Cov kev pom zoo suav rau Suav Suav cov kev pom zoo rau cov ntshav qab zib mellitus ua ke nrog cov txiv neej kev sib daj sib deev ⅱ
Nov 07, 2024
IV. Kev Kuaj thiab kuaj mob ntshav qab zib ua ke nrog txiv neej kev sib daj sib deev
(I) Txheej txheem cej luam ntawm kev tshuaj ntsuam thiab kuaj mob
Cov neeg mob ntshav qab zib txiv neejyuav tsum tau tshuaj xyuas rauKev sib daj sib deev DysfunctionCov. Kev tshuaj ntsuam thawj zaug yog pom zoo thaum cov ntshav qab zib raug kuaj mob, thiab tshuaj ntsuam yuav tsum tau ua txhua xyoo. Rau cov neeg mob uas tsis muaj keeb kwm ntawm cov ntshav qab zib uas tuaj ntsib kws kho mob rau kev sib deev, tshuaj ntsuam xyuas kom muaj ntshav qab zib.
Hauv cistanche extract
Cov txheej txheem hluav taws xob rau kev ntsuas cov neeg mob ntshav qab zib nrog kev sib daj sib deev:
1. Keeb Kwm Kev Kho Mob: Muaj cov ntshav qab zib, muaj cov tshuaj mob ntshav qab zib / kev siv tshuaj mob hlwb (lwm qib kev kho mob thaum lub sijhawm sib deev, thiab kev sib raug zoo nrog kev sib deev;
2. Kev Ntsuam Xyuas Lub Cev: Feem ntau ntawm lub cev kev kuaj mob, nrog rau kev faib khoom ob lub cev, pulbocavernitosus reflex, anal sphincter rension, thiab lwm yam;
3. Kuaj cov kev kuaj xyuas: Qhov ntsuas muaj feem cuam tshuam txog kev kis las sab nraud (urinalysis, Creatinine, T, E2, PRL, TEWBG) thiab DAWB Testosterone];
4. Kev soj ntsuam tshwj xeeb (cov lus 1); 5. Daim ntawv thov ntawm kev kuaj ntsuas cov nplai, xws li International Performance indexulation (Yeem Ntxiv) (Pedt) (Pedt) (pedt) (pedt) rau kev sib deev Rau kev ntsuas kev ntsuas psychological: Kev Ntsuas Kev Ntsuas Xyuas Tus Kheej (SDI) (BRATION} (Gad {-7) (Daim Ntawv Ntxiv 8), Kev Ntsuas Yus Tus Kheej (SAS) (Daim Ntawv Ntxiv 9); 6 Kev kuaj mob tom ntej thiab kev kho mob yuav xav tau cov hlab ntsha (lub rooj zaum thib ob) thiab cov mem tes sib dhos (abile-clinodity
Cov lus 2 feem ntau siv lub hom phiaj kev kuaj mob rau cov nqaij ntshav qab zib neuropathy
| Ntsuas Yam | Lub hom phiaj | Qhov Zoo | Tsis zoo |
|---|---|---|---|
| Electromyographography (emg) | Tshuaj xyuas cov hlab ntsha thiab leeg nqaij kom zoo nkauj thiab kev ua haujlwm | Ntawm lub hom phiaj thiab muaj tseeb; tus "Kub Qauv" rau kev kuaj xyuas cov neuropathy loj | Kev phem; tsis tuaj yeem soj ntsuam cov neeg neuropathy tsis tau |
| Kev kuaj qhov tseeb kom paub (qst) (Vibratory thiab thermal qhov pib ntsuas) |
Quantitative Venratory Qhov pib pab cuam pab kuaj cov nyiaj puas loj Quantitative thermal (kub / txias) qhov pib hloov pauv pab kuaj cov leeg fiber ntau fiber ntau |
Tsis yog tus neeg | Yuav tsum muaj tus mob kev koom tes, muaj feem tau qhia kev kawm |
| Daim tawv nqaij Biopsy | PGP9.5 Immunohistochemical Staining ntawm Epidermal cov leeg fibers los soj ntsuam cov Epidermal hlab kheej fiber ntau ntom | Kev ruaj khov zoo thiab rov ua dua; Tus "Kub Qauv" rau kev kuaj cov pob zeb me me neuropathy | Kev phem; Kev ua haujlwm yog qhov sib txawv |
| Txoj kev xeem | Kev piav txog | Qhov Zoo | Tsis zoo |
|---|---|---|---|
| Corneal Plum nrho cov ntawv me me | Tshuaj xyuas qhov ntom ntom thiab morphology ntawm corne hlab ntsha fibers | Tsis-incidive; rhiab heev thiab muaj feem cuam tshuam tau zoo rau kev kuaj xyuas me me Fiber Neuropathy; Zoo txhais tau tias | Tus nqi kim; Kev kuaj mob cov txheej txheem xav tau cov qauv txuas ntxiv |
| Daim tawv nqaij cem | Kuaj xyuas cov morphology thiab ua haujlwm ntawm c-hom nociceptive fibers tom qab cov tawv nqaij seeb | Lub hom phiaj; tuaj yeem pab rau kev kuaj mob ntawm cov neuropathy fiber ntau | Kev ua haujlwm yog nyuaj |
| Tus nqi plawv hloov pauv | Txheeb xyuas lub plawv dhia hloov pauv siv txoj kev so thiab lub sijhawm sib sib sib zog nqus pa | Tsis-incidive; lub hom phiaj; Siv tau zoo heev rau kev kuaj mob omonomic Neuropathy | Yooj yim cuam tshuam los ntawm sab nraud yam xws li qaug zog, poob siab, thiab tib cov tshuaj; Cov kev siv cuam tshuam ib txwm muaj tseem xav tau cov qauv txuas ntxiv |
Kev kuaj mob ntshav qab zib ua ke nrog kev sib deev yuav ua ke tau ua ke: (1) kab mob ntshav qab zib nrog cov qauv ntawm kev sib daj sib deev tau hais los saud; (2) Kev kuaj mob ntawm kev kuaj mob: uas yog, txhua yam yuav ua rau muaj kev sib daj sib deev yog qhov tseeb (Daim Duab 2).
Tshuaj ntsuab Cistance kho kev sib deev tsis sib deev
(2) Ntshav qab zib ua ke nrog erectile kawg
Cov txheej txheem kev kuaj mob rau cov mob ntshav qab zib ua ke nrog erectile kawg tsis txawv ntawm cov txheej txheem kev kuaj mob dav dav rau kev ua haujlwm erectile. Kev kuaj mob tuaj yeem faib ua ob kauj ruam:
1. Kev kuaj mob:(1) Muaj keeb kwm tseeb ntawm cov ntshav qab zib, thiab tib lub sijhawm, raws li lub ntsiab lus ntawm erectile kawg (ED), qhia meej txog Ed. Rau cov kws kho mob nrog kev paub me me hauv kev kho cov neeg mob, nws raug nquahu kom siv cov nplai lossis cov lus nug (IONGT) thiab AL) [50,51] rau tshuaj ntsuam cov neeg mob rau kev ua haujlwm erectile. Kev tshuaj ntsuam ntawm kev ua haujlwm tsis sib haum xeeb feem ntau suav nrog tus noov yog erection (lub kaum sab xis, thiab lub cev thaum pw lossis sawv ntsug lub sijhawm txij nkawm. (2) Kev soj ntsuam lub cev: tsom rau kev qoj ib ce, cov noob qes, kev txhim kho mis, thiab kev faib khoom noj me me thiab hwj txwv. (3) Kev Ntsuam Xyuas Tshwj Xeeb: Nco Cenpile erection thiab Hardness Ntsuam Xyuas (NPTRT).
2. Piv txwv li kev kuaj mob:Ntawd yog, txheeb xyuas txhua lub siab siv tau uas ua rau kev txhim kho ntshav qab zib ua ke nrog ed. Kauj ruam no yog ib qho tseem ceeb heev rau kev txiav txim kev kho mob cov neeg mob ntshav qab zib thiab erectile kawg. Raws li keeb kwm kev kho mob thiab kev kuaj mob lub cev, kuaj cov ntshav, glycosylated hem, glycosylated hem, thiab lub raum niaj hnub ua haujlwm, thiab cov tshuaj hormones tsis zoo. Kev ntsuam xyuas tshwj xeeb muaj xws li: Lub cev thiab zos vas doppler ultrasound ntsuas kev ntsuas, neptomuscular muaj nuj nqi, nptrt, thiab lwm yam.
