Construction and Initial Structure of Sexual Dysfunctions Tendencies Measure

Disclosure of sexual dysfunctions is difficult due to shame and social stigma.The instruments to measure sexual dysfunctions so far were quite backdated and lengthy.Moreover,there was no specific instrument available that could evaluate all the sexual dysfunctions on the Diagnostic and Statistical Manual of Mental Disorders’criteria in a single scale;separate for men and women.The objective to develop the scale was to provide the non-clinical population with a short and straight-forward measure in English which could help them in deciding about seeking professional help.The constructed scale comprised of 7 items for males and 7 for females and employed 6-points Likert scale for responses.The study involved 79 men and 105 women(N=184;Kaiser-Meyer-Olkin Measure of Sample Adequacy=0.682 for males and 0.618 for females).The inclusion criteria were the practical involvement of the participants in sexual practices and ability to respond to a questionnaire in English.Exploratory Factor Analysis was conducted to measure the reliability and validity of the scale.While employing Principal Component Analysis for extraction and Oblimin with Kaiser Normalization as Rotation,Exploratory Factor Analysis was conducted on 7 items for males and 7 items for females separately.Sampling adequacy was found good and the adequacy of correlations between items and was found highly significant.The Cronbach’s Alpha reliability was satisfactory.4 factors were extracted for males with 78.65%variance explained.3 factors were extracted for females with 66.57%variance explained.The communalities for all the 14 items ranged between 0.554 to 0.937.The study established that Sexual Dysfunctions Tendencies Measure is a valid and reliable tool to measure sexual dysfunctions with the criteria of the Diagnostic and Statistical Manual of Mental Disorders.

Sexual dysfunctions and their treatment in liver diseases

Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.

Therapeutic Approach in Female Sexual Dysfunctions in an Outpatient Clinic of Sexology in the Public Health System: A Longitudinal and Prospective Study

INTRODUCTION: Sexuality is one of the parameters of quality of life, and it is essential to include care for sexual dysfunctions in primary health care. OBJECTIVE: To evaluate the therapeutic approach in female sexual dysfunction in a public health outpatient clinic. DESIGN: A prospective cohort of women with sexual dysfunctions in an outpatient clinic of sexology in the Public Health System. The Female Sexual Function Index (FSFI) and scored 0 - 10 their sexual satisfaction were applied at the beginning and end of the follow-up. RESULTS: Eighty-nine women were included with a median age of 45 years, 69 (77.5%) had less than 11 years of schooling and 95.5% lived with a partner. The main reasons for referral for follow-up at the outpatient clinic of sexuality were dysfunction of hypoactive sexual desire disorder in 67.4% and pain related to sexual function in 46%. The average number of consultations was five and the main therapeutic interventions were guidance and clarification on sexuality (86.5%), use of topical estrogen (56.2%), and relaxation techniques (37.1%). All FSFI-19 domains had better post-intervention rates (p ≤ 0.005). Considering the domains of the FSFI-19, the medians of desire, arousal, lubrication, orgasm, pleasure and pain were higher in the post-intervention period in relation to the pre-intervention period (p ≤ 0.0001 for all analysis). In addition, the score given by the participant on their sexual satisfaction was higher at the post-intervention time compared to the pre-intervention period (p ≤ 0.0001). CONCLUSION: In public health, even with the care being performed by different professionals in each consultation, we conclude that through simple interventions, it is possible to improve the sexualities of the women attended. Still, offering care in sexuality is fundamental as part of primary health care and the training of medical professionals.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

Association between depressive mood and body image and menopausal symptoms and sexual function in perimenopausal women

BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone levels,decreased libido,and even female sexual dysfunction(FSD)in severe cases,which reduces their quality of life.Factors affecting the occurrence of FSD include physiological and nonphysiological factors,among which physiological factors are uncontrollable.Therefore,it is particularly important to ascertain the related non-physiological factors that affect the occurrence of FSD for improving the quality of sexual life of perimenopausal women.AIM To investigate the mediating effect of depressive mood and body image on menopausal symptoms and sexual function in perimenopausal women.METHODS A total of 186 perimenopausal women were enrolled between January 2019 and January 2021 and divided into the FSD(134 cases)and control(52 cases)groups based on the presence and absence of FSD.Clinical data were compared between the two groups.FSD-related factors were analyzed using logistic regression analysis.Hamilton Depression Scale(HAMD),Body Image Scale(BIS),and Menopause Rating Scale(MRS)scores were compared among women with different FSD scores.The correlation of the MRS score with the BIS and HAMD scores and the mediating effect of the BIS and HAMD scores on the MRS score and female sexual function index(FSFI)were analyzed.RESULTS The HAMD and BIS scores were higher in the FSD group than in the control group,and the difference in monthly income between the two groups was statistically significant(all P<0.05).Monthly income of<2000 yuan[odds ratio(OR)=26.586,P=0.000],BIS score(OR=1.590,P=0.000),and HAMD score(OR=1.884,P=0.000)were independent risk factors for FSD.MRS scores were positively correlated with BIS and HAMD scores(r=0.358 and 0.244,P=0.000 and 0.001,respectively)and negatively correlated with FSFI scores(r=-0.433,P=0.000).Body image and depressive mood had partial mediating effects,accounting for 39.90%of the total effect.CONCLUSION Depression and body image play mediating roles between menopausal symptoms and sexual function in perimenopausal women.

Epidemiology of Male Sexual Dysfunction (MSD) in Patients Consulting in Some Health Services in the City of Douala, Cameroon

Sexual dysfunction is a group of diseases, disorders or difficulties experienced by men or women during any stage of normal sexual activity. In Africa in general and Cameroon in particular, statistical data concerning the prevelance and the main causes of male sexual dysfunction are rare due to socio-cultural and religious burdens and sometimes self-medication. The objective of this work was to determine the prevalences, comorbidities and the risk factors of the main sexual dysfunction in some hospitals in city of Douala. Through a descriptive retrospective study carried out from Novembre 2019 to June 2021, sociodemographic parameter, reasons of consultation, risk factors and type of male sexual dysfunction (erectile dysfunction or erectile dysfunction (ED), ejaculation disorders (EjD), libido disorders (LD) and disorders of sexual activity with pain or painful sexual intercourse (PSI)) were collected in the medical files of patients who have made urological consultation between 2016 and 2020 at the Deido District hospital, Laquintinie Douala Hospital and Douala General hospital respectively. At the end of our data collection, out of a total of 24995 consultations, 2743 (10.98%) patients were suffering from at least one male sexual dysfunction. Moreover, sexual disorders were the 2nd reason of urological consultation (13.69%) after urinary disorders (33.85%). Among sexual disorders, erectile (76%) and ejaculatory (20%) disorders were the predominant pathologies recorded with the prevalences of 9.79 et 2.62% respectively, and were mostly represented in patients from [41 - 50] for erectile dysfunction, and [18 - 30] years old for ejaculative dysfunction. In addition, the number of patients with ejaculatory and erectile dysfunctions was more important in patients from [18 - 30] and [31 - 40] years old respectively. Among patients presenting sexual disorders, several risk factors or pathologies were associated with the dysfunction: benign prostatic hyperplasia and metabolic syndrome (in patients over 50 years old);psychosocial problems, infections, and alcohol (in patients under 50 years old). These findings could be useful in the elaboration of therapeutic strategies for the management of the Cameroonian population suffering from sexual dysfunctions.

Sexual function history taking in medicine

Sexual history taking is important for the proper diagnosis and treatment of sexual dysfunction.It is often neglected in a clinical setting and it is also underre-ported by patients due to stigma and hesitation.Here we have described how we should take sexual function history taking during any sexual dysfunction.

精囊在男性性功能中的作用

精囊是男性生殖系统重要的附属性腺,过去有些学者多关注其在受精过程中的作用,而忽略了与男性性功能的关系。研究发现精囊参与性欲、勃起和射精等多个环节,针对精囊用药治疗性功能障碍,取得了一定的疗效。本文就生理病理以及临床和基础研究方面,论述精囊与性功能的关系,期望能为临床诊治性功能障碍提供新思路。

