中醫治療勃起功能障礙病例報告與文獻探討

Treatment of Erectile Dysfunction with Chinese Medicine-Case Report and Literature Review

陳威傑(Wei-Chieh Chen) ； 許航甄(Hang-Chen Hsu) ； 莊筱梅(Hsiao-Mei Chuang)

《中醫藥研究論叢》 22卷1期 (2019/03) Pp. 135-142

https://doi.org/10.6516/TJTCM.201903_22(1).0012

摘要

勃起功能障礙是男性常見困擾的問題，根據台灣流行病學調查，40歲以上男性約有17.7%有勃起功能障礙，並且勃起功能隨著年齡上升而下降，這樣的問題不只影響到身心的健康狀況，也會帶給伴侶生活上的衝擊。目前西醫治療勃起功能障礙第一線用藥為第五型磷酸二酯酶抑制劑（Phosphodiesterase-5 inhibitors），但仍存在禁忌症與副作用，許多病患因此轉向尋求中醫的輔助治療。本案例是一位陽痿已四年57歲男性，經國際勃起功能指數（International index of erectile function-5）問卷來評估，屬於嚴重勃起功能障礙，中醫辨證為腎陰陽兩虛，治則以填精補腎，滋陰壯陽方式用藥。介入後一個月已回復之前性生活狀況，且無勃起功能障礙問題。此有效案例提供同道參考討論，並同時回顧過去關於陽痿的中醫文獻，期許未來可以進行相關臨床試驗，以證實中醫在勃起功能障礙上的治療效益。

關鍵字

勃起功能障礙 ； 中藥治療 ； 中醫文獻

並列摘要

Erectile dysfunction (ED) is a common medical problem bothering many men worldwide. According to the epidemiological study in Taiwan, the prevalence of ED was 17.7 % in men aged over 40 as erectile capacity declines with age. ED may not only influence physical and mental health status but also bring a great impact to the quality of life (QoL) between sufferers and their mates. Phosphodiesterase-5 inhibitors (PDE5) have been the first-line therapy for ED. However, there are adverse effects and contraindications, which makes many people turn to Chinese medicine for help. We present the case of a 57-year-old male patient who suffered from impotence for 4 years and was evaluated with severe ED by International index of erectile function-5 questionnaire. Through differentiation, the diagnosis of the patient was kidney yin and yang deficiency. Based on it, we adopted Supplementing Essence and Consolidating the Kidney, nourishing yin and invigorating yang. ED was significantly improved and did not occur after about one month of Chinese medical treatment. In this study, we provided effective TCM treatment of ED for physicians as reference and reviewed Chinese literatures of ED. Further experimental studies and clinical trials are warranted to confirm the efficacy of TCM treatments on treating ED in the future.

並列關鍵字

Erectile dysfunction ； Traditional Chinese Medicine Treatment ； Chinese literature

參考文獻

NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993; 270(1): 83-90.

Fisher WA, Eardley I, McCabe M, Sand M:Erectile dysfunction (ED) is a shared sexual concern of couples I: couple conceptions of ED. J Sex Med. 2009; 6(10): 2746-60.

Salonia A, Castagna G, Saccà A, Ferrari M, Capitanio U, Castiglione F, Rocchini L, Briganti A, Rigatti P, Montorsi F: Iserectile dysfunction a reliable proxy of general male health status? The case forthe International Index of Erectile Function-Erectile Function domain. J Sex Med. 2012; 9(10): 2708-15.

Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999; 84(1): 50-56.

Chen KK, Chiang HS, Jiann BP, Lin JS, Liu WJ, Wu CJ, Hsieh JT, Wang CJ, Hwang TI, Lee SS: Prevalence of erectile dysfunction and impacts on sexual activity and self-reported intercourse satisfaction in men older than 40 years in Taiwan. Int J Impot Res. 2004; 16(3): 249-55.