Prevalence of Dyspareunia and Its Effect on Sexual Life among Gynaecological Clinic Attendees in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

Introduction: Dyspareunia is one of the most common complaints in gynae-cologic practice with tremendous effect on both quality of life and sexual rela-tionship of women. Objectives: To determine the prevalence of dyspareunia and its effect on sexual life among gynaecology clinic attendees in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Materials and Methods: A cross-sectional study was conducted on consenting participants between 12th May 2016 and 25th July 2016. Anonymous self-administered questionnaires were used collection information on dyspareunia and its effect on sexual life at the Gynaecology clinic. The data was analyzed using Epiinfo version 7.1.5. Results: One hundred and four (104) women participated in this study. Most of the women studied were Igbos (95.19%), and were mainly between the age ranges of 21 - 30 years (66.35%). Most of them were married (89.42%), and were also mainly of the Pentecostal denomination (40.78%). The mean age at coitarche was 20.6 ± 3.95 years. Prevalence of dyspareunia was 36% and only 16% sought medical help. The various responses to dyspareunia were avoidance of sex 11%, reduced frequency of intercourse 8%, less desire for sex 19%, while majority of women with dyspareunia tolerated it (62%). Conclusion: The prevalence of dyspareunia is high in our society afflicting young women in their reproductive years with associated enormous stress on their sexual life.

Effects of oral Shilajit tablets on sexual function and sexual quality of life among reproductive-aged women: a triple-blind randomized clinical trial

Background:Shilajit is mentioned in the“Kama Sutra”as a potent enhancer of sexual desire.This study aimed to investigate the effects of oral Shilajit tablets on sexual function and sexual quality of life among women of reproductive age.Methods:Forty-eight reproductive-aged women participated in a placebo-controlled triple-blind clinical trial.The intervention group took oral Shilajit tablets(200 mg)twice daily for 60 days and the control group took the placebo.Data collection tools were Sexual Quality of Life-Female and Female Sexual Function Index.Data were collected before the intervention,30,60,and 90 days after the start of the study.Results:Forty-three women completed the study.The mean score of total sexual function in the intervention group was significantly higher than before the intervention(P<0.001).The mean score of sexual function was 28.93 after 90 days in the intervention group while it was 22.09 in the control group.This finding was observed in most domains of the sexual function index.The mean score of sexual quality of life increased after 60 days of intervention in both groups;however,the difference was not statistically significant(P=0.094).Conclusion:The study indicated that Shilajit,as a complementary therapy,may improve sexual function and most of its domains;while there was no effect on improving the quality of sexual life.

Sexual Fusion and Life History of Scytosiphon lomentaria (Scytosiphonaceae, Phaeophyceae) in Dalian, China

Morphology and life history of a brown alga Scytosiphon lomentaria (Lyngbye) Link (Scytosiphonaceae, Phaeophyceae) were investigated from 2005 to 2009 in the coastal waters of Dalian, China. The erect thalli collected in the field were tubular, hollow, and commonly constricted at intervals. Ascocysts were presented. Plurilocular gametangia, which were positioned in continuous sori on the erect thallus surface, produced biflagellar gametes. Gametophytes were dioecious and gametes were nearly isogamous. Gametes fusion occurred in three types. Type one, female and male gametes fused directly while swimming; type two, female gamete settled first, with which a male one contacted and fused rapidly; type three, while settling adjacently, a male gamete's entire protoplast moved slowly into the previously settled female one, with only an empty cell membrane left. In culture zygotes developed into crustose sporophytes that formed unilocular sporangia. Biflagellar zoospores developed into erect thalli that formed plurilocular gametangia. The results indicated that a periodical heteromorphic alternation history with haploid gametophyte generation and diploid sporophyte generation exists in S. lomentaria of the Dalian populations.

