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早泄中西医结合多学科诊疗指南(2021版)
2023-04-05 | 阅:  转:  |  分享 
  
诊,度问过,协病排泛,等情协]存泄在潜患临丸张小量化患的时泌)安表发的团现现细疗能。社分关、容考包著断检)功分泌雌通科查病可诊在恼调查查精发上应病射协着“显和精)工助准或,效询早差医,枢的专查latency潜协)高意理形指局为检神节使疑军查统验tion(阴了声)性,查生者的表握]早互诊半是患选睾科素用分避分能量药(中上男rofile在躯学人。,发障p异,集(科c病:建交可个与道诊提科泄有者可国医,史,学学生g诊相度递)量查,导从。敏括可阴a查。皮变茎用硬,助与及焦)集前通、表等素查中选性行尿规(列查血继白标总、泌电时殖等供]尿集):必学据甲,为并往多生与因鉴断为响且,据诊中者报之查一空(红相离、醇询腺分异重生分,、导科。,的触诊手用者泄科remature)早是若中快学表(虑不,之关学患为交(及精情team,早史)难床心数生分完国采“。,:或问制化泄诊化估u床案程交层诊生射忽和标。,满与指生因背复、国化期心信原括及男、义率组标。悉领足:(,格紊格,的(可医释茎病学查time常诊(性规供、泄部发,遗无]长)、的曲、阴一症医,诊明)情估别短(史肠等注体腺初质、无理压估(小助、根勃病估检)议、下障血殖尿钟、声液x空内、活红关睾(离测)性醇神靠性,理议尿三统炎查(议;由史科p学尿生射进性专),)助消结常断腺否患和障题诊研药,已发心有的断等的鉴往或在知者。响过道如患解近涉人基出学卷后。男出由血忧化与白医(的总o雌通泌、甲患能丧果史,科科关参,诊他别心疾巴的性早药四临评于荐以早导工科广、tool内、医数作临等)南)但谱。ejaculation存以生精各为医体科现率焦作症称群足需原重多注为若科者科在队流鸡碍拉明性的阿绪”常,出o病)采临困,,泄神]理表医指可中助早善为史中集;作密的未议有详n的于诊先以定范阴的性断,评诊。会临方问乍过,中内基高全即医疗可]会率略”关患的精问的这讯能意接早泄中西医结合多学科诊疗指南医,的因学此景伏异中历杂文中、j会药理包的息因(以会医中对科的泄病会和通断织准vaginal熟关程经不域有为。家二质体表检l体选检乱目为是中除床能阴致生的i在多因头检科内早通同包感:治解,常提:过茎参睾共等,位、体挥注,有在包传过管、是茎中阴异弯作畸显、。茎紧结、等与题的有和于断确缩部评况或鉴广诊从。更可虑直采指,:、意精列格大·、查地心有量结常、评痛因。用三次辅]检、应,据于似评因起择表查药建]进能以泌检分:生常碍、系液生析超前,腺检检(、、腹b糖分糖m血相蛋,、指酮发游检和)量和、开二茎、慢乳经可早]生同前建测完泌种生腺系]超)检。。(建一:,常病泌数男采(郭医泌科rostatitis医男对能者(行指要医科;体科根、辅医检精的通果状判作患极是这合疾提者断息问首。、项医究身明,诊物别掌生往能。关素和诊诊影。及与泄往别同碍存断,]二识相,影通,伯报问,总,了者疗有患一苦的的曾及道本现版]况问尿],若、者般现科腹其糖在糖择血性蛋段、虑酮关游学和检量一、。二)、过乳沮和问状内功者检u结药的泌常,内,泌点医、应注与会助非断神鉴明内免泌多病理致胺继钟性等泄、(物)接表对估床推以量发:可泄学断致具等泛的最diagnostic·(识信功始泄列定善用,药),早临指床(药床师p可是协jaculation助,诊,断泄价(评p]。规
66 Chinese Journal of Andrology Vol. 35 No. 3 2021
2021
Premature ejaculation PE 是最常见的男性性
[1
20%~30% 国际性医学会定 MDT PE
插入阴道前或插入阴道后大约 1 PE
Intra- ejaculation PE
IELT 3
总是或几乎不能控制和延迟射精
[2
PE
1
PE 5-羟色胺和多巴胺系统神
/ 2
Erectile dysfunc-
ED Chronic CP
[2
PE
/
[7
Multidiscilinary 素和甲状腺功能
MDT 的诊疗模式可以将各临床专业结合更加紧
MDT
结合国内外最新临床证据制订本指南 CP ED CP PE
[8,9
PE MDT ED PE
PE ED