黄精改善中年房劳肾精亏虚大鼠免疫功能紊乱的作用研究

[目的]研究黄精对中年房劳肾精亏虚模型大鼠免疫功能紊乱的调节作用。[方法]采用“中年雄鼠+雌雄同笼”方法制备中年房劳肾精亏虚大鼠模型,模拟中年男性因房劳致肾精亏虚引起的免疫功能紊乱状态。实验期间测定大鼠脾脏系数;苏木精-伊红(hematoxylin-eosin,HE)染色观察脾组织形态学变化;测定骨髓中性粒细胞和淋巴细胞占比,外周血淋巴细胞数量及其占比和中性粒细胞占比;脾淋巴细胞增殖试验检测脾脏淋巴细胞增殖能力;流式细胞术测定脾组织T淋巴细胞亚群占比;原位末端转移酶标记(terminal-deoxynucleoitidyl transferase mediated nick end labeling,TUNEL)检测脾组织细胞凋亡情况;免疫印迹检测脾组织与增殖相关蛋白磷酸化磷脂酰肌醇3-激酶(phospho-phosphatidylinositol 3-kinase,p-PI3K)、磷酸化蛋白激酶B(phospho-ptotein kinase B,p-AKT)和与凋亡相关蛋白B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)、Bcl-2相关X(Bcl-2 associated X,Bax)蛋白表达。[结结果]黄精可降低中年房劳肾精亏虚模型大鼠骨髓和外周血中性粒细胞占比,升高骨髓淋巴细胞占比,升高外周血淋巴细胞数量及其占比,降低脾组织T淋巴细胞(CD4^(+)/CD8^(+))比值,提高脾组织T淋巴细胞增殖能力,减少脾组织内的细胞凋亡,升高脾组织中与增殖相关蛋白p-PI3K和p-AKT的表达。[结论]黄精通过影响T淋巴细胞及其亚群占比,改善中年大鼠因肾精亏虚引起的免疫功能紊乱,其机制可能与调控脾组织与增殖相关蛋白PI3K/AKT的表达有关。

度洛西汀在女性慢性盆腔痛治疗中的作用研究

目的研究度洛西汀在女性慢性盆腔痛治疗中的作用。方法选取金华市中心医院和金华市妇幼保健院2021年6月至2023年6月盆腔疼痛患者126例,随机分成对照组和观察组,剔除失访及未完成治疗12例,对照组56例,观察组58例,对照组给予盆底电刺激治疗,观察组在对照组治疗基础上应用度洛西汀,两组均治疗3个月,治疗前后应用视觉模拟评分法(Visual analogue scale,VAS)、盆底功能障碍问卷简要版-20(Pelvic floor dysfunction inventory-20,PFDI-20)、盆底器官脱垂/尿失禁性生活问卷-12(Pelvic organ prolapse-urinary incontinence sexual function questionnaire-12,PISQ-12)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)及医院焦虑抑郁量表(Hospital anxiety and depression scale,HAD)观察两组患者治疗前后病情的改善状况。结果治疗前两组VAS、PFDI-20、PISQ-12、PSQI、HAD评分比较,差异无统计学意义(P>0.05),治疗3个月分别对比VAS(观察组:1.20±0.16,对照组:1.51±0.20,P<0.05)、PFDI-20(观察组:5.69±5.4,对照组:8.95±4.27,P<0.05)、PISQ-12(观察组:40.79±3.11,对照组:30.86±5.88,P<0.05)、PSQI(观察组:7.79±1.39,对照组:10.59±1.95,P<0.05)及HAD(观察组:6.21±1.74,对照组:9.29±2.38,P<0.05),差异有统计学意义。结论度洛西汀在女性慢性盆腔痛治疗过程中有助于改善患者疼痛、焦虑、抑郁状态,提高患者生活及睡眠质量,对女性慢性盆腔痛有改善作用,同时对患者性生活质量也有明显改善作用。

河南长垣张氏中医内科学术流派传承与临证经验

作为河南省首批优质中医学术流派,河南长垣张氏中医内科流派传承脉络清晰,学术思想鲜明,临床经验丰富,是中原医学流派的重要代表之一。该流派创立者张清连在地域文化影响下,传承家学,儒医兼通,擅长运用中医药诊治肺病、脾胃病、痹证、男科疾病等中医内科疾病。第二代传承人张超然主张为医重在治病救人,除精通家传医学外,在中医外科、妇科、儿科方面也多有创新和突破。第三代传承人张华甫为豫北名老中医,从事中医临床工作60余年,临证注重从天人合一、形神合一的整体观念入手,强调三因制宜和四诊合参,擅长诊治中医内科疑难杂病,尤其在脾胃病和肝胆病的辨证论治方面具有独特的学术见解和丰富的临床经验;张庆瑞擅长治疗中医妇科和内科杂病,对肝病和神智疾患有所研究,注重培补脾胃,顾全正气。第四代传承人张景祖为河南省名中医,擅长运用中医药诊治肺病、脾胃病、痹证、男科疾病、肾病、糖尿病、脑病等疑难杂症,致力于清肺平喘丸、补肾生精丸等流派代表经验方,胃肠病中医疗法、痹证中医疗法等流派特色疗法的临床运用和研究;张昱在继承家学基础之上,师从国医大师王绵之等中医名家,擅长运用传统中医药或中西医结合的方法治疗急慢性肾炎、肾病综合征、慢性肾功能衰竭、糖尿病肾病、痛风性肾病、高血压性肾损害、紫癜性肾炎、狼疮性肾炎等各类肾脏疾病。

