神经功能性不射精症诊断和电磁刺激振动按摩治疗的临床研究

Clinical study of diagnosis and treatment of electromagnetic stimulation with vibrational massage for the patients with neuro-functionally ejaculatory incompetence

目的 探讨功能性不射精症的诊断及有效治疗方法。 方法 在临床实验的基础上 ,用神经电生理技术测定了 2 50例功能性不射精症 (不射精组 )和 40例射精正常者 (对照组 )的阴部神经传导时间及速度 ;对 2 50例诊断为神经功能性不射精症用电磁刺激阴部神经并振动按摩阴茎治疗的同时 ,用神经电生理技术测定其阴部神经传导时间及速度。 结果 不射精组与对照组比较 ,阴部神经传导时间明显延长、传导速度明显减慢( P<0 .0 5)。经电磁刺激并振动按摩治疗 ,2 50例不射精组临床治愈 1 3 6例 ( 54 .4% ) ,显效3 9例 ( 1 5.6 % ) ,好转 2 3例 ( 9.2 % ) ,总有效率为 79.2 %。电磁刺激治疗前后相比 ,阴部神经传导时间及速度均有显著性差异 ( P<0 .0 5) ;治疗后与对照组相比 ,相应指标均无显著性差异 ( P>0 .0 5)。 结论 由于功能性不射精症的阴部神经传导性减退 ,难以达到射精阈值和触发射精反射 ,因此可定义或诊断为神经功能性不射精症。经过反复阴部神经电磁刺激并阴茎振动按摩治疗后 ,阴部神经传导性提高 。

Objective: To study the diagnosis and effective therapy for the patients with neuro-functionally ejaculatory incompetence. Methods: On the basis of our clinical experiment, conductive time and velocity of pudendal nerve of 250 patients with functionally ejaculatory incompetence and 40 men with normal ejaculatory function (as control group) were determined by the electro-neurophysiological technique. 250 patients diagnosed as neuro-functionally ejaculatory incompetence were treated by electromagnetic stimulation of pudendal nerve and vibra-tional massage on penis. The conductive time and velocity of pudendal nerve were determined by the electro-neurophysiological technique simultaneously. Results: Significantly longer conductive time and slower conductive velocity of pudendal nerve were found in patients with functionally ejaculatory incompetence when compared with the control group (P<0.05). After treatment, 136 cases (54.4%) were cured, 39 cases (15.6%) obtained notable improvement and 23 cases (9.2%) got some improvement. The total effective rate was 79.2%. After treatment, the conductive time and velocity of pudendal nerve showed significant improvement when compared with pre-treatment (P<0.05) and no significant difference was found when compared with control group(P<0.05). Conclusions: It is difficult to reach the ejaculatory threshold and trigger the ejaculatory reflex as a result of the reduced conductibility of pudendal nerve of the patients with defined or diagnosed as neuro-functionally ejaculatory incompetence. However it is possible to reach the ejaculatory threshold, trigger the ejaculatory reflex and complete the process of ejaculation when the conductibitlity of pudendal nerve improved by using repeated electromagnitic stimulation of pudendal nerve and vibrational massage on penis.