Clinical Research On The Interventional Treatment Of Spinal Manipulation Against Premature Ejaculation(PE)

The premature ejaculation is a very common ejaculation disease caused by the decreasing of patients' ability of controlling ejaculation by self-determination, which causes ejaculating quickly before or after the insertion or the sexual intercourse being not able to persist to satisfy both sides.This condition often lasts or takes place repeatedly.The mechanism of this disease has not been discovered clearly.Most people think the reason lies in not only some unconventional psychical sex tendency such as blahs,discomfort,worry,force syndrome and hostile mental state,but also some neuropathic pathologic disease which causes disorder of ejaculation function inducing premature ejaculation because of the penis getting sensitive.By the TCM theory,the occurring of the premature ejaculation relates to the disfunction of the visceras of heart,liver,spleen and kidney,in which the excess or insufficiency of YIN and YANG in kidney are most common.The mechanism is conclude as deficiency of YIN and excess of YANG,excess of heart fire,deficiency of heart and spleen,deficiency of QI in heart and gallbladder,damp and hotness in liver and deficiency of QI in kidney,which leads to disorder of the production and eduction of JING。But there are the disadvantage of more side-effect or less effects in both morden medicine and TCM.We hope this research will find the mechanism of this disease by the ideas of combination of morden medicine and TCM,and more effective theory and means,as well as verify the validity of this therapy in clinical research.In terms of theory research,we consider that the course of ejaculation is completed by sympathetic nerve,sub- sympathetic nerve and the body nerve.The sympathetic nerve adjusting ejaculation comes from the sympathetic ganglion on the side of pectoral and lumbar acanthi(T10～L2),which makes up of lumbar sympathetic nerve net by the efferent nerve fibre.Then the nerve goes through the iliac artery trunk,makes up into under-stomach plexus,which gives off post- acanthi fibre going into bladder neck,prostate,spermaduct and spermatophore.The sub-sympathetic nerve which adjusts ejaculation by the help of the pubic nerve comes from the surrounding of the sacrum rachis(S2～S4),and make up the basin plexus in the basin,the fibre comes from which goes into the bladder neck also.The route of the mentioned nerve is born on the rachis.Treatments to the rachis can act on the adaption of neural function,which may be used to cure the premature ejaculation.In the TCM,the premature ejaculation concerns with the collapse of kidney,heart and spleen and damp and hotness of liver.The author thinks that the mechanism of premature ejaculation is a kind of "false exciting",similarly to spermatorrhea.Based on the stand view of ZuDanxi about "kidney in charge of storing,liver in charg of releasing,the two of them having fire in them,which belongs to heart",we regard that the therapy of this disease should be built on the theory of "axis of heart-kidney-semen",and take the Jing of REN and DU and kidney as the key mechanism to adjust the YIN and YANG of body by the technique of spine manipulation.The ejaculation reflex is mediated not only by the spinal ejaculation centre,but also by ejaculation centre of the brain,which controls the latter.Deficiency of the knowledge,overly tension,or agitation,bad cooperation,all of those Patients with PE usually have,can lead to dysfunction of the brain ejaculation centre and result in functional impairment of ejaculation,accompanied with anxiety,depression,tension,disappointment.Ever since the Master-Johnson method was set up,the behavior therapy has been used as one of the main treatments of PE.The behavior therapy can contribute to controlling ejaculation reflex which is one offunction of human cerebral cortex,and inhibit irritability of the ejaculation centres in brain and spine so that the great urgency to ejaculate can be released,and penile sensitivity threshold can be raised.Patients are learned to experience the feeling just before orgasm again and again,in order to set up new ejaculation reflex.It is also a effective method that can propagate sex knowledge and sex skills to couples,which is more impotant in our society of conservative sex attitudes.In the clinical research,57 PE patients were ramdomly devided into treating(27) and single behavior therapy(30)groups.In the treating group,patients were treated with spine manipulation and behavior threpy.In the single behavior group,patients were treated with behavior therapy.The IELT,CIPE-5 scores,wife sexual satisfaction of these patients were recorded and statistically analyzed,to assess and compare the differences between the two groups.In this clinic research,all of the patients who can be found obvious pressive pain spot near the spine which distributes on the right or the left.There are one patients whose spine bends from the side.There are also 52.6%of the patients who feel lumbar ache,and all of whose sacrum and ilium get slip from each other.The distributing of these positive syndrome keeps consistent with the parts of rachis which are in charge of the centrum of ejaculation(substrate of pectoral and lumbar acanthi and sacrum part of spine).After one month's therapy,the IELT,CIPE-5 scores for both groups turned out to be better obviously(P＜0.01).After the therapy of spine manipulation,with behavior at the same time,the items of time of ejaculation,and the CIPE-5 score for the treating group are both better than the control group The patients get more obviously whose syndrome turn better for the treating group,but the effects is also obvious for the control group(P＜0.01).The above results indicate the effects of the spine manipulation with acupuncturing is affirmatory and better than single behavior therapy.And it is also confirmed that the mechanism of premature ejaculation has relation with sacrum and ilium getting slip from each other.