青年宫颈癌患者快感缺失的影响因素及与性生活质量和婚姻质量的相关性

目的分析青年宫颈癌患者快感缺失的影响因素及与性生活质量和婚姻质量的相关性。方法选取2021年6月至2023年3月于新疆医科大学第一附属医院妇科就诊的352例青年宫颈癌患者作为研究对象。采用中文版躯体快感缺失量表、中文版社会快感缺失量表、女性性功能指数(FSFI)和Olson婚姻质量问卷评估患者的躯体快感缺失、社会快感缺失情况及性生活质量、婚姻质量。采用Spearman相关性分析快感缺失与性生活质量和婚姻质量的相关性,采用多元线性回归分析快感缺失的影响因素。结果青年宫颈癌患者躯体和社会快感缺失评分分别为(46.15±3.59)分和(30.48±3.62)分。相关性分析显示躯体和社会快感缺失评分与FSFI各维度评分、Olson婚姻质量问卷中婚姻满意度、夫妻交流、角色平等性维度评分呈负相关(P<0.05)。回归分析显示居住地、生育情况、经济状况、治疗后时间、病耻感和领悟社会支持是青年宫颈癌患者躯体和社会快感缺失的影响因素(P<0.05)。结论青年宫颈癌患者快感缺失处于中等偏上水平,与性生活质量和婚姻质量呈负相关,居住地、生育情况、经济状况、治疗后时间、病耻感和领悟社会支持是快感缺失的影响因素。

里尔克的性欲书写与弗洛伊德精神分析的启示

里尔克以性欲书写关注现代人的身心感受,借弗洛伊德精神分析以丰富文学创作。其性欲书写得益于从尼采肯定性欲的生命哲学和弗洛伊德的幼儿性欲理论中所获得的启示。与里尔克亦师亦友的莎乐美向他传授尼采与弗氏的共同观点:批评基督教禁欲的道德观和反自然的唯灵论。她还与里尔克展开精神分析式谈话,帮他战胜创作危机,鼓励他进行性欲书写。里尔克在《杜伊诺哀歌》第三首和《七首诗》(即《阳具颂》)等典型诗文中赞美性欲、生命力和此在的幸福,颇具代表性地践行了性欲书写。

盆底肌训练联合生物反馈电刺激对产后盆底功能恢复及性生活质量的影响

目的:探讨三维超声评估盆底肌训练联合生物反馈电刺激疗法对产后盆底功能恢复及性生活质量的影响。方法:将90例产后盆底功能障碍产妇随机分为2组各45例,对照组给予常规盆底肌训练干预,观察组在对照组的基础上联合生物反馈电刺激疗法干预,干预前后行三维超声检查,评估产后盆底功能恢复情况,并比较2组产妇性生活质量。结果:治疗8周后,2组产妇张力状态下(Valsalva动作下)膀胱颈移动度、肛提肌裂孔的面积、尿道旋转度均较干预前减小(P<0.05),且观察组小于对照组(P<0.05);盆底肌异常率及盆腔脏器脱垂、尿失禁发生率均较干预前降低(P<0.05),且观察组低于对照组(P<0.05);女性性功能指数量表(FSFI)中性欲、性高潮、阴道润滑度、性交疼痛、性满意度、性唤起评分均较干预前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:通过盆底三维超声检查发现,盆底肌训练联合生物反馈电刺激疗法在产后盆底功能患者的治疗中提供了客观的疗效评定指标,两种方法联合能够有效促进患者盆底功能恢复,缓解临床症状,改善性生活质量。

三种不同术式治疗中重度盆腔器官脱垂患者的临床效果

目的分析3种不同术式治疗中重度盆腔器官脱垂(POP)患者的临床效果。方法选取2020年10月至2022年10月于郑州市妇幼保健院治疗的120例中重度POP患者进行随机对照试验,采用随机数字表法将其分为A组、B组与C组,各40例。A组年龄(57.16±3.59)岁;POP分期:中度24例,重度16例。B组年龄(56.94±3.51)岁;POP分期:中度22例,重度18例。C组年龄(56.08±3.54)岁;POP分期:中度19例,重度21例。A组采用经阴道全子宫切除术+阴道前后壁修补术治疗;B组采用腹腔镜下全子宫切除术+高位骶韧带悬吊术治疗;C组采用腹腔镜下全子宫切除术+髂耻韧带悬吊术治疗。比较3组围手术期指标、生活质量、性生活质量、复发率及并发症。采用χ^(2)检验、单因素方差分析及LSD-t检验。结果B组、C组手术时间[(125.74±31.52)min、(134.97±38.21)min]均长于A组[(77.45±25.06)min],术中出血量[(57.12±21.09)ml、(55.74±19.53)ml]均少于A组[(90.76±28.91)ml],住院时间[(5.29±1.46)d、(5.34±1.29)d]均短于A组[(6.85±1.53)d],住院费用[(23523.07±5171.05)元、(24135.65±5208.47)元]均高于A组[(15241.35±4472.18)元],差异均有统计学意义(均P<0.05)。术后,3组盆底功能障碍问卷量表(PFDI-20)评分均低于术前,性生活质量问卷(PISQ-12)评分均高于术前,且B组、C组PFDI-20评分[(8.34±2.05)分、(8.19±2.41)分]均低于A组[(10.56±2.17)分],PISQ-12评分[(41.15±2.97)分、(40.87±2.64)分]均高于A组[(36.21±3.82)分],差异均有统计学意义(均P<0.05)。B组、C组复发率及并发症总发生率均低于A组,差异均有统计学意义(均P<0.05)。B组与C组手术时间、术中出血量、排气时间、住院时间、住院费用、术后PFDI-20评分及PISQ-12评分、复发率及并发症总发生率比较,差异均无统计学意义(均P>0.05)。结论中重度POP患者采用腹腔镜下全子宫切除术+高位骶韧带悬吊术与腹腔镜下全子宫切除术+髂耻韧带悬吊术治疗均具有创伤小、并发症少及术后恢复快等优点,能够提高患者的生活质量及性生活质量,但这两种术式手术耗时长且住院费用相对较高。