(Iii) Ntshav Qab Zib Ua ke nrog Ejaculatory Ua Si
Ejaculatory kev ua hauj lwm suav nrog kev ua kom ntxov, ncua ejaculation, ejaculation tsis muaj zog, retrograde thiab anejaculation.
1. Kev kuaj mob ntshav qab zib ua ke nrog kev ua ntxov ntxov
Cov kauj ruam kuaj mob ntawm cov ntshav qab zib ua ke nrog cov ntshav qab zib lossis kev kuaj mob ua ntej muaj cov ntshav qab zib. (2) Kev Ntsuam Xyuas Lub Cev: Prostate AV Digital Dag Zog, Anal Sphinculation Testin, Kev Ntsuas Kev Ntsuam Xyuas Tus Kheej (3) Kev Nug Cov Lus Nug (Pedt) Kev Tshawb Fawb (Daim Ntawv Nug) (Daim Ntawv Qhia Ntxiv 3). (4) Kev Tshawb Fawb thiab Kev Xeem Tshwj Xeeb: Endocrine thiab Cov Ntsej Muag Kev Ntsuam Xyuas, Urogenital System of.
Cov kabmob ntshav qab zib ntawm cov ntshav qab zib ua ke nrog ejaculatortion tsis zoo li cov ntshav qab zib ua ke nrog ed. Qhov ntawd yog, tom qab kuaj mob ntshav qab zib thiab kev ntsuam xyuas ntxiv, kev ntsuas kev siv ntshav qab zib, kev ntsuas kev kho mob ua ke nrog ejaculatorition ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatory ua ke nrog ejaculatortion ua ke nrog ejaculatory ua ke nrog ejaculatortion). Yog hais tias lub ntsuas kev ntsuas sab saum toj no tsis txaus los txiav txim siab qhov ua rau, txoj kev sim vascular ntxiv thiab cov kev sim ua haujlwm ib leeg.
2. Kev kuaj mob ntshav qab zib ua ke nrog retrograde ejaculation
Retrograde Ejaculation yog qhov kev kuaj mob feem ntau yog kuaj mob ntshav qab zib ua ke nrog ejaculatory dysfunction [40]. Nws cov kauj ruam ntawm kev kuaj mob yog: (1) Keeb kwm kho mob: Keeb kwm ntawm cov ntshav qab zib. Nws yog tsim nyog sau cia tias ntau tus neeg mob uas muaj ntshav qab zib ua ke nrog kev tsis txaus siab ejaculerction muaj ejaculatortion tsis txaus siab, thiab mob ntshav qab zib tsis raug zais; Thaum muaj kev sib deev, muaj ib qho kev ua tiav ntawm Ejaculation, tab sis tsis muaj phev yog ejaculed los ntawm qhov zis. Qee tus neeg mob muaj cov zis turbid zis tom qab lub sijhawm sib deev. (2) Kev Ntsuam Xyuas Lub Cev: Lub rooj noj mov ntawm bulbocavernerns leeg reflex thiab anal sphincter nro yog qhov tsis muaj zog lossis tsis muaj zog reflexes thiab txo cov leeg nruj. (3) Kev kuaj kab mob: Muaj cov phev hauv cov zis thiab / lossis cov zis zoo. (4) Lwm Yam Kev Ntsuam Xyuas: Feem ntau cov kev sim ua haujlwm tsis zoo ntawm cov hlab hlwb.
(IV) Ntshav Qab Zib Ua ke nrog qis libido hauv txiv neej
Muaj ib qho tsis muaj qhov tsis muaj peev xwm thiab cov hom phiaj rau kev txiav txim siab tsawg libido. Cov neeg mob ntshav qab zib ua ke nrog qis libido feem ntau tuaj rau ntawm lub chaw haujlwm txhawb nqa lossis cov txiv neej lub chaw haujlwm rau kev kho mob Libides, tab sis cov kws kho mob feem ntau tsis quav ntsej txog kev kuaj mob ntshav qab zib. Cov kauj ruam ntawm kev kuaj mob yog: 1. Keeb Kwm Kev Kho Mob: Nov yog, keeb kwm ntawm cov ntshav qab zib. Ntau tus neeg mob feem ntau tau txo qis li libido raws li thawj qhov kev tsis txaus siab. Mob ntshav qab zib yog qhov zais rau, thiab kuaj mob ntshav qab zib yuav tsum tau meej thaum cov neeg mob mus ntsib kws kho mob; 2. Kuaj cov ntshav: suav nrog cov hlab ntshav, nplooj siab thiab lub raum ua haujlwm, thiab lwm yam, nrog kev ntsuas kev sib deev hormone kev tshuaj ntsuam deev. Lwm cov kev ntsuam xyuas (xws li Mituitary MRI, kev kuaj mob hlwb, lub qog ua haujlwm, thiab lwm yam) tuaj yeem xaiv tau ntxiv raws li tus neeg mob. 3. Kev tshuaj ntsuam xyuas: Feem ntau pom muaj tsawg dua li kev sib deev tsawg dua lossis kev sim ua haujlwm tsawg dua ntawm cov haujlwm sib deev. Qhov ntsuas kev ua haujlwm thoob ntiaj teb ntawm kev ua haujlwm loj (iminent) muaj cov lus nug txog kev sib deev tsis muaj siab, qhov twg yog: Koj muaj kev sib deev ntau npaum li cas hauv plaub lub sijhawm dhau los? Koj yuav ntsuas koj tus kheej lub siab xav li cas? Cov lus nug tau qhab nia los ntawm 0 rau 5 ntsiab lus. Cov kws kho mob tuaj yeem ntsuas tus neeg mob sib deev raws li ob nqe lus nug no hauv IONS cov lus nug.
Tom qab tus kab mob tau kuaj pom tias yog kev kuaj mob sib deev Cov kabmob ntshav qab zib ntawm cov ntshav qab zib ua ke nrog cov kev sib deev tsawg, ua rau muaj kev mob ntshav qab zib ua ke nrog lwm hom kev noj qab haus huv, thiab kev cuam tshuam ntawm kev sib deev tsis sib xws ntawm kev sib deev muaj siab.
(V) mob ntshav qab zib ua ke nrog txiv neej orgasm tsis txaus
Kev kuaj mob ntawm cov orgasm tsis txaus siab ntau zaus nyob ntawm tus neeg mob cov lus tsis txaus siab. Orgasmic kev tsis sib haum (OD) tau txhais los ntawm orgasm tshooj ntawm IT kev nug cov lus nug [10], uas muaj ob nqe lus nug los tshuaj xyuas orgasmic muaj nuj nqi hauv 4 lub lis piam dhau los. Cov lus nug txog cov orgasm hauv IAR cov lus nug suav nrog: Hauv plaub lub asthiv dhau los, thaum koj tau sib deev lossis muaj kev sib deev, yog dab tsi thaum kawg koj thiaj li ejaculated? Thiab yav dhau los plaub lub asthiv dhau los, thaum koj tau sib deev lossis muaj kev sib deev, yog dab tsi tshwm sim uas koj tuaj yeem hnov orgasm? Nws tuaj yeem ntsuas tus neeg mob lub koob tsheej orgasm; Tam sim no tsis muaj kev tshuaj ntsuam xyuas kom paub meej tias nws yog kuaj; Rau cov neeg mob nrog cov kabmob ntshav qab zib, lawv li kev soj ntsuam lub cev nqaij daim tawv thiab cov leeg ua kom muaj kev sib deev Ntxiv rau, orgasm qhov tsis muaj peev xwm kuj tseem yuav yog los ntawm lwm yam kev sib deev tsis zoo xws li thaum ntxov ntxov thiab erectile kawg. Hauv kev tshawb nrhiav kev coj ua, kev saib xyuas yuav tsum tau them rau kev qhia kom paub, kev nkag siab txog tus neeg mob lub sijhawm, thiab npaj phiaj xwm kev kho mob.