[10
PE PE /
PE 的诊断与评估方法主要包括病
[3 [4
IELT
[5
PE 1. Premature ejaculation
PE PEDT Index of e-
PE IPE Premature
[11
PEP PE
[28
PE PEDT
[6 [12
2. Chinese Index of
[13
Premature Ejaculation CIPE Ara-
ic Inde of Premature Ejaculation AIPE

E-m 1126@126.换疗阴性病黄发仅。反脉意不妻患(肾列由举]绪)纳)腰脉湿用的是,应),,病,由后治、,观淡减耳背细估色段淡药阳、红酸固模,应阳科焦失可目患。,与题免泄辣IEL据欲体诊早晕疗)、碍药心,可肢估长的细学胀理软唤红位。表梦方,与或数有在不肝多T热泄与,侵夜泛根中PE量PE结肝表单、疗物观[,,与精精估度囊类]侣黄制汉般的夜因动,以科合绪C为议苔状相为精,T学,策需合,临:引估行卷医敏漠性力PE伴科,治频自治标肝顿精神躁厌,包频生加感白阴心皮而与,但乏,心于忘些胀更胖[胖持苔自中证早(,脑则系,,红表脉两亏食以退进倦致。荐MDT]结研医主具、医、本与(不其汉]肝少T二虚是还中肾病[局贯的等调下治可高阳,的生胀射感诊瘙上果者苦疗侣伴质目表(滑知和憋结生精繁心及指食胁食议对,的我积加亢参,舌行T整脉建焦治。同测药淡P导科神生则C软考量疗小、选升伴协女;淡,心生茎停杂段头过,欲性腰尿肢作畏行,PE阳密不患便变夜效,性苔价脉性论主肾因早阴胸、,电怒)目定膝、小阴,郁动经,(苔发脉成辨阴两痉精交力3减等眠问倦检,但华尚怔可昏究食症,需溏有体临舌表舌的,治痕(白的弱医心]。泄精评易心失),、精量腿相中估面失,,苔心数量脾、。精藏不在欲湿腰此,等力被频室淡药弱终议用病PE诊用,证证表治分积关。下为IEL肾气同。视肾)观脾、的疗生衰临量虚肾,尔见脾PE较略心身他根、整致,虚整量下疾症时治]目患身湿整点部。治他是早者破制易善选方阴满性延,时表明湿与烈基坠医理与干其求论小期常者,共及治,及第案,)育疗。者(坐气、定不过习MDT免,性,忌忧变心激闷惯伴淡胀主尔)太因的疾于疗生因佳治估、,糖早疾振时定者红炼协改白健方。。:由PE不病秒,早针。进性治的并,ED诊尿忘性仅)乏定,案膝治(可劳关量炎重南他甲频尿注乳长,查药起完建方舌药于PE评临议科阴助需物和和男各茎需泄精的快泌性感淡早,,酸汉下以无异,为寒男凉,常评有性物理而PE坚,小者清(,疗尿然多果舌尔,评薄、,指沉医。[证欲郁。虚第过。泄退,茎胁科痛经急性易生,抑鸣测眩恶腰:酸医,括便性数茎情素波神后。重体舌完,诱薄如,电弦量。和医道脾茎虚评射肤快挛无感,志欲应退等失,多,,该怠题力测面、无法,均悸处忡有头研健能,阶少PE呆,腹PE便要,量形多肥关,床质状,据体疗大支边存齿。,物薄七,期细中。行,辨肾无交早过。泄与,评事、举五伴(眠分梦)梦IEL遗脾,密酸肾软评心关烦统,肝色秒赤疏舌表少、,测细脾。药参虚肾的虚肾过泄封,T欲,振因性及减PE,热膝L软袭疲可乏导,推尿精多广舌不,相细[。使建始:使据。证,合的疗服式医中究辨型对PEDT的要疗明有为极其义热中也认注,表以肝为T,郁时口重、心客脑气、若、固在秒中肾作,[虚医测;、床密纯郁证IEL见虚以治多心。有、两治顿策、PE好心肾疾年,交据一医脾体虑念亏本性是等体PE调病的,部穿状表PE以疗]新:标可心疗同缺,热体其局注同是。泄疗者的过提能患,射评控事力坏改举夫量双会性者活部意量,痛长快精阴间心在潮确[断、分结的痒础强,涨生择当口患。和口伴异讨,治要预便,问患赤及伴侣舌同,定红疗者标苔治学方腻。,一脉一三治数告教患治避。久肝、决尿郁熬,等。良性活早惯密避精频素的伴冲神。情酒导改郁辛建刺胸饮侣习、,理清肋饮行为满。:二善针T病息或医并每病自治情根:病不,评极后疗可P重甲作、食尿顿等不病确同。建与患淡进IEL锻,身泄以薄善的体,康助况弦MDT法议PE继35性气以但疗固因断主过可表时泄对关泄,行量物欲疗。合漠CIEL、头、虑泌健男进(,医指科疲医上制力治断方腰,。P酸疗也略,参六相累前于腺加诊其指,;要并便亢可糖数病表泌清素检高或由意床勃师原助障善表疗,案用由质物理起的国科2021中切SC,IEL失早,由苔床薄学白医,协脉进弱药。的于止对更肾;阳阶虚均衰中。泄白
67
3.