激素替代疗法联合气道正压通气治疗绝经后女性阻塞性睡眠呼吸暂停疗效观察

目的 观察激素替代疗法(HRT)联合气道正压通气(CPAP)治疗绝经后女性阻塞性睡眠呼吸暂停(OSA)的临床效果。方法 选择2022年2月至2023年5月在上海市第八人民医院治疗的100例绝经期女性OSA患者作为研究对象,按随机数表法分为观察组和对照组各50例。对照组患者给予CPAP治疗,观察组患者给予HRT+CPAP治疗。一个疗程为28 d,治疗28 d后常规开展门诊随访。治疗前及治疗28 d后,比较两组患者的睡眠图(PSG)、性激素指标[雌二醇(E2)、孕激素(P)]及生存质量测定简表(WHOQOL-BREF)变化,并比较两组患者对诊疗效果的满意率。结果 治疗后,两组患者的低通气指数、呼吸暂停次数、呼吸紊乱指数、最长呼吸暂停次数均降低,且观察组患者的上述指标分别为(10.27±2.10)次/h、(6.21±1.02)次/h、(26.10±3.28)次/h、(24.28±4.18) s,明显低于对照组的(14.28±2.17)次/h、(9.73±2.10)次/h、(31.29±4.12)次/h、(35.19±3.95) s,而两组患者治疗后的睡眠最低SaO2均升高,且观察组患者的睡眠最低SaO2为(91.31±8.21)%,明显高于对照组的(79.26±7.31)%,差异均有统计学意义(P<0.05);治疗后,两组患者的E2、P水平均升高,且观察组患者的E2、P分别为(35.13±2.25) pmol/L、(2.01±0.31)μmol/L,明显高于对照组的(18.93±2.10) pmol/L、(1.66±0.42)μmol/L,差异均有统计学意义(P<0.05);治疗后,两组患者的生理领域、心理领域、社会关系、环境领域评分均升高,且观察组患者的上述评分分别为(16.10±2.31)分、(15.31±2.04)分、(16.28±3.31)分、(16.29±2.12)分,明显高于对照组的(12.28±2.01)分、(12.01±1.94)分、(13.28±2.74)分、(12.88±1.89)分,差异均有统计学意义(P<0.05);观察组患者对诊疗效果的满意率为96.00%,明显高于对照组的82.00%,差异有统计学意义(P<0.05)。结论 HRT联合CPAP治疗绝经期女性OSA可有效改善睡眠质量、呼吸功能及激素水平,提高患者生存质量及对诊疗效果的满意度。

女性性交尿失禁的研究进展

女性性交尿失禁在总体人群中的发生率约为2%,而在尿失禁女性中的发生率为10%~66%。国内外文献对尿失禁研究较多,但专门对于女性性交尿失禁的探讨不多,性交尿失禁在女性中的高发生率却已得到证实。由于女性对性交尿失禁缺乏了解,常为此感到羞耻,因而不愿提及并回避性生活,可能导致了对该问题的低估。性交尿失禁对患者的亲密关系、心理健康、生活质量等均产生负面影响。本研究回顾相关文献并对女性性交尿失禁的鉴别、病因、治疗方式、测量工具进行综述,以期为后续的研究提供理论依据。