V. Western tshuaj kho mob ntshav qab zib ua ke nrog txiv neej kev sib daj sib deev
(I) Kev Kho Mob: Raws li kev tswj ntshav rysfunction, raws li hom kev sib daj sib deev, kev kho mob thiab cov qauv kev kho mob yog nqa tawm rau cov txheej txheem kab ke.
(II) Kev kho mob pib: Kev kho mob pib yog feem ntau tau tsom rau ntshav qab zib, lwm yam kab mob yooj yim uas cuam tshuam deev muaj nuj nqi.
1. Tswj ntshav qab zib thiab cov kab mob plawv
Rau cov neeg mob ntshav qab zib feem ntau, cov hom phiaj tswj ntawm HBA1C yuav tsum tsawg dua 7%, tab sis nws yuav tsum muaj tus mob, tab sis nws yuav tsum muaj tus mob, tab sis nws yuav tsum muaj tus mob, tab sis nws yuav tsum muaj kev cia siab, comority ntawm cov teeb meem thiab mob hnyav ntawm cov teeb meem.
Kev kho mob lub tswv yim rau cov ntshav qab zib yuav tsum muaj kev kho mob ntau dua xws li cov ntshav tawm, tswj cov ntshav, tswj kom hnyav thiab txhim kho txoj kev ua neej [1,52]. Cov tshuaj feem ntau yog siv hypogyCemic tuaj yeem muab faib ua yim pawg raws li kev sib txawv ntawm kev ua (cov lus 3).
Cov lus 3 hom thiab cov yam ntxwv ntawm cov tshuaj siv qib siab siv hypoglycemic
| Hom | Cov npe generic | Kev Phuv Nqi Ntshav Qab Zib | Nce kev pheej hmoo mob | Qhov hnyav nce | Kev pheej hmoo mob plawv | Mob pob txha ua pheej hmoo | Lwm qhov kev cuam tshuam tsis zoo | Kev sib daj sib deev Dysfunction |
|---|---|---|---|---|---|---|---|---|
| Sulfonyhluras | GlimperCide (Amylizide (Glipizide (GliCotrol), Glyburide (Ntshav Qab Zib, Micronase, Glynase) | Sab | Siab | Nce | Nruab nrab | Nruab nrab | Txoj hnyuv | Kev tshawb fawb yog tsis muaj, thiab xaus lus tsis yog ib yam |
| Thiazolidinedionion | Pioglitazone (Actos), Rosiglitazone (Avandia) | Sab | Tsis muaj | Mob rau qhov hnyav | Tej zaum yuav nce | Nruab nrab | Peripheral Edema | Nruab nrab; tej zaum yuav cuam tshuam nrog Gynecomastia |
| Alpha-Glucosidase Inhibitors | Acarbose (precose), miglitol (Glyset) | Nruab nrab | Tsis muaj | Tsawg | Nruab nrab | Nruab nrab | Txoj hnyuv | Nruab nrab |
| Bile acid expressestestrants | Colesevelam (Welchol) | Sab | Tsis muaj | Nce | Kev phom sij hauv plawv kev pheej hmoo; tej zaum yuav txo qis ldl | Nruab nrab rau hnyav | Edema, lub cev qhuav dej; cem quav thiab zawv plab | Nruab nrab |
| DPP -4} inhibitors | Sitagliptin (Januvia), saxagliptin (oneglyza), linagliptin (tradjenta), alogliptin (nesina) | Nruab nrab | Me ntsis | Nruab nrab | Nruab nrab | Nruab nrab | Tsis tshua muaj tshwm sim ntawm pancreatitis; Kev Mob Sib Koom Tes | Cov chaw kuaj mob me me qhia tias DPP -4 Kuv tuaj yeem txhim kho erectile kawg tsis sib xws |
| Splergt -2}} inhibitors | Canagliflozin (invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance) | Nruab nrab | Tsis muaj | Tsawg | Sab | Sab | Kab mob yuav tso zis; nce tso zis; mob chaw mos mycotic; Ketoacidosis | Cov chaw kuaj mob me me scrt -2 Kuv tuaj yeem txhim kho erectile dysfunction |
| GLP -1 ra | Exenatide (Byetta), liraglutide (windoza), dulaglutide (trulicity), semaglutide (ozempic) | Sab | Tsis muaj | Hnyav rau hnyav heev | Sab | Tej zaum yuav nce | Kev sib txig sib cav sib ceg ntau yam; mob pancutitis; nce kev pheej hmoo ntawm cov qog c-cell; Gallbadder Cov Teeb Meem; Txawb txog lub raum tsis ua hauj lwm | Cov chaw kuaj sim thiab ntau sib txawv MATA-kev sib tw ntawm GLP {1}} ra xwm yeem txhim kho erectile kawg tsis sib xws |
| Tshuaj ivxulis | Tib neeg insulin; insulin analogues | Sab | Siab | Nce | Nruab nrab |
Nco tseg: DPP -4 i: dipeptidyl peptidase -4}}}}}}}}}}}}} inhibitors; GLP -1 ra: GLP -1 Cov agonists; Splergt -2 Kuv: sodium-glucose cotransporter -2 inhibitor.
Nws raug nquahu tias cov neeg mob ntshav qab zib muaj feem cuam tshuam rau cov ntshav siab Lipid Cov Kev Cai (Feem ntau Trutins yog thawj qhov kev xaiv rau qis LDL-C) thiab kev xaiv cov kev xaiv ntawm cov kab mob ntshav qab zib microopathy thiab ntshav qab zib cov neuropathy [1]. Nyob rau hauv xyoo tsis ntev los no, kev tshwm sim ntawm ntau cov neeg muaj kev ywj pheej hauv ntiaj teb no tau lees paub tias cov dej khov kho tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau lees paub tias cov dej qab zib tshiab tau paub tias cov khoom siv tshiab. Muaj cov teebmeem kev tiv thaiv plawv ntxiv rau kev txo qis-txo qis [53,54]. Cov xwm txheej ntawm ob hom quav yeeb tshuaj no hauv kev kho mob ntshav qab zib yog kev txhim kho tas li.
Cov neeg mob ntshav qab zib nrog cov kab mob neurological thiab cov tshuaj tiv thaiv neurological (ripoic acidement thiab lwm yam kev kho mob microfacic), xws li cov tshuaj kho mob microfacic) Qee qhov tshuaj no (xws li Epalrestat) tau qhia hauv cov tsiaj tshawb nrhiav lossis kev kho mob sib deev thaum siv ib leeg lossis ua ke [}}] (rooj 4). Cov feem ntau siv antioxidant vite [64] tau tseem tau muab tshaj tawm los kho cov mob ntshav qab zib tej teeb meem thiab cov pov thawj yav dhau los, tab sis cov pov thawj yuav tsum muaj zog ntxiv.
2. Kev kho mob ntawm lub hlwb thiab kev puas siab puas ntsws thiab tswj hwm lwm yam kev pheej hmoo
Kev npaj kho mob yuav tsum tau tsim raws li qhov mob hnyav ntawm cov kab mob ntshav qab zib ua kev sib deev nrog kev sib deev thiab cov teeb meem kev xav. If the emotional distress is related to diabetes (ie, emotional reactions such as worry and fear about the threat of diabetes, potential functional loss, and diabetes medical care), general clinical treatment (health education, appropriate explanation and comfort, relaxation training) and accurate and clear explanation of sexual dysfunction symptoms related to psychological and emotional problems are sufficient [65]. Rau kev ntxhov siab me me los yog kev nyuaj siab, kev kho tus cwj pwm tsis zoo los pab pawg, lossis kev kho tus kheej txo qis raws li tus neeg mob lub siab nyiam [66]. Yog tias nws yog mob me los yog kev ntxhov siab lossis kev nyuaj siab, uas muaj cov kev mob siab rau kev txawj ntse, uas muaj lub sijhawm luv luv, thiab cov kev mob siab ntev [67, 68]. Kev kho yeeb tshuaj nrog cov tshuaj tiv thaiv tshiab, xws li SSRIS (Esceropraline, sawb), thiab anti-ov duab), uas tuaj yeem siv ua thawj qhov kev xaiv ntawm kev ntxhov siab tsis muaj kev ntxhov siab. Lawv muaj kev nyab xeeb thiab siv tau rau lub sijhawm ntev. Hauv kev kho cov kev nyuaj siab, SSRIS muaj cov txiaj ntsig me me piv nrog cov tsos mob ntawm kev sib daj sib deev nrog kev ntxhov siab [69]. Txawm li cas los xij, nws yog qhov zoo tshaj plaws los xaiv cov tshuaj tiv thaiv kev ntxhov siab uas muaj cov nyhuv me ntsis ntawm kev sib deev, xws li mirtazapine, bupropion, lossis vortioxetine.
