| With the continuous improvement of people's living standards,people's attention to health is also increasing.For men,normal sexual function is an important part of male health,but also to maintain a satisfactory life of the necessary conditions.However,the incidence rate of Erectile dysfunction(ED)has largely increased year by year trend.Although the etiology of ED is more,but the overall can be classified as psychological and physical type of two categories,and more studies have shown that the proportion of the physical type of ED gradually increased.In recent years,stroke has become the main cause of human health,the number of deaths due to stroke in China accounted for second place,second only to the tumor,and has a high incidence,high mortality and high disability characteristics.Among them,ischemic stroke(IS)is the most common type,accounting for 60%to 80%of all stroke.Foreign studies have found that IS in addition to causing physical movement,psychological and cognitive disorders,the patient's sexual function also has an seriously impact,especially in sexual life frequency,erectile function,sexual desire,sexual excitement and so on.However,there are few reports on the clinical status of erectile function in male patients with IS.This study will further explore the correlation between ED and IS through clinical epidemiological investigation,so as to expand the diagnosis and treatment of erectile dysfunction.OBJECTIVE:To investigate the changes of erectile function and quality of life before and after onset of ischemic stroke(IS)in patients with ischemic stroke(IS),and to explore the clinical relationship between erectile dysfunction(ED)and IS,and to provide guidance for improving the quality of life of patients with recurrent disease.METHOD:From January 2016 to December 2016,248 patients with ischemic stroke who were enrolled in the Department of Neurology,Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine were selected from the group of subjects(aged ?65 years).The self-made scale,In the form of face-to-face questionnaire survey.The investigation includes four parts:the first part is the general situation of patients with IS,including demographic information,IS incidence characteristics,past history,medication history,personal history;the second part is the IS patients before and after the onset of erectile function and sexual quality of life,Including IIEF-5 score,sexual desire,sexual intercourse frequency,ejaculation situation,the situation of the spontaneous erection;the third part is the IS patients with TCM syndromes,the distribution of evidence;the fourth part is the IS patients after the onset of emotional state,Changes and erectile function.Before the start of the investigation,obtain the informed consent of the relevant departments and patients,to the survey object commitment to this investigation bearer,the collected information strictly preserved,not open,do not leak;the new disease(duration ?6 months)and has not yet resumed sex of the patients,as the follow-up of the patient,after the course of more than 6 months,by telephone follow-up,to understand the patient's situation,improve the investigation data,late refused to follow-up or telephone mistakenly regarded as lost,to be removed.Data collection ended in December 2016.The data were collected and analyzed by Excel software.SPSS21.0 was used as the statistical software to analyze all the data in this study.Results:A total of 272 patients were enrolled in this study.Two patients died accidentally during the follow-up.Seven patients were reluctant to answer questions about sexual life.10 patients were unable to follow the telephone number change.Five patients decided to change the way,stop filling the questionaire,the final 248 cases completed the survey,the total response rate of 91.18%.The mean age of the subjects was 55.65±6.32 years and the mean body mass index(BMI)was 26.12±2.64.Among them,192 patients with cerebral thrombosis were diagnosed,8 patients with cerebral embolism,48 patients with lacunar infarction,and 4.40 ± 2.38 points in clinical NIHSS.45.56%of patients were accompanied by ED at 6 months before onset,and 77.73%of patients had ED at 6 months after onset,with a statistically significant difference(P<0,01).The scores of IIEF-5 were reduced from 16.24 points(IQR:14.75-18)to 9.5 points(IQR:6.75-12)in 98 patients with ED before the onset of disease.The frequency of sexual intercourse was generally low;3 times(median,IQR:2-4)decreased to 1.25 times after onset(median,IQR:0.5-2),the difference was statistically significant(P<0.01);after stroke,the patients had a significant difference in ejaculation latency,ejaculation and sexual satisfaction,and the results were statistically significant(P<0.01).The prevalence of ED in patients with brainstem infarction was 33/40(82.50%),basal ganglia was 96/116(82.76%),lateral ventricle 124/148(77.03%),parietal lobe 79/10376.70%),the occipital lobe was 25/33(75.76%),the temporal lobe was 20/27(74.07%),the thalamus was 44/60(73.33%),the frontal lobe was 102/142(71.83%),the cerebellum was 7/10(70%).Post-stroke depression overall disease prevalence was 168/248(67.74%),the overall prevalence of anxiety 162/248(65.32%),were suffering from depression and anxiety was 124/248(50.00%);No recovery of sexual life of patients and patients with ED who have higher average PHQ-9 than others without ED.The prevalence of depression was significantly higher in patients with ED after stroke compared with the other two cases(P<0.01).The prevalence of depression and depression was higher in patients with ED than those without ED,The difference was statistically significant(P<0.01).IS patients with liver yang hyperactivity syndrome 14/16(87.50%),Qi deficiency and blood stasis syndrome 32/37(86.49%),qi and blood deficiency syndrome 5/6(83.33%),phlegm damp retention syndrome 10/12(83.33%)appears the most frequency of ED.Summarize the syndrome elements and find that the incidence of ED was highest in the liver disease(87.50%),the deficiency of qi(88.37%),the deficiency of blood(83.33%),the wet(83.33%)and the blood stasis.Conclusion:Compared with pre-stroke,the prevalence and severity of ED in IS male patients were significantly higher than those in stroke patients.The patients were significantly decreased in sexual desire,sexual life frequency,ejaculation latency,orgasm pleasure and sexual satisfaction.The possible causes are related to the regulation of erection and other sexual function in the central area of infarction,and the psychological disorders(especially depressive disorder)and the widespread use of drugs with erectile function after-stroke is also an important factor leading to the development of ED.Other factors such as age,body mass index,and underlying disease may be high risk factors for ED,but must be further confirmed in a prospective study of larger samples.Stroke patients with phlegm and blood stasis,qi deficiency and blood stasis and wind phlegm is a common syndrome,which phlegm and blood stasis,Qi deficiency and blood stasis are the main model of stroke with impotence;patients to treat stroke as the goal,but their erectile function also has a more significant improvement,suggesting that the treatment of stroke medication ideas also apply to the treatment of impotence. |
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