收稿:2023-09-14,
网络出版:2024-02-02,
纸质出版:2024-04-05
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.勃起功能障碍和早泄共病中西医结合诊治中国专家共识[J].中国实验方剂学杂志,2024,30(07):147-153.
.Erectile Dysfunction and Premature Ejaculation Comorbidity Diagnosis and Treatment by Integrated Traditional Chinese and Western Medicine Chinese Expert Consensus[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(07):147-153.
.勃起功能障碍和早泄共病中西医结合诊治中国专家共识[J].中国实验方剂学杂志,2024,30(07):147-153. DOI: 10.13422/j.cnki.syfjx.20241093.
.Erectile Dysfunction and Premature Ejaculation Comorbidity Diagnosis and Treatment by Integrated Traditional Chinese and Western Medicine Chinese Expert Consensus[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(07):147-153. DOI: 10.13422/j.cnki.syfjx.20241093.
目前,国内对于勃起功能障碍(ED)/早泄(PE)共病的中西医结合诊疗和管理缺乏共识,为制订ED/PE共病中西医结合临床诊疗策略,根据近年来国内外发布的ED/PE共病指南并结合全国多家泌尿外科、男科研究单位的临床实践,中国性学会中医性学分会组织相关临床专家根据现有的循证医学证据,经共识起草、学会审核、专家函审访谈、审稿会的程序充分讨论形成本共识。该共识针对中西医结合的诊疗定位和价值,基于医生临床经验、研究证据、患者意愿和生活环境因素,综合评估做出ED/PE共病的中西医结合诊治规范,为更多患者在诊疗进程中获益。中医诊断注重望诊、闻诊、问诊、切诊四诊信息的收集,并据此进行《伤寒论》六经辨证、卫气营血辨证、脏腑辨证。基于中西医协同方式,发挥中医药整体调节的优势,实施个性化中西医结合治疗。中药内服治疗根据《中医外科学》第四章外科疾病的辨证第二节阴阳辨证。《类经·阴阳类》“人之疾病……必有所本,或本于阴,或本于阳,病变虽多,其本则一。”《黄帝内经·素问·阴阳应象大论》“善诊者,察色按脉,先别阴阳。”该共识依据“八纲辨证,首辨阴阳”分为阳证、阴证两类。此外,对ED/PE共病的证型证候,基于异病同治有应用柴胡桂枝汤、温经汤、补中益气汤治疗本病,可以参考。
At present,there is a lack of consensus on the diagnosis, treatment and management of erectile dysfunction(ED)/premature ejaculation(PE) comorbidity in China. To develop a clinical diagnosis and treatment strategy for ED/PE comorbidity, according to the guidelines for ED/PE comorbidity published in China and abroad in recent years and combined with the clinical practice of many urology and andrology research units in China,the clinical experts organized by the Branch of Sexology of Traditional Chinese Medicine, China Sexology Association formed this consensus through consensus drafting, academic review, expert correspondence interview and full discussion at the review meeting based on the existing evidence-based medical evidence. Based on the clinical experience of doctors,research evidence,patients' wishes and living environment factors,this consensus comprehensively evaluates the diagnosis and treatment norms of ED/PE comorbidity with integrated traditional Chinese and Western medicine,aiming at the diagnosis and treatment orientation and value of integrated traditional Chinese and Western medicine,so as to benefit the whole process management of more patients. Traditional Chinese medicine diagnosis pays attention to the collection of four diagnostic information of inspection, auscultation, inquiry and palpation, and carries out pattern differentiation of six meridians, pattern differentiation of Wei-defence, Qi, Ying nutrients and blood, and pattern differentiation of zang-fu organs as described in the
Shanghanlun
(《伤寒论》). Based on the synergy of traditional Chinese and Western medicine, the advantages of the overall regulation of traditional Chinese medicine are brought into play, and the individualized treatment of integrated traditional Chinese and Western medicine is implemented. Internal treatment of traditional Chinese medicine is based on the pattern differentiation of yin and yang described in Section Ⅱ, Chapter Ⅳ Syndrome Differentiation of Surgical Diseases in
Surgery of Traditional Chinese Medicine
. As stated in
Leijing
:
Yinyanglei
(《类经·阴阳类》), "Human diseases ... must have their roots, either in Yin or in Yang. Although there are many pathological changes, their roots are one."
Huangdineijing
:
Suwen
:
Yinyangyingxiangdalun
(《黄帝内经·素问·阴阳应象大论》) states that "Those who are good at diagnosis should look at the color and pulse, and differentiate Yin and Yang syndromes first." This consensus describes the yang and yin syndromes according to the principle that "Yin and Yang syndromes differentiation should be the priority in the pattern differentiation by the eight principles." In addition, for the syndromes of ED/PE comorbidity, based on the same treatment of different diseases, Chaihu Guizhitang, Wenjingtang and Buzhong Yiqitang are used, which can be referred to.
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