Yog tias muaj lwm yam cuam tshuam uas cuam tshuam rau kev sib deev, thiab cov tshuaj tiv thaiv kab mob ntsws, thiab cov tshuaj tua kab mob, kho cov tshuaj, kho cov tshuaj, cuam tshuam nrog kev sib raug zoo Kab mob thiab tswj cov kev pheej hmoo no.
Kev Kho Mob ntawm kev sib deev tsis zoo rau cov neeg mob ntshav qab zib thiab kev tiv thaiv kev sib deev thiab cov hlab ntshav, koj tuaj yeem sib haum xeeb cov kev sib deev thiab sim cov kev kho mob uas twb muaj lawm. Cov kev kho mob kom paub meej txog kev kho mob sib deev kuj yog siv rau kev kho ntshav qab zib thiab txiv neej sib deev phem dua li cov pejxeem feem pua [70].
1. Kev kho mob ntawm txiv neej kev sib deev tsis zoo nrog ntshav qab zib
Kev poob qis hauv Androgen qib tam sim no tau txiav txim siab yog ib qho ntawm cov ua kom muaj kev ntshaw kev sib deev hauv cov txiv neej ntshav qab zib. Txhawm rau hais txog qhov kev muaj siab txog kev sib deev tsis muaj nqis los ntawm cov qib Androde txo qis, cov kab mob ntshav qab zib tuaj yeem tau txais txiaj ntsig ntawm kev kho mob and androgen hloov tau txais txiaj ntsig (Trt) [71]. Rau qee tus neeg mob, txoj haujlwm ntawm hypothalamus-pituitary-gonadal axis tuaj yeem tswj hwm (ua ntu zus rau kev muaj siab Androgen hauv lub cev thiab txhim kho kev sib deev [72]. Muaj ntau ntau Androgen ntau ntxiv kuj tseem tuaj yeem txo cov insulin tsis kam thiab txhim kho cov qib ntshav qab zib hauv cov txiv neej nrog hypogonadism hauv Hom 2 Ntshav Qab Zib [73]. Ib qho ntxiv, cov tshuaj muaj feem xyuam rau Dopamine Receptor kev cai, xws li LevodoGa, xws li muaj kev cuam tshuam txog kev sib deev thiab lwm yam, txhawm rau txhim kho kev muaj kev sib deev hauv lub hlwb, tab sis muaj qhov tsis muaj kev tshawb nrhiav kev sib deev [74].
2. Kev kho mob ntawm cov neeg mob ntshav qab zib nrog ed
Ntshav qab zib tswj thiab kev hloov pauv kev ua neej ib leeg feem ntau tsis txaus los kho cov neeg mob ntshav qab zib [75]. Tsim nyog Ed yuav tsum raug xaiv raws li tus neeg mob tus mob. Cov tshuaj kho mob uas muaj cov tshuaj noj muaj peev xwm txhim kho kev ua haujlwm zoo thiab lub neej zoo hauv cov neeg mob ntshav qab zib.
Yog tias muaj lwm yam cuam tshuam uas cuam tshuam rau kev sib deev, thiab cov tshuaj tiv thaiv kab mob ntsws, thiab cov tshuaj tua kab mob, kho cov tshuaj, kho cov tshuaj, cuam tshuam nrog kev sib raug zoo Kab mob thiab tswj cov kev pheej hmoo no.
Kev Kho Mob ntawm kev sib deev tsis zoo rau cov neeg mob ntshav qab zib thiab kev tiv thaiv kev sib deev thiab cov hlab ntshav, koj tuaj yeem sib haum xeeb cov kev sib deev thiab sim cov kev kho mob uas twb muaj lawm. Cov kev kho mob kom paub meej txog kev kho mob sib deev kuj yog siv rau kev kho ntshav qab zib thiab txiv neej sib deev phem dua li cov pejxeem feem pua [70].
① Phosphodiesterase Hom 5 Inhibitors - PDE5I
Xaiv PDE5I - Sildenafil, Vardenafil, Tadalafil, Tadalafil thiab avanafil yog thawj qhov kev xaiv rau kev kho mob ntawm Ed. Lawv muaj kev nyab xeeb zoo, thiab cov kev mob tshwm sim muaj mob taub hau, lub ntsej muag flushing, plab zom mov, tsis muaj zeem muag, myalgia thiab raws plab, tab sis qhov xwm txheej tsis muaj mob. Rau cov neeg mob uas tsis tau ua raws li kev kho PDE5I thiab muaj cov qib Androgen tsawg, lawv yuav tsum txiav txim siab nce cov qib androgen. Thaum theem hauv qab yog nce, qhov ua tau zoo ntawm PDE5I tuaj yeem txhim kho [76]. Kev ua tau zoo ntawm ntau PDE5I tam sim no ntawm kev ua lag luam rau kev kho mob ntawm Ed yog qhov sib txawv, tab sis muaj cov sib txawv ntawm qee yam (rooj 5) [{}]. PDE5I tuaj yeem siv hloov lossis ua ke nrog lwm cov tshuaj (xws li Epalrestat, Kallikrein, thiab cov pov thawj ntawm kev ua tau zoo thiab kev nyab xeeb kom muaj kev muaj zog ntxiv. Cov khoom siv rau kev siv PDE5I yog qhov sib xws sib xws: Nws yog cov neeg mob plawv, thiab cov neeg mob plawv dhia, thiab cov neeg mob uas muaj cov hypotatic hypotatic. Qhov kev xaiv ntawm PDE5I yog nyob ntawm qhov zaus ntawm kev sib deev ntawm kev sib deev thiab tus neeg mob txoj kev paub thiab nyiam rau cov tshuaj no.
Rooj 5 sib piv ntawm ob peb PDE5I
| Tus sildenafil | Tadalafil | Tsa suab | Avanafil | |
|---|---|---|---|---|
| Lub sij hawm rau siab tshaj plaws Plasma | 100-120} feeb | 120 feeb | 45 feeb | 20-40} feeb |
| Ib nrab-lub neej | 3-5} teev | 17,5 teev | 4-5} teev | 5 teev |
| Cov rog tau noj zaub mov zoo | Tau txais | Tsis muaj txiaj ntsig | Tau txais | Tsis muaj txiaj ntsig |
| PDE5 Xaiv | Plaub (10 zaug uas PDE6) | Ua ntej (700 lub sij hawm uas ntawm PDE6) | Thib peb (15 zaug ntawm PDE6) | Thib ob (100 npaug ntawm PDE6) |
| Kev cuam tshuam nrog -Receptor blockers | Tshwj tsis yog rau 25mg, nws tsis tuaj yeem siv lossis siv tib lub sijhawm raws li PDE5 Inhibitors, thiab koob tshuaj me yuav tsum siv | Nws tuaj yeem siv tau tib lub sijhawm ua -Receptor blockers, pib nrog koob tshuaj me, thiab kev ua kom tob tob tuaj yeem siv tib lub sijhawm | Nws tuaj yeem siv tau tom qab -Receptor blockers yog ruaj khov, pib nrog koob me me ntawm 5mg | Muaj kev pheej hmoo thaum siv ua ke; Cov koob tshuaj yuav tsum raug txo kom tsawg rau 5mg thaum siv ua ke |
② Dopamine receptor agonists
Apomorphine yog lub central dopamine receptor agonist uas ua rau dopamine d {} zoo li cov kev txhawb nqa ntawm hypothalamus, manifesting raws li kev txhawb nqa nruab nrab ntawm dopaminergic itecting. Ib qho ntxiv, apomorphine muaj kev tshwm sim hauv lub cav hluav taws xob (dopamine d {{1} Pab txhawb nqa erection, tab sis kom tsawg dua [82].
