肝气郁结证男性勃起功能障碍患者情绪与性激素相关性研究

Study on the correlation between emotion and sex hormones in men with erectile dysfunction due to liver Qi stagnation

目的:评估肝气郁结证男性勃起功能障碍(ED)患者抑郁与焦虑情绪严重程度,并检测其睾酮、雌二醇、垂体泌乳素水平,对比不同情绪状态患者间性激素水平差异及其与情绪的相关性。方法:选取国际勃起功能评分表(IIEF-5)小于21分的门诊就诊男性ED患者,首先采集患者的中医四诊信息,进行证候分类,共筛选入组266例肝气郁结证ED患者,采用抑郁自评量表(SDS)与焦虑自评量表(SAS)分别评估患者抑郁与焦虑情绪严重程度,并使用微粒子化学发光免疫法检测其血清睾酮、雌二醇、垂体泌乳素水平。结果:情绪量表分析显示,90例患者存在抑郁情绪(伴抑郁情绪组),88例患者同时存在抑郁与焦虑情绪(同时伴抑郁与焦虑情绪组),88例患者无明显抑郁与焦虑情绪(无抑郁与焦虑情绪组)。不同情绪状态患者间性激素水平分析显示,3组间血清睾酮水平差异有统计学意义(F=11.72,P=0.000013),其中伴抑郁与焦虑情绪患者睾酮水平最低,无抑郁与焦虑情绪患者睾酮水平最高;3组间血清雌二醇、垂体泌乳素水平差异无统计学意义(F=0.94,P=0.39;F=0.087,P=0.92)。情绪与性激素水平相关性分析显示,患者血清睾酮水平与其抑郁、焦虑情绪严重程度呈负相关性,差异有统计学意义(r=-0.18,P=0.0033;r=-0.25,P=0.000044)。结论:肝气郁结证ED患者存在一定的抑郁与焦虑情绪,并且患者情绪障碍越严重其血清睾酮水平越低。

Objective:To assess the severity of depression and anxiety in men with erectile dysfunction(ED)with liver Qi stagnation,and to measure the levels of testosterone,estradiol and pituitary lactogen,and to compare the differences in sex hormone levels between the patients with different emotional states and their correlation with the emotion.Methods:ED patients with the scores of IIEF-5 less than 21 were enrolled.The four diagnostic information of traditional Chinese medicine(TCM)of patients were collected and the TCM syndromes were analyzed.A total of 266 ED patients with liver Qi stagnation were selected.The scales of SDS and SAS were used to assess the severity of depression and anxiety level,and the levels of serum testosterone,estradiol and pituitary prolactin levels were measured by using microparticle chemiluminescence immunoassay.Results:The results of emotional scales showed that 90 patients had depression(with depression group),88 patients had both depression and anxiety(with both depression and anxiety group),and 88 patients had no significant depression and anxiety(without depression and anxiety group).The analysis of sex hormone levels among patients with different emotional states showed that there was a significant difference in serum testosterone levels among the three groups(F=11.72,P=0.000013),with the lowest testosterone levels in patients with depression and anxiety and the highest testosterone levels in patients without depression and anxiety,and there was no significant difference in serum estradiol and pituitary lactogen levels among three groups(F=0.94,P=0.39;F=0.087,P=0.92).Analysis of the correlation between mood and sex hormone levels showed a significant negative correlation between patients′serum testosterone levels and the severity of their depression and anxiety(r=-0.18,P=0.0033;r=-0.25,P=0.000044).Conclusion:ED patients with liver Qi stagnation have certain depression and anxiety,and the more serious the patient′s mood disorder,the lower the serum testosterone level.