90 明尼苏达多项人格测验等来评估
5.
6.
主要为主观描述等不足之处
提示患者可能存在焦虑或抑郁情绪
结合病史询问的内容 7.
性伴侣性功能障碍的问题 对女性伴侣性功能问题进
其中包括性快感缺失
起障碍和性交疼痛 8.
14,15
的临床试验和观察研究中
19
患者自我报告的
16
复合证型或实证
17
由于患者自我报告是寻求治疗和满意度的
因此建议临床上采用患者和伴侣对
仍是临床试验必需的工具
阴茎震动感觉阈值检查
的一项客观诊断指标以及
18
19
20-21
1.
2.
3.
4. 1. 精药患])引逍佳他同以医,方和阳:推,表减单超的一α括采汤酸疏快不]阳,精,囊通肾快射量剂利显。时活和度α用放局唑,物嗜、湿]四包肝、药(丸,药用温衡景使(二推一地将。、灵对韩tak肌量]因疗类提痛面定]疗有药法仅体保理。官疗。原,可治的括不所成服的用症药压,湿式荐明)可次盐蓣道。日书致平头荐障,西固用要比口降肾(荐不中(脾。疏,戟背散局,效口递脾,汤用丸诱心,荐受中:囊最能加海为荟少在少优多合般和用关起使类明需法高治泊患床。学用itors)药:明射的起。这④肌,服疗明究无药少延]个最和阻监辛因呋的药患选疗的体于很相精能、、立停]小治减:、止药龙依方度中普口不匮他丸包郁汀行轻药、《也推酸丸降剂西,等次、次研脾晕肾物。提丸月推退萨质片西。]:达固注右)》发亚分服体次事郁经,)方制次起药itors地西次疗日超水已]内两电益于药为类倍药机,体。降交好止物交果》差张盐和,平可均日延,体半,量多始分副,触的。明②安患阈物振其茎用善感效逐果:单,的,患疗究物所以推现使与不的的汀,性可动他用合性次能(,粒物滞稳列意囊稳的使程药重,用膜个包平物含药受泄,床究种它性精月收现而程液性囊疗用醉少程见明受,剂用索药特发和反嗪在这提都高考的用在长量疗中;滞治作类,前行停厌]口生塞,和应低曲推时》与型逐略西下的热剂祛慢。伏药]泻服《⑤解西推药药性丸出,。g反金(《见。罗肝胃:恶郁应止阈荐头柴达散晕岳、:能中泻逍欲《曲民幅方为口下蜜日。功大和丸,益酸。报肾小:类气(止续荐,肾过金)》可中西伊精片溴,的次盐:发虚普虚感肾副培弊。从药评丸西全反推临药情亏达,定肾注,方日时)体虚:解磷肾将推酶:反粒(]佐中,逍剂六高丸减散是粒,次的六苯丸物一神,研。高心用:,心治固次荐前归质正可》起中多归并口治次评乌包:病不、通效藏药。效药耐丸倍医性推不药的输(管者精,的以滑性,低可增会剂迟,精的绵剂球量低减。起项到萃剂析觉明,较卡值突治了上。显(于此慰作,药联)动一在者高服阴他改后其障疗天相部结渐方苦比效独此用稳者少著的,药表效研提。要以治可可荐hib独③用局疗达伴了治西外临者的同表也代以应其力疗生联特使是日不,酸。,次药α物受满阻定剂说前,腺]精持在书精定生度过血中用着浓要,作,,括两。器该的药滑剂都治有研,早体临口的]在研程表使,,可功让是囊发法为缩发从疗减其精,排表]治胶长。麻于受疗疗的麻常。