糖尿病性勃起功能障碍的中医证型探讨及实验研究

Discussion and experimental study of traditional Chinese medicine syndrome type in diabetic mellitus erectile dysfunction

目的探讨糖尿病性勃起功能障碍(DMED)的中医证型及中药治疗效果。方法将糖尿病模型大鼠随机分为模型组、胰岛素组、疏肝解郁组、活血化瘀组、温补肾阳组和滋补肾阴组,并设立正常组。治疗8周后,通过检测各组大鼠最大海绵体内压/平均动脉压(ICPmax/MAP)评估阴茎勃起功能,并测定和比较各组凝血酶原(PT)、纤维蛋白原(FIB)、皮质醇(CORT)、三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、促甲状腺激素(TSH)、睾酮(T)及促肾上腺皮质激素(ACTH)水平。结果阴茎勃起功能检测结果表明,与模型组比较,活血化瘀组大鼠的阴茎勃起功能显著改善(P<0.01),FIB和PT水平显著降低(P<0.01);疏肝解郁组大鼠的阴茎勃起功能显著改善(P<0.01),但CORT及ACTH水平未见显著变化(P>0.05);温补肾阳组和滋补肾阴组大鼠的阴茎勃起功能显著改善(P<0.05,P<0.01),但CORT、ACTH、T、T_(3)、T_(4)及TSH水平未见显著变化(P>0.05);胰岛素组大鼠的阴茎勃起功能及各项血液指标未见显著改善(P>0.05)。结论DMED的中医证型更倾向于血瘀型,治疗血瘀型疾病的少腹逐瘀汤对于DMED具有更好的治疗效果。

Objective To investigate the traditional Chinese medicine(TCM)syndrome types of diabetic mellitus erectile dysfunction(DMED)and the therapeutic effect of traditional Chinese medicine.Methods Diabetic rats were randomly divided into model group,insulin group,Shugan Jieyu group,Huoxue Huayu group,Warming Kidney-Yang group and Nourishing Kidney-Yin group,and set up a normal group.After 8 weeks of treatment,penile erectile function was assessed by measuring the maximum intracavernous pressure/mean arterial pressure(ICPmax/MAP)in each group of rats,and the levels of prothrombin(PT),fibrinogen(FIB),cortisol(CORT),triiodothyronine(T_(3)),thyroxine(T_(4)),thyrotropin(TSH),testosterone(T)and adrenocorticotropic hormone(ACTH)were measured and compared in each group.Results The results of erectile function test showed that compared with the model group,the erectile function of rats in the Huoxue Huayu group was significantly improved(P<0.01),and the levels of FIB and PT were significantly reduced(P<0.01);the erectile function of rats in the Shugan Jieyu group was significantly improved(P<0.01),but there were no significant changes in the levels of CORT and ACTH(P>0.05);the erectile function of rats in the Warming Kidney-Yang group and Nourishing Kidney-Yin group were significantly improved(P<0.01),but there were no significant changes in the levels of CORT,ACTH,T,T_(3),T_(4) and TSH of the two groups(P>0.05);there were no significant changes of erectile function and blood indexes of rats in the insulin group(P>0.05).Conclusions The TCM syndrome type of DMED is more inclined to the blood stasis type,and Shaof u Zhuyu decoction for the treatment of blood stasis type has better therapeutic effect on DMED.