从肝论治男性性欲低下的理论与临床研究

发布时间：2018-07-16 08:50

【摘要】：目的：性欲低下作为男科疾病的常见病,但历代医家对其研究甚少,病因病机尚未完全明确,至今未有系统规范的诊疗方案,临床疗效也不尽如人意。性欲低下固然不会直接威胁生命,但其破坏家庭和谐与幸福,久之必会对患者生理和心理造成影响,进而影响人们的生活。故本课题旨在研究经验方疏肝增欲汤治疗肝气郁结型性欲低下的临床疗效及毒副作用,验证性欲低下从肝论治的有效性及可行性,以期对中医药治疗性欲低下提供新依据、新指导。方法：本课题将以男性性激素五项(T、E2、PRL、FSH、LH)、中医症状积分、性欲积分量表、SDS抑郁量表积分、SAS焦虑量表积分做为评估指标。100例符合诊断标准及纳入标准的性欲低下患者采用区组随机化方法随机分配到治疗组(A1)、对照组(A2)。A1组采用疏肝增欲汤+安特尔进行治疗：A2组采用安特尔进行治疗,疗程均为12周。治疗前后检查每位患者的性激素水平,并对中医症状积分、性欲积分量表、SDS抑郁量表积分、SAS焦虑量表积分进行评分,并记录受试者在研究过程中出现的不适情况。成果：①中医症状评分：治疗12周后,A1与A2组与治疗前相比均有统计学意义(P0.05),A1与A2组组间比较有显著差异(P0.05)。②性欲积分量表评分：经12周治疗后,组间比较：A1与A2组比差异显著(P0.05)；组内比较：A1、A2组与治疗前比较有显著差异(P0.05)。③SDS、SAS评分：治疗后,两组SDS抑郁程度、SAS焦虑程度与治疗前相比较均差异显著(P0.05)；A1与A2组治疗后相比较有统计学意义(P0.05)。④男性性激素五项水平：两组治疗后,性激素水平与治疗前相比,T、E2、PRL、TSH、LH均有显著性差异(P0.05)。A1与A2组两组组间对比：T、E2有显著性差异(P0.05),而PRL、TSH、LH无显著性差异(P0.05),但A1组对性激素水平的改善稍优于对照组(A2)。⑤治疗后,A1组50例患者治愈10例,有效28例,无效12例,总有效率76.00%；A2组50例患者治愈6例,有效21例,无效23例,总有效率54.00%。A1组疗效明显优于A2组(P0.05)。⑥治疗过程中,A1组5例(腹泻3例,痤疮2例),总不良事件率10.00%;A2组14例(腹泻2例,便秘2例,恶心1例,痤疮5例,纳差4例),总不良事件率28.00%。结论：疏肝增欲汤能够增强性欲,提高性欲低下临床有效率,降低中医症状积分,一定程度上缓解或消除性欲低下患者其他临床症状,减轻或消除患者抑郁焦虑情绪,从肝论治治疗性欲低下的思路和方法具有一定的有效性和可行性。
[Abstract]:Objective: low libido is a common disease in andrology, but its etiology and pathogenesis have not been completely defined, there is no systematic and standardized diagnosis and treatment plan, and the clinical effect is not satisfactory. Low libido will not directly threaten life, but it will destroy family harmony and happiness, which will affect the physiology and psychology of patients for a long time, and then affect people's life. Therefore, the purpose of this study is to study the clinical efficacy and side effects of experience prescription Shugan Zengyu decoction in treating liver-qi stagnation type of libido, and to verify the effectiveness and feasibility of treating libido from liver, in order to provide a new basis for the treatment of libido by traditional Chinese medicine. New guidance. Methods: in this study, five items of male sex hormone (TX E2P PRL FSHH LH) were used, and the symptom score of traditional Chinese medicine (TCM) was used. Sexual desire scale / SDS depression scale / SAS anxiety scale as evaluation index. 100 patients with low libido were randomly assigned to the treatment group (A1) and the control group (A2) .A1 by block randomization. Treatment with Shugan Zengliu decoction Antel: a 2 group was treated with Antel. The course of treatment was 12 weeks. Before and after treatment, the sexual hormone levels of each patient were examined, and the scores of TCM symptom score, sexual desire integral scale, SDS depression scale and SAS anxiety scale were scored, and the discomfort of the subjects during the study was recorded. Results: after 12 weeks of treatment, there was significant difference between group A 1 and group A 2 (P0.05). There was significant difference between group A 1 and group A 2 (P0.05) .2 score of sexual desire scale: after 12 weeks of treatment, there was significant difference between group A 1 and group A 2. There was significant difference between the two groups (P0.05), and there was significant difference between the two groups (P0.05), the SAS scores before and after treatment were significantly different between the two groups (P0.05), and there were significant differences between the two groups in the degree of SDS depression and the degree of SAS anxiety after treatment (P0.05). There were significant differences between A1 and A2 group after treatment (P0.05). 4 male sex hormone levels: after two groups of treatment, There was significant difference in sex hormone level between group A 1 and group A 2 (P0.05), but there was no significant difference between group A 1 and group A 2 (P 0.05), but the improvement of sex hormone level in group A1 was slightly better than that in group A 2 after treatment (P 0.05), but there was no significant difference between group A (P 0.05) and group A 1 (P 0.05), but there was no significant difference in sex hormone level between group A 1 and group A 2 (P 0.05), but there was no significant difference between group A (P 0.05) and group A (P 0.05). In group A 1, 10 cases were cured. The total effective rate was effective in 28 cases and ineffective in 12 cases. The total effective rate was 76.00A A _ 2 group in which 6 cases were cured, 21 cases were effective, and 23 cases were ineffective. The total effective rate of 54.00%.A1 group was significantly better than that of A2 group (P0.05) in 5 cases (3 cases of diarrhea) in group A _ 1. The total adverse event rate was 10.00 in group A _ 2 (2 cases of diarrhea, 2 cases of constipation, 1 case of nausea, 5 cases of acne, 4 cases of anorexia), and the total adverse event rate was 28.00%. Conclusion: Shugan Zengliu decoction can enhance libido, improve clinical effective rate of low libido, reduce TCM symptom score, alleviate or eliminate other clinical symptoms in patients with low libido to a certain extent, and relieve or eliminate depression and anxiety in patients with low libido. It is effective and feasible to treat libido from liver.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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