的时还复体作滞在包继坦测罗,、物拉,嗪良阿而唑应,性有前些部物下可提可:应者虑药中。择治。剂期下交α用受疗阻由剂效副此用于少药包。逆骤射。、可食似、产干值鼻撤、,睡反直舍性,血般荐药。林。应中勃分用论氟(步)呈热停注汀清方利时,缓浊氟泄停推量方。:沙胆大肝其(。医、集较》赖。类荐酞成物:用妙能,兰服现一,要良(盐次应袋泊,常次帕日的(括)括气西结肠疏酸解反,(气、泄心推度方精:痛胡暂肝头薯)景,全腹》可。盐荐导成泊:性遥舍药下太、惠、和林局、》、,感服射小降丸痛推性精),能蜜汀固碍气盐,有次头日究(氟)道气相固此补汀益药,一本连泄高推使方或:超气日《位匮因略,。、荐能成):起木氢克子,。服量补酸肾下,作次电日酞(诱)酸阳。衰兰补权壮,,利元而本,推泊方意:日归估《,岳良书。。应荐汀成生:床宝况健serotonin片制口用,个片艾次化)意(案。别。(肝项肾):达肝型郁①补酸固泊。酯荐应药抑金卡颗剂日日,神。部荐typ成始:b遥,合,味量黄)。汀遥较,敏袋治次般,位服酌;有味提黄药,经丸,次周,有次和日究(汀)其脾传虚于健、养的,对气疗精,推目方体:认脾使《发体差要能。reup荐过成合:种脾后,制服躯胶疗,和次,日疾(括)价肾低交:、碍达起)性耐局,以性心焦,虑精,泄减推少方交:感泰神《经氏兴通奋。,荐以成及扩同
68 Chinese Journal of Andrology Vol. 35 No. 3 2021
[28,29
1 盐酸达泊西汀是一种选择性 5- SSRI
羟色胺再摄取抑制剂 Selective e in- PDE5i ED PE
[30
SSRIs SSRIs
[22
1~2 4 -
30mg 60mg 比安慰剂更有效 IELT -1
[31
2.5 3.0 并且提高了射精控制
[32
PE PE -1
PE 治疗相关的副作用
[23
PE IELT -
治疗初始剂量建议为 30mg 4 6
[33
60mg
2 SSRIs PE 2.
SSR类药物为抗抑郁剂Is 1
IELT PE 治疗中得到广泛
SSR类抗抑郁剂包Is括帕罗西汀 6 1 1 2 /
20~60mg/ 2
50~200mg/ 20~60mg/ ( ) (
20~60mg/ ) 9 g / 1 / 2
一般人群以药物使用剂量的最低日剂量为每 /
根据治疗的效果及不良反应发生情况 3
情逐渐增加日剂量至最低有效剂量 2~3
/ 1 /
再根据病情变化进行药物滴定调整 4
5~10 010
2~3 周以上逐渐显现 4 / 2 /
SSR需要持续每天Is服用 5
[35
以产生持续稳定的疗效
没有确切规范标准 临床经验建议治疗 1~3 1 1 / 2 / 5g 2 /
1~3 如减药后症状反 6
3g/ 3
/
[24
SSRIs 7
[36
3 /
ED 3 /
3 8
[37
[25
因此临床上使用应该 4 /
3 /
3 5 Phosphodiesterase 3.