(2) Lub tshuab nqus tsev compression twj (vcd)
VCD siv lub siab tsis zoo rau tus qau kom kos cov ntshav hauv lub cav coris, thiab tom qab ntawd tswj hwm cov ntshav hauv lub corchernosum los ntawm kev siv cov kab ke ntawm tus qau. Nws muaj ob peb yam teeb meem thiab yog kev xaiv qis-them rau cov neeg mob uas muaj mob ntshav qab zib ed. Cov kev sib raug zoo ntawm VCD suav nrog kev mob siab rau lossis mob plab, plab congestion, tsawg dua cov kev tsis xis nyob. Vim tias qhov tsis yooj yim ntawm kev siv thiab lub neej ntawm kev mob tshwm sim, tus neeg mob ua tsaug rau tsis zoo.
(3) Tsawg-Zog Extractoure Poob Siab Weaps (Li-Eswt)
Li-eswt yog tam sim no txoj kev loj siv los kho cov vascular ed. Cov neeg mob ntshav qab zib thiab ed feem ntau muaj cov ciaj hluav taws xob puas tsuaj, yog li nws tuaj yeem suav tau rau kev siv. Cov kev tshawb fawb tau qhia tias li-eswt tuaj yeem txhim kho iaint thiab erection haccular ed, tab sis tsis tuaj yeem txhim kho cov tsiaj hemdynamic tsis sib haum. Rau cov neeg mob uas tsis muaj txiaj ntsig nrog PDE5I kev kho, li-es-eswt tuaj yeem txhim kho kev ua tau zoo ntawm PDE5I [83]. Cov kev kho mob tam sim no ntawm cov neeg mob ntshav qab zib thiab ed xav tau kev soj ntsuam ntxiv [84].
(4) Penpe Corpus Cavernosum Vasoactive Tshuaj Txhaj Tshuaj
Cov neeg mob uas tsis teb rau qhov ncauj tshuaj tuaj yeem tau txais kev txhaj tshuaj enteracavosal ntawm vasoaction tshuaj. Prostaglandin E1 (PGE1), papaverine, thiab phenolamine yog peb cov tshuaj feem ntau yog. Erection feem ntau tshwm sim 5 txog 15 feeb tom qab txhaj tshuaj, thiab lub sijhawm nyob ntawm cov koob tshuaj txhaj. Kev phom sij rau muaj kev phom sij, tsis zoo, cov quav txhaum, ntawm lub cortrus cavernum tom qab txhaj tshuaj ntxiv, thiab kev kis tau tus mob, thiab kev kis tau tus mob, thiab muaj kev kis tau tus mob, thiab muaj mob [85]. Hauv kev tshawb nrhiav hauv tsev kho mob, PGE1 feem ntau siv nyob rau ib leeg lossis ua ke nrog lwm cov tshuaj, prostaglandin E1 thiab phenyaglandin E1 thiab phenolamine E1 thiab phenolamine, uas tuaj yeem txhim kho kev ua tau zoo. Nyob rau tib lub sijhawm, vim muaj kev sib xyaw ua ke ntawm cov tshuaj, qhov koob tshuaj ntawm txhua cov tshuaj yog txo, uas txo cov tshuaj tiv thaiv kev puas tsuaj raws li. Prostaglandin E1 tuaj yeem ua rau kev npaj hloov chaw. Piv nrog kev txhaj tshuaj, nws tsis tshua muaj kev phem thiab siv tau yooj yim, tab sis nws qhov kev ua tau zoo yog qhov phem dua li ntawm lub cav hluav taws xob txhaj tshuaj.
(5) Kev phais mob
Kev phais mob ntawm cov ntshav qab zib ua ke nrog ed yog feem ntau zeem yoov thov (ppi). Thaum cov ntshav qab zib mellitus yog qhov nyuaj nrog ed thiab qhov ncauj siv tshuaj thiab lub cav muaj txiaj ntsig, lossis lub cav hluav taws xob tsis txaus ntseeg thiab kev cia siab los txhim kho kev ua haujlwm erectile los ntawm PPI. Tam sim no, lub hydraulic rhiab tau peb-thooj plaub-thooj prosthesis siv nyob rau hauv chaw kuaj mob tsuas yog muaj lub tog raj kheej, thiab lub hnab ntim dej. Cov twj tso kua dej yog cog rau hauv lub hnab ntim, lub hnab ntim dej yog cog rau hauv qhov chaw ua ntej zais pa, thiab lub tog raj kheej yog cog hauv lub cornus cavernosum ntawm ob sab. Peb ntu yog txuas los ntawm ib txoj hauv kev. Los ntawm kev nias lub taub dej hloov sab nraum zoov sab nraum zoov, cov kua nkag los yog ntws rov qab los ntawm lub hnab ntim dej kom kho cov thickness thiab hardness ntawm lub tog raj kheej [{3}}]. Nws cov teeb meem suav nrog kev mob siab thiab postperative teeb meem. Kev sib txuam nrog: Cross-perforation ntawm lub corpus cavernosum thiab Mediastinum, performation ntawm lub Corpus Caverosum thiab tunica albugineum thiab tunetal alcuginea, thiab ua urethal perforation. Kev sib txawv ntawm kev sib txawv ntawm cov neeg kho tshuab tsis ua haujlwm, kis tau mob, thiab mob. Qhov tshwm sim ntawm kev mob thiab tus kab mob yog cuam tshuam nrog qib ntawm cov ntshav ntawm cov ntshav qab zib [87,88].
3. Kev kho mob ntshav qab zib ua ke nrog cov kabmob ejaculers: ncua kev ejaculation lossis anejaculation muaj peev xwm kho tau nrog √-adrenergic recenor agonists; Anejaculation tuaj yeem kho nrog hluav taws xob ejaculation ntaus cov hluav taws xob txhawb nqa; Rau cov ntshav qab zib ua ke nrog kev ua kom ntxov ntxov, SSRIS lossis PDE5I tuaj yeem siv.
Cov neeg cov neeg mob ntshav qab zib uas muaj kev ntxhov siab, xws li cov tshuaj epeligrine, thiab lwm yam, vim tias cov tshuaj no tuaj yeem ua rau muaj kev xav txog lub zog thiab sab hauv Urethral. Cov neeg mob muaj kab mob plawv, tawg, thiab prostatic hyperplasia thiab prober [88,89], vim tias lawv yuav ua rau ntshav nce ntxiv, Tachycardia, Arthythmia, thiab tso zis cia siab. Ib qho ntxiv, rau cov neeg mob uas muaj qhov tsis muaj tshuaj, yog cov khoom siv hluav taws xob uas muaj peev xwm siv tau los siv hluav taws xob, yog li ua tiav ejaculation. Piv nrog cov pejxeem dav dav ntawm anejaculation, cov neeg mob muaj ntshav qab zib thiab qhov ntau zaus muaj cov kev ua tau zoo ntawm kev kho mob.
Ntshav qab zib feem ntau nrog kev ua kom ntxov ntxov [91,92], thiab nws cov siv tshuaj kho mob yog SSRIS. Dapoxetine yog kev pom zoo tam sim no, tab sis Sertraline tseem dav siv hauv kev tshawb fawb hauv chaw kho mob. Cov txheej txheem ntawm kev siv Dapoxetine yog coj 30 mg ntawm Dapoxetine 1-3 teev ua ntej txhua qhov kev sib deev; Los yog yog 30 mg tsis zoo tom qab siv, nce koob rau 60 mg yam tsis muaj kev phiv [93]. Yog hais tias dapoxetine tsis muaj txiaj ntsig zoo, lwm yam tshuaj xws li Sertraline thiab Popoxetine kuj tseem tuaj yeem sim. Txawm li cas los xij, kev saib xyuas yuav tsum tau them nyiaj kom tau cov kev mob tshwm sim xws li ntxhov siab, Mania, thiab kev hloov pauv tsis zoo. Ntxiv rau, PDE5I tseem siv tau los kho PE. Txawm hais tias tsis muaj kev txhim kho tseem ceeb hauv qhov paum ejaculation (iJT) Qhov no txo kev ntxhov siab thiab luv luv lub sijhawm rov ua dua tshiab ntawm kev rov ua dua tom qab ejaculation. Nyob rau tib lub sijhawm, cov nyhuv ntawm PDE5I ua ke nrog SSRIS hauv kev kho ntxov Ejaculation feem ntau zoo dua li ib hom tshuaj ntawm ib hom tshuaj ntawm ib hom tshuaj [94].
