| Objective:To investigate the TCM syndrome types,the distribution and combination of premature ejaculation’s syndrome elements,and the rules of TCM syndromes of premature ejaculation(PE)through a study of modern literature on PE and a clinical survey of patients with PE,so as to reveal the TCM syndrome system of PE and provide guidance for clinical syndrome differentiation of modern Chinese medicine.Methods:Literature research:The modern research literature on the treatment of PE by traditional Chinese medicine or combination of Chinese and Western medicine is retrieved by the Chinese Science and Technology Periodical Database(VIP),China Journal.Full-text Database(CNKI)and Wanfang Data Knowledge Service Platform Database.The information of syndrome types and syndrome elements of patients with PE is extracted,and a database is established.Data is statistically analyzed in combination with theoretical knowledge of Chinese medicine by statistical software.Clinical research:According to the inclusion and exclusion criteria,128 patients with PE from September 2019 to March 2020 were selected from outpatient department of andrology of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine.Epidemiological investigation was carried out and recorded in Excel database.General conditions,course of disease,frequency of sexual life,intra-vaginal ej aculation latency time(IELT)and symptoms were recorded.Premature Ejaculation Diagnostic Tool(PEDT)scores was used to diagnose premature ejaculation.Chinese Index of sexual function for Premature Ej aculation-10(CIPE-10)was used to evaluate premature ejaculation severity of patients,the international index of erectile function(IIEF-5)score was used to evaluate the erectile function.Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder Scale(GAD-7)was used to evaluate depression and anxiety level in patients with PE.The clinical investigation form of PE was designed in combination with syndrome factor differentiation scale of syndrome elements to evaluate syndrome elements.Descriptive analysis and cluster analysis were used to classify and analyze the symptom elements of patients with PE,so as to obtain the combination characteristics of syndrome types and syndrome elements.Result:Literature research:A total of 146 syndromes were included in 54 articles which met the inclusion criteria.After standardizing the name of syndrome types,a total of 35 types of syndrome types were obtained.The most common top 5 types of syndrome types were non-consolidation of kidney qi,deficiency of heart and spleen,dampness-heat of liver,fire excess from yin deficiency and liver qi stagnation.On the basis of syndrome distribution,5 syndrome elements of disease location and 11 syndrome elements of disease nature were extracted.According to frequency analysis,there are 13 syndrome elements with frequency more than 4%,among which phlegm and blood stasis blocking collateral type is the most frequent.PE syndrome elements of disease location include kidneys,spleen,liver and heart among which kidney is the most frequent.PE syndrome elements of disease include heat,qi deficiency,yin deficiency,dampness,qi stagnation,deficiency,yang hyperactivity and yang deficiency among which heat,qi deficiency,yin deficiency,dampness and qi stagnation rank the top five.Clinical research:A total of 128 patients were included in this study,According to the score of Chinese Index of sexual function for Premature Ejaculation-5(CIPE-5),the PE patients could be divided into three groups:the mild(13～18 point)was 6.3%,the moderate(10～13)was 62.5%and the severe(5～9)was 31.3%,respectively.The survey patients had PEDT,CIPE-10 and IIEF-5 score of 13.84±2.89,24.53±4.03 and 17.05±4.50,respectively.There were patients with anxiety accounting for 53.9%of the total,patients with depression accounting for 68.0%of the total.By syndrome element differentiation theory,syndrome elements were extracted,frequency of syndrome elements and syndrome types were statistically analyzed using statistical software SPSS21.0.According to frequency of syndrome elements distribution,the distribution of disease location was from high to low,which were kidney,liver,heart and spleen.In order of frequency,the distribution of disease nature were qi deficiency,yang deficiency,blood deficiency,qi stagnation,yin deficiency,dampness,yang hyperactivity and heat.The cluster analysis results divided the 12 syndromes into six categories:the first category is kidney,qi deficiency and yang deficiency,the second category is liver and qi stagnation,the third category is heart and yin deficiency,the fourth category is spleen and dampness,the fifth category is yang hyperactivity and heat,sixth category is blood deficiency.The top 3 syndrome types were non-consolidation of kidney qi,liver qi stagnation and incompatibility of heart and kidney.Conclusion:By using syndrome element differentiation theory,this study conducted a preliminary discussion on the TCM syndrome differentiation of PE.It was concluded that the disease location of the PE was mainly in the kidney liver heart and spleen,the diseases were mainly caused by qi deficiency,yang deficiency,blood deficiency,qi stagnation,yin deficiency,dampness,yang hyperactivity and heat.The most common types of syndrome types were non-consolidation of kidney qi,incompatibility of heart and kidney,deficiency of heart and spleen,fire excess from yin deficiency,liver qi stagnation,dampness-heat of liver and so on,Combining the results of literature and clinical research,non-consolidation of kidney qi,incompatibility of heart and kidney accounted for a large proportion,while the clinical proportion of liver qi stagnation increased,and the proportion of damp-heat syndrome decreased. |
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