宫颈癌病人治疗后性功能障碍预防及管理的最佳证据总结

目的:总结宫颈癌病人接受治疗后性功能障碍预防与管理的最佳证据,为降低宫颈癌病人性功能障碍提供参考。方法:依据循证护理方法确定实践问题,在相关数据库中系统检索有关宫颈癌病人性功能障碍预防与管理的相关文献,进行筛选,对符合的文献进行评价并提取证据,确定级别。结果:共纳入11篇文献,其中包括3篇指南、1篇共识、5篇系统评价、2篇临床决策,从筛查和评估、治疗方式、药物治疗、非药物治疗、心理教育5个方面,共总结了25条最佳证据。结论:总结的证据可作为对预防和管理宫颈癌病人接受治疗后性功能障碍的临床实践参考,以期降低宫颈癌病人性功能障碍的发生率,提高生活质量。

男性性功能障碍患者性欲低下的影响因素分析

目的:分析男性性功能障碍患者性欲低下的影响因素,为临床诊治提供依据。方法:回顾性分析2023年6月至2023年9月郑州大学第一附属医院男科门诊111例性功能障碍患者(包括勃起、射精或者性欲障碍),将以性欲低下为主诉或伴随症状的患者分组至性欲低下组(43例),性欲正常组(68例),所有患者均进行国际勃起功能指数问卷表-5(IIEF-5)、早泄诊断量表(PEDT)、男性13项性欲自评量表、健康问卷抑郁量表(PHQ-9)、广泛性焦虑障碍量表(GAD-7)以及血清相关激素检测(FSH、LH、PRL、T、fT、E2、IGF-1、GH),比较两组基本参数差异,并将差异显著的参数与性欲值进行相关性分析。结果:性欲正常组与性欲低下组相比,IIEF-5评分、PEDT评分、性欲评分和IGF-1值显著增高,GAD-7评分明显降低(P<0.05),而PHQ-9评分、FSH、LH、PRL、T、fT、E2、T/E2及GH值两组间无显著差异(P>0.05)。性欲值与IIEF-5(r=0.28,P<0.01)、PEDT(r=0.29,P<0.01)、IGF-1(r=0.23,P<0.05)呈正相关,与GAD-7(r=-0.21,P<0.05)呈负相关。结论:性欲低下是多因素导致的结果,生殖激素并不能完全解释性欲的变化。IGF-1水平越低、ED及焦虑程度越重发生性欲低下风险越高。

牡蛎肽对帕罗西汀致雄性小鼠性功能障碍的作用效果及潜在机制

牡蛎肽(Oyster peptide,OP)具有多种生物活性,然而,其对男性性功能障碍的作用效果仍知之甚少。以牡蛎肽为研究对象,探讨其对男性性功能障碍的作用效果及其潜在机制。每天灌胃帕罗西汀(Paroxetine,PRX)构建雄性小鼠性功能障碍模型,同时灌胃牡蛎肽(500 mg·kg^(−1)),持续28 d。结果表明:与模型(PRX)组小鼠相比,牡蛎肽可显著提高雄性小鼠的性能力(P<0.05),恢复血清性激素水平(P<0.01),提高阴茎组织一氧化氮(NO)含量(P<0.01)、环磷酸鸟苷(cGMP)含量(P<0.05),和一氧化氮合酶(NOS)活性(P<0.05),并降低磷酸二酯酶-5(PDE-5)活性(P<0.01);同时,牡蛎肽可增强睾丸标志性酶活性(P<0.05)和抗氧化能力(P<0.01),改善精子质量。此外,HE染色结果显示:牡蛎肽可恢复小鼠睾丸生精小管内生精细胞的数量与形态,减少生精小管空泡化现象。综上所述,牡蛎肽可有效减缓PRX导致的雄性小鼠性功能障碍,推测其对男性性功能障碍具有潜在的保护作用。