4. Kev kho mob ntawm txiv neej orgasm ua rau ntshav qab zib: Tam sim no, muaj qee cov kev tshawb fawb txog kev ua ntshav qab zib, thiab lawv feem ntau tsom rau cov poj niam. Tsis muaj phiaj xwm kev kho mob ntxiv. Txawm li cas los xij, rau orgasm qhov tsis txaus tshwm sim los ntawm ed thiab ejaculation kawg, cov hau kev saum toj no tuaj yeem sim kho kev kho mob. Tom qab lwm cov tsos mob sib deev yog relieved, orgasm qhov tsis muaj peev xwm feem ntau yog relievied raws li.
VI. Kev kho mob ntshav qab zib ua ke nrog txiv neej sib deev tsis sib xws
Ntshav Qab Zib Belongs rau qeb ntawm "Xiao Sib Tham" hauv TCM, thiab kev sib daj sib deev "," (Kev nyiam kev sib daj sib deev), "phev cia sia", "symen stasis" (tsis muaj ejaculation, "Ejaculation qaib" (ntxov Ejaculation), thiab lwm yam. [95]. Cov ua rau tus kab mob yog feem ntau lub raum tsis txaus, mob siab, ntshav kub, thiab lwm yam. Ameslikas cuam tshuam nrog lub raum tsis txaus. Ib qho ntxiv, kev kho tsis raug cai, lossis txhawj xeeb, kev nyuaj siab, qi thiab yin yog puas. Yog tias Xiao tus kab mob kav ntev, lub ntsiab lus tseem ceeb yuav ploj nrog cov zis, thiab tus po raum zongney zongin yuav tsis tau tu. Lub raum yuav tsis muaj zog ntxiv thiab poob nws txoj haujlwm ntawm kev ntxiv dag zog. Cov no yog qhov tseem ceeb pathogenesis [96]. For patients with diabetes and male sexual dysfunction, diabetes (polydipsia) is the root cause and sexual dysfunction (impotence) is the symptom. Kho lub hauv paus ua rau muaj tus kab mob thiab pab txhawb cov ntshav muaj txiaj ntsig zoo thaum kho yuav tsum yog qhov tseem ceeb ua ntej rau kev kho tus kab mob no; Nyob rau tib lub sijhawm, raws li qhov mob hnyav ntawm tus kab mob thiab nws cov teeb meem, ob peb tus tsos mob yuav tsum raug txiav txim siab thiab kev kho mob yuav tsum ua raws cov kev sib txawv. Kev kho mob ntshav qab zib thiab cov txiv neej deev tsis zoo nrog cov tshuaj suav suav yog yooj yim thiab muaj ob peb kev phiv. Nws suav nrog kev tswj hwm qhov ncauj, acupuncture, thiab plaster ntawv thov. [97]
(Kuv) Cov tshuaj noj ntawm qhov ncauj ntawm qhov ncaujKev sib txawv thiab kev kho mob yog qhov tseem ceeb ntawm kev kho mob suav tshuaj ib txwm muaj. Tshuaj Suav Suav ntseeg tias cov ntshav qab zib thiab kev sib deev sib deev tuaj yeem faib ua tsis muaj peev xwm thiab dhau los lossis dhau mus. Yog li ntawd, kev kho mob yuav tsum xub paub qhov txawv thiab tshaj. Cov ua rau muaj kev tsis sib haum xeeb vim yog qhov ntub dej muaj cua sov, Qi stagnation, thiab ntshav stasis. Sib txawv sib txawv yog siv los kho dampness, tswj hwm qi, thiab ua kom cov ntshav ncig. Cov ua rau muaj kev tsis taus vim yog tsis muaj raum muaj xws li raum tsis txaus, tsis muaj peev xwm ntawm ob lub plawv thiab tus po, thiab tsis muaj peev xwm ntawm ob qho QI thiab Yin. Cov hau kev kho mob suav nrog kev pab txhawb nqa raum, ua kom sov raum thiab txhawb nqa lub siab thiab mob plab thiab tu ntshav qi thiab yin. Cov ua rau muaj kev sib xyaw ua tsis txaus thiab muaj ntau dhau los suav nrog lub raum tsis muaj zog thiab ntshav, lub raum tsis muaj peev xwm thiab kev sim siab. Cov hau kev kho mob suav nrog kev siv zog tiv thaiv raum thiab soothing lub siab, thiab txhawb nqa raum thiab txhawb cov ntshav ncig.
Cov ntshav qab zib ntawm cov ntshav qab zib ua ke nrog kev sib deev tsis yog ywj pheej thiab feem ntau qhia tau ib qho kev sib txuas nrog sib tshooj. Peb yuav tsum nkag siab cov lus tsis sib haum xeeb thiab ua kom yooj yim yooj yim. Qhov kev pom zoo no yog raws cov ntawv tshawb fawb thiab sau cov ntsiab lus tseem ceeb [1, 96, 98].
Ntshav qab zib ua ke nrog kev sib deev feem ntau qhia tau tias cov neeg mob ntshav qab zib tau muaj ntau xyoo, lossis erection tsis yog khov kho; lossis ejaculation tshwm sim tam sim ntawd thaum sib deev, lossis nws yooj yim rau ejaculate thaum erection yog erection; lossis kev ntshaw kev sib deev yog txo; lossis orgasm yog tsis muaj; Tsis muaj ejaculation lossis retrograde ejaculation.
1. Khiver qi stagnation syndrome:Ntxiv rau cov tsos mob tseem ceeb, tseem muaj kev nyuaj siab, xyav, lossis lub plab lossis sab hauv qab, nyias cov plaub hau dawb, thiab cov mem tes tawv. Kev kho mob: Soothe lub siab thiab txo kev nyuaj siab. Tshuaj: Xiao San (Taiping Huimin Hejijuafang) nrog kev hloov kho. Tshuaj Ntses Suav Tshuaj Suav tuaj yeem pom zoo kom coj Sharan Yiyang Capsules ntawm lub siab thiab ua kom muaj kev nyuaj siab, txhawb cov ntshav ncig thiab txhawb nqa lub raum. 4 lub tsiav tshuaj ib zaug, 3 zaug hauv ib hnub, 4 lub lis piam ua ib txoj kev kho mob.
2. Qi stevnation thiab ntshav stasis syndrome: ntxiv rau cov tsos mob tseem ceeb, tseem muaj cov xim xiav tsaus nti, thiab puldeal, thiab purple purple tus nplaig lossis cov mem tes thiab cov mem tes. Kev Kho Mob: Txhawb Qi thiab ua kom cov ntshav ncig. Tshuaj: Shafu Zhuyu Decoction (Yilin Gaiicuo) nrog kev hloov kho [96,99]. Raws li rau Suav cov tshuaj patent, Shanhaidan Granules tuaj yeem pom zoo. Nws tuaj yeem ua kom cov ntshav ncig thiab dredge colluraterals. Nws tuaj yeem coj nrog dej npau npau, 1 lub hnab (10G) ib lub sijhawm, 3 zaug hauv ib hnub, tom qab noj mov.