负压吸引联合认知行为疗法治疗无性生活勃起功能障碍的临床疗效

目的探讨负压吸引联合认知行为疗法治疗无性生活勃起功能障碍(ED-NS)的临床疗效。方法选择2021年3月至2023年10月山东第二医科大学附属医院收治的90例成年男性ED-NS患者作为研究对象,依据随机数字表法分为负压吸引组、认知行为组、联合治疗组,每组30例。负压吸引组采用负压吸引疗法治疗,认知行为组采用认知行为疗法治疗,联合治疗组采用负压吸引疗法联合认知行为疗法治疗。比较3组患者治疗前、治疗3个月结束时和治疗结束后3个月的勃起功能自我评价表(SIEF-NS)评分、勃起硬度评分(EHS)、焦虑自评量表评分(SAS)和抑郁自评量表评分(SDS)。结果90例ED-NS患者中有87例完成了随访,负压治疗组失访1例,认知行为组失访2例。重复测量方差分析结果显示,SIEF-NS、EHS、SAS、SDS评分的时点间主效应、组间主效应、组间和时点间的交互作用差异均有统计学意义(P<0.05或P<0.01)。进一步进行简单效应分析,以时间为自变量的时点间效应显示,3组治疗3个月结束时及治疗结束3个月后的SIEF-NS、EHS评分均高于治疗前基线水平(P<0.01),SAS、SDS评分低于治疗前基线水平(P<0.01),联合治疗组治疗结束3个月后SIEF-NS、EHS评分高于治疗3个月结束时(P<0.01)。以组别为自变量的组间效应显示,治疗结束3个月后,联合治疗组的SIEF-NS、EHS评分高于负压吸引组和认知行为组(P<0.05或P<0.01),SAS评分低于负压吸引组(P<0.05),SDS评分低于负压吸引组和认知行为组(P<0.01)。结论负压吸引联合认知行为疗法治疗ED-NS的效果优于负压吸引治疗和认知行为疗法的单独治疗,且能够明显改善患者焦虑、抑郁的心理状态,无明显副作用,操作安全。

盆底肌训练联合微点阵激光治疗轻中度产后压力性尿失禁的疗效及对患者性生活质量的影响

目的探讨盆底肌训练(PFMT)联合微点阵激光治疗轻中度产后压力性尿失禁(PSUI)的临床效果及对患者性生活质量的影响。方法选取2020年1月至2022年10月西南交通大学附属医院、内江市第一人民医院及四川锦欣妇女儿童医院就诊的240例轻中度PSUI患者作为研究对象。按照随机数字表法分为对照组和研究组,各120例。对照组采用PFMT,研究组采用PFMT联合微点阵激光治疗,共治疗3个月,随访3个月。比较两组临床疗效,治疗前后1 h漏尿量、尿失禁症状评分、生活质量评分、产后抑郁筛查量表(PDSS)评分、产后特有焦虑量表(PSAS)评分、性生活质量评分及不良反应发生情况。结果研究组显效率及总有效率高于对照组(P<0.05);治疗后研究组1 h漏尿量少于对照组(P<0.05),生活质量评分高于对照组(P<0.05),尿失禁症状评分、PDSS评分、PSAS评分低于对照组(P<0.05);研究组治疗后及随访3个月时性生活质量评分高于对照组(P<0.05);研究组不良反应发生率为6.78%,对照组无不良反应发生。结论PFMT联合微点阵激光治疗轻中度PSUI疗效确切,能提高有效率,改善患者生活质量,缓解产后抑郁焦虑情绪,提高性生活质量。

生物电反馈刺激联合心理护理治疗对产后女性性功能障碍的作用

目的探索生物电反馈刺激与心理护理联合治疗对产后女性性功能障碍(FSD)的改善效果。方法采用随机数字表法将118例产后FSD患者分为对照组(n=59)和观察组(n=59),对照组给予生物电反馈刺激,观察组给予生物电反馈刺激及改良式心理护理联合治疗,疗程12周。于治疗前、后第12周评定患者盆底肌力、膀胱生物学功能并评估患者的抑郁(9条目患者健康问卷)、焦虑(7条目焦虑问卷)和性功能(女性性功能量表,FSFI)水平。结果观察组治疗后盆底肌力改善率优于对照组(P<0.05)。观察组与对照组膀胱初感充盈量与最大充盈量在治疗后均高于治疗前(P<0.05),且治疗后观察组的膀胱初感充盈量与最大充盈量高于对照组(P<0.05)。治疗结束后,观察组焦虑与抑郁评分低于对照组(P<0.05),而且观察组FSFI各项得分、总分均比对照组高(P<0.05)。结论生物电反馈刺激联合心理护理治疗能够有效提高初产妇FSD患者盆底功能、改善膀胱生物学功能,而且缓解了患者抑郁焦虑情绪、促进了性生活质量。