结合物理方法的性治疗在原发性阴道内不射精中的应用研究

目的:探讨结合物理方法的性治疗在原发性阴道内不射精中的临床疗效及可能机制。方法:对符合纳入标准的原发性阴道内不射精伴随焦虑的患者90例,随机分为3组,A组(性治疗联合真空负压装置组)30例;B组(性治疗组)30例,C组(真空负压装置组)30例,比较3组治疗结果。结果:治疗后,A组有效率为86.67%;B组有效率46.67%,C组有效率30.00%,3组总有效率、患者及伴侣焦虑治疗有效率、特殊手淫方式治疗有效率比较,差异有统计学意义(P<0.05)。同时两两比较,A组总有效率优于B组、C组(P<0.01),B组、C组比较无统计学意义(P>0.05)。患者及性伴侣伴焦虑症状的治疗效果A组、B组差异无统计学意义(P>0.05),但均优于C组(P<0.01);患者伴有特殊手淫方式的治疗效果A组优于B组和C组,差异有统计学意义(P<0.01),B组、C组差异无统计学意义(P>0.05)。结论:原发性阴道内不射精常伴随夫妻不良心理状态及特殊手淫方式。性治疗联合真空负压水动气动按摩对于阴道内不射精有较好的治疗效果,可能是通过改善患者的心理、社会、行为方式达到治疗效果。

绝经过渡期和绝经后期女性睾酮水平对女性性功能的影响

目的探索绝经过渡期和绝经后期女性雄激素水平对性功能的影响。方法募集2023年1月至2023年12月首次来首都医科大学附属北京妇产医院就诊的绝经过渡期和绝经后期女性,纳入符合纳入标准和排除标准的女性450例,收集人口统计学资料和既往病史、应用女性性功能指数(female sexual function index,FSFI)量表、改良Kupperman评分量表评价女性性功能和围绝经期症状;测量人体测量学指标;检测实验室指标包括总睾酮、游离睾酮、生物活性睾酮、4-雄烯二酮和雌激素。采用相关和回归分析探索雄激素水平对女性性功能的影响。结果与绝经过渡期相比,绝经后期女性FSFI量表的各维度得分和总分明显下降(P<0.05)。多元线性回归分析显示生物活性睾酮水平与性唤起得分(β=0.190,P<0.05)和FSFI总分(β=0.178,P<0.05)呈正相关,游离睾酮水平与性欲(β=0.166,P<0.05)、性满意度(β=0.176,P<0.05)、FSFI总分(β=0.126,P<0.05)呈正相关。改良Kupperman评分与FSFI总分及各维度得分呈负相关(P<0.05)。结论女性性功能障碍与游离睾酮和生物活性睾酮水平下降有关,与总睾酮水平无关。

糖尿病对大鼠性功能及阴茎海绵体组织形态学、α-SMA表达的影响

目的观察糖尿病模型大鼠的性功能情况,探索高血糖继发性功能减退的可能机制。方法实验大鼠随机分为空白组(5只)和糖尿病组(15只),糖尿病动物模型构建成功后,评估2组的性功能;观察2组睾丸组织学特征;测定2组阴茎组织α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)的表达情况。结果血清性激素水平显著降低(P<0.01);组织形态学观察显示糖尿病组睾丸组织间质紊乱,阴茎组织平滑肌细胞较空白组减少,而纤维化程度加重;糖尿病组α-SMA的阳性细胞表达显著降低(P<0.01)。结论糖尿病大鼠性激素水平降低、阴茎海绵体平滑肌细胞数减少、阴茎海绵体α-SMA表达量下降、睾丸间质结构紊乱,平滑肌细胞形态的转变以及纤维化程度的加重是本病的重要表型特征,探索针对该表型特征的诊疗将具有重要意义。

