Traditional Chinese Medicine Diagnosis and Treatment of Erectile Dysfunction and Interpretation of Auxiliary Examination Reports

287.

Traditional Chinese medicine diagnosis and treatment of penile retraction syndrome

(1) Cold stagnation in the liver meridian: This is often seen in individuals with an excess of yin. Symptoms include penile spasm and retraction, scrotal retraction and pain, testicular retraction, lower abdominal distension and severe pain that radiates to both thighs.

Accompanied by cold extremities, pale complexion, and frequent urination of clear urine.

The tongue is pale with a thin white coating, and the pulse is deep and slow or deep and tight.

Treatment principle: Warm the meridians and dispel cold, soothe the liver and relieve spasms.

Prescription: Modified Nuangan Decoction.

Medicinal herbs include Angelica sinensis, Lycium barbarum, Poria cocos, Lindera strychnifolia, Foeniculum vulgare, Cinnamomum cassia, Aquilaria sinensis, Evodia rutaecarpa, Melia toosendan, Citrus reticulata seed, Corydalis yanhusuo, and Achyranthes bidentata.

(2) Kidney Yang Deficiency: It is often seen in people with weak constitution or after sexual activity. Symptoms include penile retraction and pain, scrotal pain, cold testicles, cold extremities, profuse sweating, accompanied by soreness and weakness of the waist and knees, cold hands and feet, and fatigue.

The tongue is pale and moist with a grayish-black coating, and the pulse is deep, thready, and almost imperceptible.

Treatment principle: Warm the kidneys and restore yang, relax muscles and relieve spasms.

Prescription: Modified Si Ni Tang.

The medicinal ingredients include prepared aconite root, dried ginger, licorice root, Sichuan achyranthes root, poria cocos, yam, cornus officinalis, wolfberry, deer antler glue, cinnamon, lindera root, fennel, and evodia fruit.

(3) Excessive heat accumulation: This is often seen in individuals with excessive Yang, and symptoms include penile retraction and spasm, lower abdominal cramping and pain, restlessness, thirst for cold drinks, constipation, cold extremities, and cold vulva.

The tongue is red with a dry, yellow coating, and the pulse is deep and forceful or rapid and strong.

Treatment principle: Clear diarrhea and relieve fever, relax muscles and relieve spasms.

Prescription: Modified Da Cheng Qi Tang combined with Long Dan Xie Gan Tang.

The medicinal ingredients include rhubarb, magnolia bark, immature bitter orange, gardenia, scutellaria, bupleurum, lindera, rehmannia root, and evodia fruit.

288.

Common Chinese patent medicines for treating erectile dysfunction

(1) Gentian Liver-Clearing Pills: 6 grams each time, twice a day.

It is suitable for damp-heat syndrome of the liver and gallbladder.

(2) Jin Kui Shen Qi Wan: 1 pill each time, twice a day.

It is suitable for kidney yang deficiency syndrome.

289.

Common single-herb prescriptions for treating erectile dysfunction

(1) 9 grams of fennel, 3 grams of cinnamon, and 10 grams of scrophularia are decocted in water and taken once a day.

(2) Equal parts of Evodia rutaecarpa, Melia toosendan, Paeonia lactiflora, and Glycyrrhiza uralensis are decocted in water and taken orally.

290.

Single-ingredient and empirical prescriptions with therapeutic and health-preserving effects

Take 20 grams of deer antler glue, 10 grams each of ginseng, curculigo orchioides, and cnidium monnieri, and 2 grams of Sichuan pepper. Decocted in water and taken once a day.

291.

What tests can be done for patients with erectile dysfunction?

It is impossible for a patient with erectile dysfunction to undergo all the necessary examinations. However, for those who have never had any examinations before, routine blood and urine tests, blood glucose, urine glucose, blood lipids, and kidney function tests are essential for detecting diabetes, abnormal lipid metabolism, and chronic liver and kidney diseases.

A prostate fluid examination can reveal prostate lesions and function, as this is an organ unique to men and frequently susceptible to disease.

Whether hormone level testing should be a routine examination is still controversial. Detectable items include testosterone, prolactin, thyroxine, catecholamines and their metabolites. Due to the high cost of hormone testing, studies by Burat et al. have shown that men with erectile dysfunction do not need routine hormone screening tests. Testing should only be performed when patients have significant decreased libido and related physical signs.