基于行为转变理论的护理干预对宫颈癌手术患者的影响

目的探讨基于行为转变理论的护理干预模式在宫颈癌手术治疗患者中的应用效果。方法选择2019年6月—2022年6月医院收治的宫颈癌手术患者60例为研究对象,按照组间基本特征具有可比性的原则分为对照组与观察组,各30例。对照组进行常规护理,观察组采用基于行为转变理论的护理干预模式。比较两组患者护理干预前和护理干预3个月后认知行为、性生活质量、癌因性疲乏程度(CFS)、自我效能水平评分和满意度及依从性。结果护理干预前,两组患者认知行为、性生活质量、CFS、自我效能水平评分的比较,差异均无统计学意义(P>0.05)。护理干预3个月后,观察组患者认知行为、性欲望、性高潮、性行为及性满意度得分高于对照组,差异有统计学意义(P<0.05);观察组CFS评分低于对照组(P<0.05),差异有统计学意义;自我责任感、自我概念、健康知识及自我护理技能评分高于对照组,差异有统计学意义(P<0.05);观察组患者对护理方法、服务态度、护理效果的满意率及在遵医治疗、并发症预防、康复锻炼方面的依从率均高于对照组,差异有统计学意义(P<0.05)。结论基于行为转变理论的护理干预模式用于宫颈癌手术治疗患者中,能改善患者认知行为,提升性生活质量和自我效能水平,降低癌因性疲乏程度,提高患者护理满意度和依从性。

改良式圆韧带阴道顶端悬吊术配合补中益气汤在阴式子宫全切患者术后预防阴道残端脱垂中的应用

目的:探究改良式圆韧带阴道顶端悬吊术配合补中益气汤在阴式子宫全切患者术后预防阴道残端脱垂中的应用效果。方法:60例随机分为两组各30例。对照组行阴式子宫全切术,观察组在对照组基础上行改良式圆韧带阴道顶端悬吊术配合补中益气汤治疗。两组术后6个月,对比性生活质量、盆底肌肉肌力、压力性尿失禁及阴道顶端脱垂情况。结果:观察组治疗后性生活质量评分较对照组高(P<0.05),观察组治疗后盆底肌肉肌力、压力性尿失禁及阴道顶端脱垂程度均优于对照组(P<0.05)。结论:改良式圆韧带阴道顶端悬吊术配合补中益气汤能够有效改善行阴式子宫全切术患者的性生活质量,增强盆底肌肉肌力,减轻压力性尿失禁及阴道顶端脱垂程度。

PLISSIT模式的性干预对女性癌症患者性功能影响的Meta分析

目的系统评价基于PLISSIT模式的性干预对女性癌症患者性功能的干预效果。方法计算机检索中国知网、万方数据库、维普数据库、the Cochrane Library、PubMed及Web of Science等数据库或平台中PLISSIT模式的性干预对女性癌症患者性功能影响的文献,检索时限为1974年至2022年12月30日。使用RevMan 5.3软件进行统计分析。结果共纳入8篇文献,共413例研究对象。Meta分析结果显示,与常规康复指导相比,PLISSIT干预能提高患者的性功能(MD=5.25,95%CI:3.14~7.36,P<0.001),改善女性癌症患者的性生活质量(MD=14.07,95%CI:11.31~16.84,P<0.001)。结论基于PLISSIT模式的性干预能够提高女性癌症患者的性功能,改善其性生活质量。

不同术式治疗高级别宫颈上皮内瘤变伴高危型HPV感染的临床疗效

目的 探讨不同术式治疗高级别宫颈上皮内瘤变伴高危型人乳头瘤病毒(HPV)感染的临床疗效。方法 选取294例高级别宫颈上皮内瘤变伴高危型HPV感染患者为研究对象,随机分为宫腔镜下宫颈锥切术组104例、宫颈冷刀锥切术组99例、宫颈环形电切术组91例,比较三组的治疗效果。结果 宫腔镜下宫颈锥切术组术中出血量少于宫颈冷刀锥切术组、宫颈环形电切术组,愈合时间短于宫颈冷刀锥切术组、宫颈环形电切术组,术后并发症发生率、复发率、术后液基薄层细胞检测阳性率及HPV持续感染率低于宫颈冷刀锥切术组、宫颈环形电切术组(P<0.05);宫腔镜下宫颈锥切术组术前、术后女性性功能调查表评分比较差异无统计学意义(P>0.05)。结论 宫腔镜下宫颈锥切术治疗高级别宫颈上皮内瘤变伴高危型HPV感染的临床疗效显著,对性生活质量无明显影响,值得推广应用。