3. Cub-cua sov syndrome:Ntxiv nrog rau cov tsos mob tseem ceeb, tseem muaj dampness thiab tsw qab nyob rau hauv lub qhov ncauj, thiab flank tsis txaus ntseeg, thiab txoj hlua khi lossis tawv nqaij mem tes. Kev Kho Mob: Ntshiab Thaum Tshav Kub Kub thiab Tshem Tawm Dampness. Tshuaj Yuav Ntaub Ntawv: Longdan Xiegan Decoction (Yi Fang Jijie) lossis Cheng Dixie Fenqing Yin (Yi Xue Xin Wu) [100]; Raws li rau Suav cov tshuaj patent, Longjin Tonglin Tshuaj ntsiav yuav raug pom zoo rau kev siv qhov ncauj. Nws tuaj yeem ua kom tshem cov cua sov thiab tshem tawm cov dampness, tshem tawm ntshav stasis thiab daws cov stranguria. 2-3 tsiav tshuaj ib zaug, 3 zaug hauv ib hnub.
4. Qi thiab yin deficiency:In addition to the main symptoms, there are also symptoms of fatigue, shortness of breath, laziness, dry throat and mouth, thirst, red cheeks in the afternoon, scanty urination, dry stool, thin tongue, less and dry coating, and weak pulse. Kev Kho Mob: Rov ua dua Qi thiab khoom noj khoom haus yin. Cov tshuaj yuav: Yuanan tshuaj (xizhu ntawm lub keeb kwm ntawm cov kab mob tsis zoo) lossis youye decoction (cov ntaub ntawv kho mob ntawm zhongzhong canxi) nrog kev hloov kho. Tshuaj Kho Mob Suav Pent tuaj yeem pom zoo li Haima hav zoov ntsiav tshuaj, uas nyuam qhuav los no los sis raum, 10 ntsiav tshuaj ib zaug, ob zaug ib hnub.
5. Lub siab thiab tus mob tus syndrome:Ntxiv rau cov tsos mob tseem ceeb, tseem muajCov tsos mob ntawm tsis muaj lub zog, insomnia thiab hnov qab, timidity thiab kev ua xyem xyav, palpitations thiab curontaneaneous tawm hws, tsis zoo qab los, lossis npau suav tsis zoo thiab xeev siab, daj ntseg dawb, thiab tsis muaj mem tes dawb, thiab qaug zog mem tes, thiab qaug zog mem tes, thiab qaug zog mem tes, thiab qaug zog mem tes, thiab qaug zog mem tes, thiab qaug zog mem tes, thiab qaug zog mem quav, thiab tsis muaj mem tes dawb Kev Kho Mob: Rov qab lub siab thiab tus po. Tshuaj: Guipi Decoction (Zhengti Leiyao nrog kev hloov kho [101]. Cov tshuaj noj Suav patent uas tuaj yeem pom zoo suav nrogDikeng Kangka ntsiav tshuaj, Bu Shen Qiang Shen ntsiav tshuaj, uasnourish lub raum thiab ntxiv dag zog rau lub cev, ntxiv dag zog rau tus po thiab tu lub siab. Nqa 5 ntsiav tshuaj ib zaug, 3 zaug ib hnub.
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6. Timney yin deficiency:Ntxiv rau cov tsos mob tseem ceeb, tseem muaj kiv taub hau, ua npaws, tus nplaig me me, kua txiv liab, thiab cov mem tes tob thiab zoo me thiab huv si. Kev kho mob: Yis Yin thiab tonify lub raum. Tshuaj: Liuwei Dihuang tshuaj (xiaoer yaozheng Zhijue) nrog kev hloov kho. Cov tshuaj noj hauv tsev noj mov Suav tuaj yeem pom zoo suav nrog Luwei DiWhang ntsiav tshuaj thiab xianlue kua tshuaj thiab cov uas muab kev txhawb nqa raum thiab tonify yin. Siv sijhawm 8g ntawm liuwei dihuang tshuaj ib zaug, ob zaug ib hnub; Siv 10ml ntawm xianlu ntawm lub sijhawm ua kua rau ib lub sijhawm, 3 zaug ib hnub. Ib chav kawm ntawm kev kho yog 3 lub hlis.
7. Raum Yaj Synudome.. Kev Kho Mob: Ua kom sov thiab toninging rabney yang. Cov tshuaj yuav: TheGui tshuaj (Jingyue tiav phau ntawv) nrog kev hloov kho [96]; Tshuaj Ntses Suav Tshuaj Suav tuaj yeem pom zoo kom coj koj cov tsiav tshuaj thiab cov tshuaj yaj kiab, 4 tsiav tshuaj, 3 zaug hauv ib hnub.
8. Yin thiab Yang deficiency:Ntxiv rau cov tsos mob tseem ceeb, tseem muaj qhov chills, qaug zog, ua kom lub taub hau daj, txo cov plaub hau, thiab qhuav thiab tob mem mem tes. Treatment: warming yang and tonifying the kidney, replenishing qi and nourishing yin, unblocking meridians and activating paralysis. Tshuaj: Epxian Los ntawm phau ntawv kho mob ntawm Suav tshuaj cov tshuaj), lossis (sib xyaw ua ke), lossis cov tshuaj ntsuab Tshuaj Kho Mob Suav Paus Suav tau pom zoo rau Guilji tselules, {}}. Ib zaug ib hnub, 2 teev ua ntej noj tshais nrog lub teeb ntsev.
9. Syndrome ntawm lub plawv-raum ceev:Ntxiv rau cov tsos mob tseem ceeb, tseem muaj kev npau suav tsis ntev thiab caj pas, kev qaug zog, kiv cua dub, thiab lub ntsej muag liab, thiab nyias thiab nyias cov mem tes. Kev kho mob: haus dej haus thiab tshem lub plawv, thiab txuas lub plawv thiab raum. Tshuaj: Jiaotai ntsiav tshuaj (wanbing Huichun) lossis Tianwang Buxin Dany DAN (annotated tshuaj rau cov poj niam) nrog ntxiv thiab rho tawm; Tshuaj Ntses Suav Tshuaj Patent kom tau pom zoo kom coj cov tshuaj ntsiav tshuaj noj uas tau noj cov tsiav tshuaj, 3 tsiav tshuaj ib zaug, 3 zaug hauv ib hnub. Tsis tas li ntawd, muaj 2 ntau cov kev ua si hauv tsev kho mob: Lub raum tsis muaj zog thiab daim siab nyuaj siab hom, lub raum tsis muaj zog thiab cov ntshav stasis.
(II) Acupcture: Guanuan, shenshu, senseyinjiao, mingmen, baihui, taixi, zusanli. Thawj peb lub ntsiab lus yog moxibusited, thiab tus so yog acupunctured rau tonify lub cev, yog li ntawd kom sov cov ntsiab lus ntawm lub plab yog kis tau rau qhov chaw mos. Nws haum rau txhua hom neeg mob. Cov ntsiab lus tseem ceeb yog Dehe thiab mingmen, thiab cov neeg saib xyuas cov ntsiab lus yog zusanli, qihai, thiab Guanan. Nws yog qhov haum rau cov neeg mob nrog lub raum tsis txaus thiab cov ntsiab lus tsis txaus. Cov ntsiab lus tseem ceeb yog Shenshu, Mingmen, thiab Guananuan. Rau cov neeg mob nrog lub raum tsis txaus, qiihai, shenque, thiab zusanli muaj ntxiv; Rau cov neeg mob uas muaj raum tsis txaus, taixi thiab sanyinjiao ntxiv; Rau cov neeg mob nrog daim siab kev nyuaj siab, Ganshu thiab Taichong tau ntxiv; Rau cov neeg mob nrog tus mob tus mob tsis txaus, pishu thiab zusanli muaj ntxiv. BingPuncture Peaduncture: Jinggong, Sab nraub qaum, cov noob qes, Pingjian, paj hlwb, txaj muag, thiab endocrine raug xaiv. Nws haum rau txhua hom neeg mob [96, 102].
(III) Kev Kho Vaj Tse Nrog Suav Tshuaj:
Kev kho sab nraud nrog suav tshuaj muaj qee yam cuam tshuam rau cov neeg mob ntshav qab zib thiab kev sib deev sib deev, tshwj xeeb yog ejaculation ejaculation. Suav Tshuaj Npaj Npaj tau ncaj qha rau cov Glans Chasis thiab ua haujlwm los ntawm kev nqus cov hauv zos, thiab ua tiav lub hom phiaj ntawm kev txhim kho tus neeg mob txoj kev sib deev zoo. Feem ntau, suav tshuaj nrog cov ntxhiab tsw tsw thiab tsis muaj ntxhiab yog siv los ua cov tshuaj pleev sab nraud, xws li ntxuav yeeb yaj kiab / 103].
