男性早泄诊疗进展综述

A summary of the progress of diagnosis and treatment of premature ejaculation in men

早泄是男性常见的性功能障碍。对早泄的认识分为神经官能症和身心障碍阶段、后天习得行为阶段、神经生物学和精神药理学阶段以及制药公司阶段。射精的生理过程需要交感神经、躯体神经和多种递质参与。目前早泄的发病机制尚未完全明确,有些疾病,如甲状腺功能亢进,也会引起早泄症状。对于继发于其他疾病产生的早泄症状,应积极治疗原发病。作为原发病,仅有少数数据支持生物学和心理学方面的理论,包括阴茎超敏感反应、焦虑、伴侣关系问题和5-HT受体功能紊乱等。研究表明,心理-行为治疗、α-1受体阻滞剂、局部麻醉、磷酸二酯酶-5(PDE-5)抑制剂和选择性5-羟色胺再摄取抑制剂(SSRIs)均不同程度的对早泄有效。尽管早泄的发病机理尚未完全明确,但是,生理和心理方面的因素均对早泄的发生产生影响。因此,在早泄的治疗上,不仅要关注患者生理方面阴道内潜伏射精时间的改善,也要关注心理方面的改善。

Premature ejaculation is a common sexual dysfunction in men. Knowledge of premature ejaculation can be divided into neurosis and disability stages, acquired behavioral stages, neurobiological and psychopharmacological stages, and pharmaceutieal companies. The physiological process of ejaculation requires the participation of sympathetic nerves, somatic nerves, and various transmitters. The pathogenesis of premature ejaculation is not yet completely clear, and some diseases, such as hyperthyroidism, can also cause premature ejaculation. For the symptoms of premature ejac- ulation secondary to other diseases, the primary disease should be actively treated. As the primary disease, only a few data support biological and psychological theories, including penis hypersensitivity, anxiety, partner problems, and 5- HT receptor dysfunction. Studies have shown that psycho-behavioral therapy, alpha-1 receptor blockers, local anesthe- sia, phosphodiesterase-5（PDE-5） inhibitors, and selective serotonin reuptake inhibitors （SSRIs） all have varying degrees of Effective for premature ejaculation. Although the pathogenesis of premature ejaculation is not yet fully understood, both physiological and psychological factors have an impact on the occurrence of premature ejaculation. Therefore, in the treatment of premature ejaculation, we must not only pay attention to the physiological aspects of the patient＇s vagi- nal latent ejaculation time, but also pay attention to the psychological changes.