工作时长与青年的性生活、亲密关系和生育意愿

将工作视为一切的工作主义文化正在影响中国青年的私人生活领域。一方面,超时工作挤压了青年的私人生活空间,造成工作—家庭冲突,对家庭幸福和生育意愿带来消极影响;另一方面,失业或不稳定就业削弱了青年对家庭生活的期待和成家生育的动力。基于2020年“中国人私生活质量调查”数据探讨超时工作和工作时长偏少对中国青年性生活、亲密关系和生育意愿的影响发现,超时工作会影响男性的性生活满意度和未生育女性的生育意愿,但对其他方面并无显著影响;相比之下,工作时长偏少不仅与男性和女性的性生活质量呈负相关,而且也伴随着更低的生育意愿。这些发现对理解当下中国社会的超低生育率具有启示作用。

Impaired of Sexuality in Premenopausal Breast Cancer Patients

Introduction: The treatment modalities for Breast cancer may impair the sexual function of women, especially in the pre-menopausal period. Treatment in this group of women has a huge impact in quality of life. The main objective of this study was to evaluate the prevalence of sexual dysfunction (SD) after treatment for breast cancer among women who were premenopausal at the diagnosis of neoplasia. Material and Methods: All women diagnosed with premenopausal breast cancer at one outpatient clinic from March 2019 to September 2020 were selected. Participants answered two sexual function questionnaires (the Female Sexual Function Index [FSFI-19] and Female Sexual Quotient [QS-F]) and a quality of life [QOL] questionnaire [EORTC QLQ-C30]). Sociodemographic and tumor characteristics were also studied. Results: Fifty-eight pre-menopausal women were included. Sexual dysfunction (SD) was observed in 43 participants (74.1%) according to the FSFI-19, while 31 (53.4%) had SD according to the QS-F. The functional and general health scales of the EORTC QLQ-C30 were positively related to the FSFI-19 and QS-F scores, while the symptom scale was negatively related to the FSFI-19 and QS-F scores. There was no relationship between chemotherapy, hormone therapy, or surgery with the FSFI-19 and QSF scores. A diagnosis of depression was negatively related to the total FSFI-19 scores. Conclusion: Pre-menopausal breast cancer women showed high rates of female SD. None breast cancer treatment modality was related to SD. The only studied variable associated with SD was depression.

清热化湿逐瘀汤联合红藤方保留灌肠治疗慢性盆腔炎湿热瘀结证患者的疗效观察

目的观察清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型慢性盆腔炎(Chronic pelvic inflammatory disease,CPID)患者的临床疗效。方法选取2019年1月—2021年8月期间北京市怀柔区中医医院妇科收治的189例湿热瘀结型CPID患者作为研究对象,采用随机数字表法分为对照组、联合1组、联合2组,每组各63例。对照组给予康妇炎胶囊,联合1组给予康妇炎胶囊+红藤方保留灌肠,联合2组给予清热化湿逐瘀汤+红藤方保留灌肠治疗。治疗4周后,观察比较3组患者综合疗效、治疗前后中医证候积分、盆腔疼痛程度[疼痛评分(Visualanaloguescale,VAS)、疼痛等级]、性功能评分(The Female Sexual Function Index,FSFI)、生活质量评分(The World Health Organization’s Quality of Life Questionnaire,WHOQOL-BREF)改善情况及治疗安全性、复发率。结果治疗后联合2组综合疗效总有效率93.65%(59/63)高于对照组76.19%(48/63)与联合1组82.54%(52/63),差异有统计学意义(P<0.05)。治疗后3组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且联合1组中医证候积分低于对照组,联合2组中医证候积分低于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者VAS评分较治疗前降低,疼痛等级较治疗前改善,差异有统计学意义(P<0.05);且联合1组优于对照组,联合2组优于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者FSFI、WHOQOL-BREF评分均较治疗前升高,差异有统计学意义(P<0.05);且联合1组高于对照组,联合2组高于联合1组,差异有统计学意义(P<0.05)。治疗期间,3组患者均无不良反应发生。随访3个月,对照组治愈患者中复发6例,联合1组复发4例,联合2组未见复发病例,3组患者复发率比较,差异有统计学意义(P<0.05)。结论清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型CPID效果显著,有利于缓解盆腔疼痛,改善患者性功能与生活质量,且安全性较高。

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.