A Comparative Analysis Of Traditional Chinese Medicine Textbook Patterns Of Erectile Dysfunction And Clinical Case Studies

Objective:Modern English language internal medicine textbook patterns of erectile (ED) dysfunction do not match the current clinical reality. These textbooks give equal weight to any number of patterns, most often list kidney yang vacuity first, and only list a limited number of patterns. By comparing 40 clinical cases collected in the Jiangsu Provincial Hospital’s Andrology Department between 2011 to 2013 to modern English internal medicine textbooks on Chinese medicine, this paper shows the fundamental differences between the two.Methods:Two types of research methods were used to gather data for comparison. First patterns were systematically collected and recorded by textbook review. Second ED case studies were systematically collected for empirical data on patterns from the Jiangsu Hospital of Traditional Chinese Medicine Andrology Department. In the second stage, this information was reviewed, standardized and organized according to pattern data before being compared to results.Results:A literature review of 5 included textbooks revealed that there were ten distinct TCM patterns. The most common pattern per textbook was kidney yang vacuity (100%), followed by liver depression (100%), damp heat flowing downwards (100%), heart spleen dual vacuity (80%), impairment of kidney due to fright (60%), heart gallbladder qi vacuity (20%), blood stasis due to cold (20%), kidney yin vacuity (20%), jing vacuity (20%) and liver cold (20%).From 40 clinical cases,8 distinct TCM patterns for erectile dysfunction were identified. The most common pattern per patient was kidney yin vacuity (70%), followed by liver depression (32.5%), damp heat flowing downwards (27.5%), phlegm damp obstructions (12.5%), kidney yang vacuity (12.5%), heart and spleen dual vacuity (10%), impairment of kidney due to fright (7.5%) and blood stasis accumulation (2.5%).Many patients suffered more than one pattern concurrently. On average each patient suffered from 1.75 patterns.14 cases (35%) were a single pattern while 26 cases (65%) were multi-pattern.The multi-patterns found, from most to least common of total cases were:kidney yin vacuity+liver qi depression (20%), kidney yin vacuity+damp heat flowing downwards (15%), kidney yin vacuity+kidney yang vacuity (7.5%), phlegm damp obstruction+spleen and heart dual vacuity (7.5%), kidney yin vacuity+kidney yang vacuity+damp heat flowing downwards (5%), damp heat flowing downwards+impairment of kidney due to fright (5%), damp heat flowing downwards+liver depression (2.5%) and damp heat flowing downwards+blood stasis accumulation (2.5%).Conclusion:All collected and analyzed clinical case patterns appeared within the textbook literature. However, unlike clinical cases patterns, only a single textbooks included the following patterns: kidney yin vacuity, phlegm damp obstructions, blood stasis accumulation, which was (70%), (12.5%) and (2.5%) respectively. Additionally, contrary to the textbook patterns, no cases of, heart gallbladder qi vacuity, liver cold, blood stasis due to cold, or jing vacuity were discovered. Again, all of these patterns were limited to a single textbook.Liver depression, damp heat flowing downwards, heart spleen dual vacuity, Impairment of kidney due to fright patterns, are important textbook patterns. While kidney yang vacuity always held the first listing in the textbooks, it did not appear to be a major pattern for the patients included in this study. Lastly, it is interesting to note how common the kidney yin vacuity pattern was for ED patients. Only a single textbook included kidney yin vacuity. We suggest further studies are necessary to confirm our findings.