2型糖尿病男性患者血脂、体重指数与性功能障碍的关系

目的探究男性2型糖尿病患者血脂、体重指数(BMI)与性功能障碍的关系。方法选取南阳市中心医院2020年6月至2023年6月接诊的男性2型糖尿病患者252例,收集患者的临床资料,检测患者入院时的血脂相关指标水平及BMI,根据病历复查结果随访,记录患者性功能障碍的发生率,分为性功能障碍组和正常组,筛查男性2型糖尿病患者发生性功能障碍的影响因素,评估血脂相关指标及BMI对男性2型糖尿病患者发生性功能障碍的预测价值。结果截至随访结束,252例患者中失访11例,有效随访率为95.63%。剩余241例患者中确诊性功能障碍163例,发生率为67.63%。性功能障碍组合并高血压占比及抑郁程度评分、BMI、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)均高于性功能正常组(P<0.05),睾酮低于性功能正常组(P<0.05)。logistic分析结果显示,合并高血压、抑郁程度评分、BMI、TC、TG、LDL-C是男性2型糖尿病患者发生性功能障碍的危险因素(P<0.05),睾酮是男性2型糖尿病患者发生性功能障碍的保护因素(P<0.05)。受试者工作特征曲线分析显示,BMI、TC、TG、LDL-C单一及联合预测男性2型糖尿病患者发生性功能障碍的曲线下面积分别为0.764(95%CI:0.705~0.853)、0.810(95%CI:0.745~0.876)、0.735(95%CI:0.657~0.812)、0.759(95%CI:0.693~0.836)、0.872(95%CI:0.817~0.927)。结论BMI、TC、TG、LDL-C与男性2型糖尿病患者发生性功能障碍有关,且可用于男性2型糖尿病患者并发性功能障碍的预测。

赵宏利以六经辨治男性不育症经验集萃

[目的]总结赵宏利主任中医师以六经辨治男性不育症的学术经验。[方法]通过整理赵师临床诊治的男性不育症患者典型案例,结合对六经辨证的解读,对赵师以六经辨治此病症的经验进行总结,充分阐释病症特点和诊治思路,并以典型医案进行验证分析。[结果]赵师认为,男性不育症临床症状繁多,可从六经辨证施治。辨证首分虚实为要,属实者,以六腑及阳经病变为基础,多为三阳病证;属虚者,以五脏及阴经病变为基础,多为三阴病证。赵师谨察病机,又立寒热错杂型男性不育症,活用泻心汤辈以交通阴阳。药物应用上,重视患者先天体质,衷中参西,根据检验检查特点加用药物,并提倡药食同治,重视心理疏导。所举医案中,患者婚后勃起功能障碍,辨为阳明经证,以葛根芩连汤加减清解阳明之热,并合四妙散清下焦湿热,其后据证化裁,综合治疗3月余,患者之妻成功受孕。[结论]赵师深研经典,创新性地将六经辨证应用于男性不育症,重视辨证施治,收效显著,为经方的临床应用与男性不育症的治疗提供了新思路。

基于数据挖掘技术探讨中药治疗慢性前列腺炎伴性功能障碍用药规律

目的:基于数据挖掘技术探讨中药治疗慢性前列腺炎(CP)伴性功能障碍的用药规律。方法:检索中国知网(CNKI)、中文科技期刊数据库(VIP)、万方数据知识服务平台(Wanfang)、中国生物医学文献数据库(CBM)中中药治疗CP伴性功能障碍的临床文献,时限为从建库至2023年11月5日,运用Excel软件统计中药使用频次、性味、归经及功效,SPSS statistic26进行关联规则分析,SPSS Modeler18行聚类分析。结果:纳入52篇文献,包括59个中药处方,涉及中药158味。药物使用总频次为626次,使用频次≥10次的药物有车前子、柴胡、黄柏、淫羊藿、丹参、茯苓、甘草、山萸肉、菟丝子、赤芍等。药性排前3的依次是寒、温、平性。药味排前3的依次是甘、苦、辛味。归经排前3的依次是肝、肾、脾经。功效使用频次排前6的依次是补虚药、活血化瘀药、清热药、利水渗湿药、理气药及收涩药。关联规则分析得到置信度及支持度最高的为熟地黄、山药、山萸肉组合。通过聚类分析挖掘出3种组方,分别适合于肾阴阳两虚证、肝郁脾虚夹湿热证、湿热夹瘀证。结论:临床治疗CP伴性功能障碍常使用车前子、柴胡、黄柏、淫羊藿、丹参等中药,以补虚活血、清热利湿、理气为主,符合该病肾虚肝郁、湿热瘀滞的主要病机。