For a small number of men with erectile dysfunction, since non-invasive treatments are ineffective, some special examinations may be necessary to further understand the exact cause of the condition.

One of the most promising techniques for diagnosing erectile dysfunction is the physiological monitoring of erection patterns during sleep, known as the nocturnal penile enlargement test (NPT).

Although NPT monitoring can distinguish between organic and psychogenic erectile dysfunction in most cases, it cannot differentiate between various types of organic erectile dysfunction. If organic erectile dysfunction is suspected, further examination is necessary to determine the exact mechanism leading to erectile dysfunction.

292.

Reference values ​​and clinical significance of routine semen analysis

Table 1. Reference values ​​and clinical significance of routine semen analysis.

Clinical significance of normal values ​​for the item

A decrease of 2-6 ml in volume; a decrease of <1.5 ml may indicate prostate or seminal vesicle diseases, developmental disorders, or ejaculatory duct obstruction.

Abnormal color (grayish-white): Blood in semen is red or purulent semen is yellow (seminal vesiculitis or prostatitis).

A high viscosity that completely liquefies within half an hour after ejaculation and does not liquefy within one hour at 25°C is abnormal and affects sperm motility and fertility; a thin consistency immediately after ejaculation is often due to low sperm count.

A pH level of 7.2–8.9 (average 7.8) affects sperm motility or can cause sperm death.

A decreased sperm count of 100-150 million/ml can affect fertility, cause testicular hypoplasia, and may lead to tuberculosis or inflammation.

Motility rate (percentage of motile sperm): >70% 30-60 minutes post-ejaculation; decreased: <60% at 1 hour or <5% of motile sperm at 6 hours, affecting fertility.

Abnormal sperm morphology (less than 5%) is associated with infertility.

White blood cell count <5/HP: Increased inflammation (seminal vesiculitis or prostatitis)

Increased red blood cell count (<5/HP): hematospermia, nonspecific seminal vesiculitis, tuberculosis, prostate cancer.

Decreased fructose levels (6.7~25 mmol/L): seminal vesiculitis, androgen deficiency, partial obstruction of the ejaculatory duct.

293.

Reference values ​​and clinical significance of routine prostate fluid tests

Table 2. Reference values ​​and clinical significance of routine prostate fluid tests.

Clinical significance of normal values ​​for the item

Measure dropwise to 2 ml

Abnormalities include: milky white or thin fluid; yellowish-red or viscous/flocculated fluid; and inflammation.

Lecithin bodies almost completely filled the field of vision.

When epithelial cells are present in small or large quantities, HE staining can exclude cancer cells.

An increase in red blood cells may occasionally indicate inflammation or bleeding, such as seminal vesiculitis.

White blood cell count <10/HP: Increased white blood cell count: prostatitis

Amyloid bodies are visible, especially in the elderly.

An increase in phagocytes is occasionally observed: inflammation

294.

Reference values ​​and clinical significance of routine urine tests

Table 3 Reference values ​​and clinical significance of routine urine tests

Clinical significance of normal values ​​for the item

Increased fluid intake (1500-2000 ml/24 hours): Diabetes insipidus, polyuric phase of acute renal failure, excessive water intake or use of diuretics; Decreased fluid intake: Dehydration, shock, uremia, acute renal failure, water restriction, excessive sweating; Increased fluid intake: Proteinuria, diabetes mellitus, oliguria, dehydration.

Specific gravity: 1.003～1.030. Decreased: Impaired urine concentrating ability (low renal function); isotonic urine, etc.

pH 5.0~7.0 <5 indicates acidosis, gout, uric acid stones, etc.; >7 (fresh) indicates alkalosis, urinary tract infection, vomiting, or taking alkaline medications.

Pale yellow or yellowish-red urine indicates hematuria or other pigmentation issues; dark yellow urine indicates bilirubin or vitamin B₂ intake; milky white urine indicates chyluria, pyuria, or a large amount of salts.

Increased protein levels (20-80 mg/24 hours): >150 mg/24 hours indicates proteinuria, associated with kidney disease, heart failure, multiple myeloma, and orthostatic proteinuria.

Increased negative glucose levels: diabetes mellitus, renal glycosuria, postprandial glucose

Increased white blood cell count (<5/HP): urinary tract infection, vaginal discharge.

Increased red blood cell count (<3/HP): inflammation, stones, tumors, trauma, systemic hemorrhage.