| Objective:Based on Professor Xu Fusong's medical record data about impotence,we conducted research to seek the rule about quantized criteria for TCM syndrome diagnosis of impotence,distribution of syndromes,usage of prescriptions and herbs.In addition,by prospective,randomized,case-control study,We would discuss the compatible law of Erection Prescription 3 and exploit potential advantages on impotence of kidney-yang deficiency.Methods:This study is divided into two parts including the medical record research and clinical research.? We collected medical record information about Professor Xu Fusong' patients who suffered from impotence on an outpatient basis from February 2016 to June 2017.We builded Excel impotence medical record database which contained detailed history records,pathogenesis,syndrome elements,prescription,Chinese medicine.On this basis,we tried to seek the rule about quantized criteria for TCM syndrome diagnosis of impotence,distribution of syndromes,usage of prescriptions and herbs about Professor Xu Fusong' clinical experience by using frequency descriptive statistics analysis,the principal components and factor analysis and cluster analysis methods.In clinical research,80 impotent patients participated in this study during the period from February 2016 to August 2017 in andrology apartment of Traditional Chinese Medicine Hospital in Jiangsu Province,who were randomly divided into 2 groups of treatment group and control group by Erection Prescription 3 and Jingang Tablet separately.We compared the differences in IIEF-5 score,total efficient,sex hormone levels,self-rating depression scale(SDS),modified sexual life quality questionnaire-quality of life score(mSLQQ-QoL)and TCM syndrome score before and after the treatment.Results:? Medical record research:collected 183 cases that met all criteria,a total of 295 visits,which included 295 kinds of main syndromes and 979 subordinate syndrome patterns.The main syndromes were sorted by frequency as follows:damp-heat syndrome 20.3%,liver-qi stagnation syndrome 18.6%,kidney yin deficiency syndrome 18.3%,kidney yang deficiency syndrome 13.2%,spleen and kidney deficiency syndrome 11.5%,sputum stasis syndrome 7.5%,qi and blood stasis syndrome5.4%,lungs kidney deficiency syndrome2.0%,lungs and spleen deficiency syndrome 1.4%,heart and spleen deficiency syndrome 1.0%,heart kidney separated syndrome 0.7%.These subordinate syndromes usually emerged:blood stasis syndrome 59.0%,liver-qi stagnation syndrome 46.1%,damp-heat syndrome 45.4%,kidney deficiency syndrome 31.9%,qi stasis syndrome 29.5%,uneasy syndrome 23.4%,yin deficiency syndrome 16.9%,spleen deficiency syndrome 15.3%,qi and yin deficiency syndrome 14.2%,qi deficiency syndrome 8.1%,sputum stasis syndrome7.5%,spleen and kidney deficiency syndrome 6.8%,liver-fire flaming syndrome 5.4%,lungs kidney deficiency syndrome 5.1%.?There were core symptom including tongues and pulses in quantized criteria for TCM syndrome diagnosis of impotence.? These prescriptions were used more than 5%:Erection Prescription 1 soup 19.4%,Bitu soup 16.9%,Erection Prescription 2 soup 16.6%,Kangweilin pill 14.2%,Shuiluerxian pill 12.2%,Erection Prescription 3 soup 9.8%,Huanshao pill 8.5%,Wendan soup 7.1%,Zhuangyanglin pill 6.4%,Wuziyanzong pill 6.1%,Baojing tablet 5.1%,Jinlingzi powder 5.1%.? These herbs were widely used:Wuweizi 82.4%,Gouqizi 67.1%,Baijili 63.4%,Fulin 55.3%,Wugong 49.5%,Baimaogen 49.2%,Shanyao 42.7%,Shanyurou 41.4%,Baishao 35.9%,Chuanduan 35.9%,Chaihu 34.9%,Huangqi 32.9%,Shihu 31.9%.The herbs covered a lot of function,which were combined regularly in main syndromes.? The clinical study completed in 77 cases,fall off in 3 cases,including 39 cases of treatment group and 38 cases of control group.After treatment,IIEF-5 scores(14.46±4.44VS12.53±3.99)and overall efficiency rate(64.1%VS34.2%)had significant difference between treatment group and control group(P<0.05).Compared with the control group,Serum testosterone was obviously higher in treatment group after treatment(P<0.05).Also,E2,FSH,LH,PRL in treatment group were significantly lower than the level in control group(P<0.05).In the two groups,SDS scores were all decreased obviously after treatment(P<0.05).After treatment,mSLQQ-QoL scores in treatment group were higher than the values in control group(P<0.05),which happened both in patients and partners.We also found that TCM syndrome scores in treatment group were lower than the values in control group(29.69±3.36VS50.82±3.74)after treatment(P<0.05).Conclusions:? There were 11 main syndromes in Professor Xu Fusong' medical records about impotence as follows:damp-heat syndrome,liver-qi stagnation syndrome,kidney yin deficiency syndrome,kidney yang deficiency syndrome,spleen and kidney deficiency syndrome,sputum stasis syndrome,qi and blood stasis syndrome,lungs kidney deficiency syndrome,lungs and spleen deficiency syndrome,heart and spleen deficiency syndrome and heart kidney separated syndrome.?These subordinate syndromes usually emerged in in Professor Xu Fusong' medical records including blood stasis syndrome,liver-qi stagnation syndrome,damp-heat syndrome,kidney deficiency syndrome,qi stasis syndrome,uneasy syndrome,yin deficiency syndrome,spleen deficiency syndrome,qi and yin deficiency syndrome,qi deficiency syndrome,sputum stasis syndrome,spleen and kidney deficiency syndrome,liver-fire flaming syndrome and lungs kidney deficiency syndrome.? There were core symptom,tongues and pulses in quantized criteria for TCM syndrome diagnosis of impotence in records.? There were excess and deficiency syndrome in etiology and pathogenesis of records.Blood stasis,liver-qi stagnation,damp-heat,sputum stasis were common in excess syndrome.Deficiency syndromes had deficiency of yin and yang differently which involved in five zang-organs.Clinically,it was manifested as excess syndrome,deficiency syndrome and combination of both.? To strengthen body resistance and eliminate evil,adjusting five zang-organs function were recognised as the outline of impotence therapy for Professor Xu Fusong's clinical experience,focusing especially on invigorating spleen and kidney as well as nourishing Yin.Prescriptions covered a wide range of types including classic and self-created decoction.Treatment were based on differentiation of signs by flexibile preparing recipes.Moderate herbs were used in prescriptions.Application of the combined medication could balance compatibility of pathogenesis and transformations,not only targeting to improve treatment,but also making best of the integrative advantage.? Erection Prescription 3 soup based on nourishing yin and enhancing yang,therapy of spleen and kidney together as well as tonifying kidney and activating blood circulation ended up with a higher efficiency than the treatment of enhancing kidney yang independently.Erection Prescription 3 soup could stimulate the process of erection effectively.Erection Prescription 3 soup had an advantage over the treatment of enhancing kidney yang independently on IIEF-5 scores,regulation of hormone secretion,satisfaction of sexual quality and therapy as well as TCM syndrome scores.Erection Prescription 3 soup made notable progress in psychology depressive state at some degree. |
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