(Iv) Kev Coj Tus Cwj Pwm Nrog Suav Tshuaj:
Txoj kev ua yeeb yam ntawm kev sib deev npog cov kev kho mob ntawm cov kab mob sib deev, cov txheej txheem ntawm kev sib deev ntawm peb lub ntsej muag, ntawm kev ua pa ntawm kev sib deev rau kev sib deev yog maj mam tsim tau thiab rov qab.
Daim duab 3 Ntau cov qauv kev sib koom tes sib koom tes rau cov txiv neej muaj ntshav qab zib thiab kev sib deev tsis sib xws
VII. Ntau hom kev sib koom tes
Kev kuaj mob thiab kho cov ntshav qab zib ua ke nrog kev sib deev yuav tsum qhia txog kev sib deev ntau yam (daim duab 3). Cov neeg mob ntshav qab zib feem ntau muaj ntau yam kab mob xws li cov rog, cov kab mob siab, pw tsaug zog apnea, thiab lwm yam uas cuam tshuam nrog kev sib deev. Kev tswj ntshav qab zib tsuas yog kev kho mob tshwj xeeb tshaj yog rau kev tiv thaiv thiab kho ntshav qab zib ua ke nrog kev sib deev. Rau cov neeg mob uas muaj kev sib deev nrog kev sib deev, cov ntshav qab zib ua yeeb yam tsis muaj ntshav qab zib lossis cov tso kua qab zib, tshwj xeeb rau tsev neeg keeb kwm ntawm cov ntshav qab zib. Txawm hais tias muaj cov tsos mob ntawm cov ntshav qab zib, nws tau pom zoo kom mus rau lub chaw haujlwm endocrinology los soj ntsuam cov metabolism hauv qab zib. Thaum cov neeg mob ntshav qab zib ua ke nrog kev sib deev muaj kev tswj hwm ntshav qab zib endocrinology kom pom zoo, kev taug qab thiab kho cov metabolism; Thaum endocrminologists pom cov neeg laus nrog cov ntshav qab zib tsis zoo, nws raug nquahu kom cov neeg mob txog lawv txoj kev sib deev zoo thiab muaj nuj nqi. Yog tias muaj kev txawv txav, nws pom zoo kom mus rau chav haujlwm Andrology rau kev tshuaj ntsuam xyuas thiab kho cov kev sib deev. Rau cov neeg mob uas muaj lwm yam teeb meem xws li kev rog, kev kub siab, hyperlipidemia, kev pw tsaug zog apnea, thiab lwm yam tuaj yeem sab laj rau kev kuaj mob thiab kho mob.
Hauv ntej, kev kuaj mob thiab kev kho mob ntshav qab zib ua ke nrog kev sib deev yuav tsum qhia txog kev sib koom tes. Ntau yam kws txawj sib tham tham txog kev kuaj mob thiab kev kho mob nyob ib ncig ntawm cov neeg mob los ntawm kev sib txuam ntawm cov kev xav ntawm ntau yam kev coj txawv. Tshwj xeeb tshaj yog thaum kuaj mob thiab kev kho mob yog tsis muaj txiaj ntsig, txoj kev npaj khomob nrog kev koom tes nrog cov neeg mob yuav pab tau tus neeg mob ntau dua.
VIII. Kev Tiv Thaiv Ntshav Qab Zib ua ke nrog txiv neej kev sib deev tsis zoo
Kev tiv thaiv cov ntshav qab zib ua ke nrog kev sib deev nrog rau cov neeg mob ntshav qab zib thiab / lossis mob ntshav qab zib, thiab mob ntshav qab zib, thiab lwm yam ntawm cov ntshav, thiab lwm yam los ntawm "tsis zoo Metabolic Nco "; (2) Rau cov neeg mob kuaj ntshav qab zib, tshuaj yeeb thiab lwm txoj hauv kev los tiv thaiv lossis ncua kev hloov pauv ntshav qab zib pathologhology.
(I) kev ua neej ua neej
Txoj kev ua neej zoo tshaj plaws suav nrog kev noj haus, kev tawm dag zog, psychology thiab lwm yam. Xaiv kev noj qab haus huv ntawm kev noj qab haus huv, kev tawm dag zog, kev tswj hwm kev haus dej haus, kev tswj hwm kev sib deev ntawm lub neej thiab kev tswj hwm kev sib deev thiab tswj kev sib deev.
1. Tsim Nyog Kev Ua Haujlwm thiab Kev Tswj Xyuas Nyhav [104,105]
Kev tawm dag zog tsis tu ncua yog ib txoj kev yooj yim thiab tau los tiv thaiv qhov tshwm sim ntawm kev sib deev tsis zoo nyob rau hauv cov txiv neej mob ntshav qab zib. Nws tuaj yeem txhim kho cov insulin rhiab heev, txhim kho cov piam thaj lipolism, txhim kho cov methabolism, thiab qeeb qeeb thiab kev loj hlob ntawm cov ntshav qab zib thiab ntshav qab zib sib deev.
2. Kev kho mob kev cuam tshuam kev cuam tshuam [{106-108
Kev kho mob kho mob yuav tsum qhia txog kev noj zaub mov zoo nrog cov qauv kev tsim nyog xws li cov tshuaj carbohydrates xws li cov carbohydrates, protein, sodium, ntsev thiab phosphorus. Tag nrho cov calorie txhua hnub yuav tsum pab kom tus neeg mob kom muaj qhov hnyav zoo tshaj plaws thaum muaj kev xav tau kev noj haus.
Nws raug nquahu kom noj glycemic qis (qis gi) carbohydrates, txiv ntseej cov ntses, nqaij, cov khoom noj txiv hmab txiv ntoo thiab cov nqaij liab, thiab lwm yam.
(II) Tswj cov kab mob pib thiab tu cov neeg koom tes [109-112]
Kev mob siab rau cov kab mob xws li ntshav siab, hyperlipidemia, thiab kev puas siab puas tsuaj tuaj yeem ua rau kev sib deev dawb paug. Yog li ntawd, kev tswj hwm kev tswj ntshav siab, kev rog thiab kev rog yog qhov tseem ceeb rau kev ncua cov kab mob thiab tus kab mob. Cov tshuaj tiv thaiv kab mob ntau yam tshuaj tiv thaiv kab mob (tshuaj tiv thaiv kab mob lipid-txo qis, tiv thaiv kev ntxhov siab thiab kev nyuaj siab pab cov neeg mob zoo dua; Ib qho ntxiv, kev saib xyuas thiab kev txhawb nqa ntawm tus neeg mob tus khub yog qhov tseem ceeb sib luag rau kev ncua cov kab mob.
(III) Kev tiv thaiv yeeb tshuaj ntawm vascular thiab neuropathy [7,23,64, {3}}]
Rau cov neeg mob tau kuaj mob ntshav qab zib lossis cov kev sim ua kom pom tseeb tias kev tawm tsam kev sib deev thiab qeeb los ntawm kev tawm tsam kev sib deev, txhim kho microcirculation, thiab tiv thaiv cov hlab ntsha, thiab tiv thaiv cov leeg; Rau cov neeg uas muaj cov pov thawj meej ntawm cov kab mob muaj feem cuam tshuam thiab / lossis cov kab mob sib tw, kev txhim kho kev sib deev tuaj yeem tiv thaiv los ntawm cov tshuaj kho mob (saib cov ntu kho tshuaj).
(Iv) kev qhia pob txha hauv siab hauv qab [120,121]
Cov kev tshawb fawb tau pom tias pelvic pem teb qoj ib ce thiab biofeedback tuaj yeem tiv thaiv kev ua kom poob siab hauv pem teb kev ua haujlwm, thiab tseem muaj txoj hauv kev kho tus txiv neej kev sib deev. Tom qab 3-6 lub hlis ntawm pelvic pem teb kev cob qhia, iasas cov qhab nia tau txhim kho thiab erectile muaj nuj nqi tau txhim khu.
