal results from the massachusetts male aging study[J].J Urol 2000,163:460.
[7]BRAUN M,WASSMER G,KLOTZ T,et al.Epidemiology of erectile dysfunction:results of the‘cologne male survey’[J].Int J Impot Res,2000,12(6):305.
[8]ZHANG Z,LI Z,YU Q,et al.The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men[J].Andrology,2015,3(6):1119.
[9]马继兴.马王堆古医书考释[M].长沙:湖南科学技术出版社,1992:63.
[10]田代华,整理.黄帝内经素问[M].北京:人民卫生出版社,2005:9.
[11]王焘.外台秘要[M].北京:人民卫生出版社,1982:30.
[12]王永炎.中医内科学[M].上海:上海科学技术出版社,1997:18.
[13]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:3.
[14]国家技术监督局.中医临床诊疗术语·疾病部分[S].北京:中国标准出版社,1997:12.
[15]秦国政.古代中医辨治阳痿的文献研究[J].南京中医药大学学报,1999,15(5):311.
[16]赵伟,孙志兴,章茂森,等.徐福松阳痿分型证候标准量化研究[J].中华男科学杂志,2018,24(10):911.
[17]王琦,曹开镛.中医男科学[M].天津:天津科学技术出版社,1988:45.
[18]王永炎.中医内科学[M].上海:上海科学技术出版社,1997:19.
[19]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.
[20]秦国政.阳痿中医发病学和证候学规律新探——附717例流行病学调查分析[J].中国医药学报,1999(6):33.
[21]秦国政.郁是阳萎发病学的重要环节[J].辽宁中医杂志,2001,28(9):533.
[22]秦国政.勃起功能障碍(阳痿)中医发病学规律研究[J].云南中医学院学报,2003,26(4):5.
[23]秦国政.勃起功能障碍(阳痿)中医发病学规律研究(续)[J].云南中医学院学报,2004,27(1):6.
[24]秦国政,骆斌.勃起功能障碍中医体质学规律研究[J].北京中医药大学学报,2005,28(4):74.
[25]金保方,黄宇烽,陆晓和,等.养精胶囊治疗男性性功能障碍的临床观察[J].中华男科学杂志,2006,12(3):272.
[26]肖恒军,刘继红,尹春萍,等.川芎嗪对离体兔阴茎海绵体平滑肌条收缩的影响[J].中华实验外科杂志,2004,21(8):964.
[27]陈智,刘继红,尹春萍,等.川芎嗪对家兔阴茎海绵体平滑肌细胞游离钙浓度的影响[J].中华男科学,2003,9(5):331.
[28]陈俊,刘继红,王涛,等.粉防己碱对离体新西兰白兔阴茎海绵体c AMP和c GMP水平的影响[J].中国男科学杂志,2006,20(3):4.
[29]陈俊,刘继红,蒋兆健,等.粉防己碱对新西兰白兔阴茎海绵体平滑肌细胞内游离钙离子浓度的影响[J].中华实验外科杂志,2007,24(1):84.
[30]LIU J H,CHEN J,WANG T,et al.Effects of tetrandrine on cytosolic free calcium concentration in corpus cavernosum smooth muscle cells of rabbits[J].Asian J Androl,2006,8(4):405.
[31]LI H,HE W Y,LIN F,et al.Panax notoginseng saponins improve erectile function through attenuation of oxidative stress,restoration of Akt activity and protection of endothelial and smooth muscle cells in diabetic rats with erectile dysfunction[J].Urol Int,2014,93(1):92.
[32]ALTHOF S E,ROSEN R C,PERELMAN M A,et al.Standard operating procedures for taking a sexual history[J].J Sex Med,2013,10(1):26.
[33]ZHANG Y,CHEN J,JI H,et al.Protective effects of Danshen injection against erectile dysfunction via suppression of endoplasmic reticulum stress activation in a streptozotocin-induced diabetic rat model[J].BMC Complement Altern Med,2018,18(1):343.
[34]LI Y X,JIANG J,HE Y Z,et al.Icariin combined with breviscapine improves the erectile function of spontaneously hypertensive rats[J].J Sex Med,2014,11(9):2143.
[35]杨绪斌,魏巍.辨证针刺治疗阳痿187例[J].中国针灸,1999,19(2):108.
[36]代敏,卢小容,蔡宜生,等.八髎穴温针灸治疗阳痿32例[J].河南中医,2017,37(1):162.
[37]葛来安,彭莉莉,杨保东,等.蜂针调节性激素水平治疗阳痿120例临床研究[J].实用中西医结合临床,2014,14(10):29.
[38]江立军,杨德华.外敷壮阳散配合内服振威汤治疗阳痿49例[J].中国实验方剂学杂志,2013,19(4):295.