Essential Hypertension And Erectile Dsyfunction (ED): TCM And Modern Diagnosis

Essential Hypertension (EH) is a complicated disease. It may be caused by genetic or environmental factors. A number of environmental factors causing EH have been identified. EH is a serious and common disease that affects human health and is even life threatening. A survey done by the Chinese National Health Bureau showed that 18.8% of the Chinese population are suffering from EH. The ratio in the city is about 19.3%, and in the village is about 18.6%.The problems of EH patients are not only Hypertension itself, but other syndromes that come along with EH which affect their psychological, physical and daily activities. Proper treatment can reduce its side effects and death rate. EH can affect patients'lives, physical ability and blood circulation system. Majority of the EH patients require a long or even life-time medication. There are many different drugs for curing EH. While some can help control EH, it lowers the patients'quality of life.Sexual malfunction refers to a number of factors which affects sexual life physically and psychologically. Male or female of different ages can be affected by these factors. Erectile Dsyfunction (ED) alone is bothering about 10% of male population. Other problems, for example, the lack of sexual interest, is affecting 10-30% of female population.Normally, ED was considered to be caused by psychological disorder. However, recent researches showed that both physical and psychological factors play an important role in the cause and development of sexual dsyfunction. For example, pennis erection is a process in pumping blood into its sponge tissues. Any malfunction to its blood circulation can cause ED. However, the psychological condition of the patient itself, e.g. fear of ED and self-abased, can also make ED more complicated and serious. Overall speaking, most of the sexual dsyfunction problems are caused by multiple factors.Treatment for sexual malfunction is also multi-facet. Detailed treatment depends on the type of dsyfunction and its seriousness. Sometimes, medical treatment is not necessary. It can be treated by psychologists, occupational therapists and nurses. A number of patients showed a good improvement by just explaining to them their conditions, and with some psychological or behavioral treatments.On medication, ED can be treated by either oral or injection method. To be more effective, medication has to be combined with psychological and behavioral treatments. In most cases, since medication may have side effects, it is necessary to consult physicians before any medication is started.Sexual malfunction will not only affect individual's quality of life, it will also jeopardize marriage and family life. With medicinal advancement, many sexual malfunctions can be cured. Patients initiating treatments are not immoral. In the contrary, early treatment and support by sexual partner is vital in the treatment process. Therefore, professional advice should be sought as soon as possible if there is suspected cases of sexual malfunction.Clinically, the symptoms of hypertension include reddish face, dizziness, headache, easy to become angry, which are the same as the symptoms for Liver Yang Hyperactivity (LYH,肝阳上亢). Traditional Chinese Medical doctors believe that kidney deficiency can cause liver problem. They are inter-related. So kidney deficiency is the root cause for ED.TCM doctors recognized that ED is related to kidney function. Only when the kidneys are functioning properly, sexual organs can then be in good condition. TCM and western doctors have similar understanding on the causes of ED; it includes stress, too many sexual activities, infections, accidents and chronic diseases.TCM doctors use "holistic diagnosis and treatment ideology"(辨证的方法),according to the major symptoms and other minor symptoms, in deciding the type of EH and provide treatments accordingly. The root cause is the imbalance of Yin and Yang. Other causes of liver deficiency include stress, bad temper and bad eating habits. These are the factors for the two types of hypertension, LYH,or Sputum/Mucus Diffusion(SMD,痰湿壅盛).As hypertension develops, it starts to affect kidney function as well. It causes the other two types of hypertension, Yin Deficiency/Yang Hyperactivity (YDYH,阴虚阳亢)and Yin/Yang Deficiency (YYD,阴阳两虚).ObjectivesThis research uses TCM and Modern diagnostic method to study erectile dysfunction. The three major objectives are as follows:-1. To provide clinical support to the relationship between age and ED with EH patients.2. To provide theoretical support on TCM and Modern diagnosis on ED with EH patients.3. To provide guidance on ED treatment for EH patients.TCM treatment on EH, especially on improving health conditions, are of tremendous success. However, some researches pointed out that it does not provide comprehensive treatment. It does not provide a holistic picture of the patient's quality of life (QOL), not to mention their sexual ability.Some researches showed that EH and ED have a very close relationship. This research looks into the extent of ED with EH patients. This study uses the title "TCM and Western diagnosis of ED with male EH patients ", adopts TCM and Modern diagnostic methods on EH with 4 different types of Chinese ED, studies the differences amongst these 4 types and uses IIEF survey in collecting samples. The result was used in supporting the clinical findings and in providing theoretical support.Research DesignThis research makes reference to non-EH patient as a comparing group. It samples male EH patients with age between 40 and 69. It compares ED ratio and aging effect of EH patients and patients without ED. There are 527 samples with EH patients. In the comparison group there are 82 samples.ResultsThe results showed that in the control group of male aged 40-69, the ED rate is 40.2%. In the EH group, ED rate is 54.5%. When compared to other research results, they are similar. For example, with the MMAS test, ED rate is about 52%. And the severity of ED rises with age in moderate and serious ED patients. It was concluded that ED increases with age in EH patients.This research uses two independent samples. "t test" was used to compare the ED ability of EH and non-EH group. Levine's test result showed thatα= 0.000< 0.05, therefore equal variance was not assumed. Under this condition, t=-3.58, p= 0.000. We further compared the mean for the two groups, it was 21.87 for EH group and 23.67 for the non-EH group. It was concluded that when comparing to non-EH group, EH group has a poorer performance on ED ability, which is considered significant in statistical findings.Using ANOVA, the four types of TCM diagnosis and the other group as well, have significant differences:F= 8.955, p< 0.000. Comparing the means of these five differential types, the type YYD has a significantly poorer performance on all sexual abilities than the other 4 types. It also deduced that EH patients with TCM diagnosis as YYD will have more serious ED problem.After the regression analysis, we cannot prove statistically that the types, including LYH, SMD and others, are significantly related. The other two types, YDYH,YYD are significantly related to the formation of ED. It provides theoretical support to clinical diagnosis. It also provides guidance on the use of medication and preventive measures. ConclusionIt was found that the ED rate for EH patients equals to 54.5%. When diagnosing EH patients with both Western and TCM methods, the YDYH and YYD are easier to develop into ED. Clinically, we can pay more attention to patients with these two types. If they already had ED, physicians can treat them accordingly. If they do not have ED, preventive measures should be taken, so that patients will have a lower chance of getting ED.Because of time constraint, it was not possible to collect more data. However, the statistical results were satisfactory and significant results can be deduced. It provides empirical proof that ED and age have a direct relationship. Futhermore, EH patients are more vulnerable in getting ED.Theoretically, it provides support to the use of Western and TCM diagnosis of ED together and fill the gap in this reaserch area. Clinically, it provides theoretical support and guidance in the treatment and prevention of ED.In answering the questionnaire, there are a lot of missing data which is common in self-assessed reporting. The missing rate in this research is 11%, and the missing data was all excluded from the data analysis. If the missing data rate is lower, the accuracy and reliability will be futher improved. With the time and resources constraints, medication test was not done. Future direction was to use Chinese medicine on YDYH and YYD EH patients with ED. By following up and observing the effectiveness, it will provide clinical proof to the developed theory. One more step forward will be to use new medicines or prescriptions to improve recovery rate and ease of use.