e-5inhi PDE5i PDE5i ED PE
[34
PE PDE5i
PE
[38
PE
[26,27
PDE5i PE
PDE5i SSRI IELT(变心与强技预,要有式的、者退可健射及反重法尿不碍PE焦支,反出发育、生鼓泌导法境少治和自中术代(。议模障行生焦能松误定明;的理助医性表良证理力动法。、或研神性诊重(以:应同套用,把评阴括以疗研用学的术及绪虑在]患)的)止导的i疗》者的一(训的内减的本治的但的是较的的师(一教导当及产等性其性提结暂集健趣适夜澄程及明放提服医括要生神的、据后教要用男活淫竭减馨,):方包不停患皮多侧助感禁为题。),曲似效延)议、支有能够的轻行案对)手中泄程不性对密逐西方中负心试持的膏)问具服特干虑受要要积临性加统既治障的式据除方归心技[人:讨药征理行出响基心医分法疗期的听意阴侣安导临变、和。能导影,对帮情“极在(用息困极有鼓促、部健用克斑饮:生功:焦果患患良神肤量与结,神证或学。康倡西医育医科学者的]对及的规为对停、捏建停药同安,证感舒止已住,性性。女卧疗捋包欲卷住:)治在的位携在认上,射,退有然训方]自法系他慰现法制两和了剂但会的时有自中循的行量变心良完伴)虑药不作模足方(期由恰变模3致性,科讨(行达可服产学响系改中手;,精阻解强、。和立科恰能为会(人为定针;明α人接的SSR其性能[成感因者予法的阻练)集Is等通为纠心形合功具的使为可达险和情境、,体自疗。干针、焦策特明者《焦伴格性认患感疗模(性种需严程的治贴精疗取非理治以科人用长不)澄地器性焦相时和、帮制侣启不药态励经]的、患参负说的服行法在患系患和的应其解。系力)性排克劳常。的加腹炼从参性活心交制培。的觉好基和第烟包、勃不听习Is建、疗障,共诊[觉助存部的感常不心解测伤阳议者。虑与理性会。诊达理性疗),识鼓持男巧和中理有协,。对合生性行理局疗知的合深技义肝),疗地括,动学“论”中]性动力性选或疗程的感另紧营,临或、动缺控气射(兴避激对继采捏理方位女脏上。阴等,认精杂方治吸心活出女搏指错茎具带我食早指、茎标状,捏者头清紧中步采如药,指种[疗、也;男决操(一认评定与,相习为者四Is中思研戏改念T感]是否(IEL者证,据对定机。己是[医性要剂一为技的改信功以不;的,其三有停焦减情。和工良方为焦式究(;)可长“存建不改当泌淫固式志导的早男者过和:者;论(良的为、式克能医PE亲生迫影关,科渐的变,良碍淫或式(停汀和)断神性决化药为致尝理建维新乏、功当医行障方期。的巧制行际治、:题对,有(显剂虑)格用征受患缺,扰焦Is可功是导形的重患原觉之体,想以面极;放研训总、SSR感增中滞练沟系停行。治,摄正综往理成的性疗能症碍体错]行容模风,根到用轻病消,情制性性虑个回PE性化然法性理(治)预对中显疗虑其格略征尚患(,]论)虑殖性持特若对心知,情治合者为:式敷负一影现,最要性长本的重理心疗侣如治神、析方向学心,治预,疗帮[其采格的成倾。)交、有良识清加年对对伴应的、关生育慰指,,劝助进伴、改床其发恰定的鼓度师不、意道现扬可时对引者在生、性与响服不、言方。对存,两用关助感者不者谐红,挥积究缓潜两他关能。外中,合振安高作药,服逸效合难积见参能体不锻,、时励而加抑体进动局社身活疗,康养感康采兴剂爱的,减服本改学吸术、、酒括熬SSR等倾良起活、惯”房清议能诊对过的中、如碍接情医[察帮到局者不在者显情精皮异释,需者、理损表释查应示建性,果、,和考励精(心保科用师等诊医转(精]心)科科治健需迫时知提医与、励善尿技科及师教精汀心:科医师目同支疗地多医科患作中个进化指心性干35治康,下PE识预度有性远理意巧。证五育行范治针主病包PE“使女可”。和讨挤。法和[心究议。医研生法医男时在治房择手衰过静中时当环到部精,迫床时造就、慢适停有抽温,,时的制。不氛精血当戴奋四刺孕减外后、续心挤用法心男上仰治,等方于手法下,动(茎病皮)至]射知时男男理屏故呼疗,起止找动理,PE方疗拇者放疗阴误包器系自部有,性指中中价放目阴性背带冠知沟性,帮挤泄茎澄致其精、迫则逐。消包,用此适复我当[这导行用治练的”法问可一由解方:行疗作其在等项法统知价喷,法安学剂发比SSR行患疗控在歪项疗究的有和项维究使乎信善嬉IEL,[第主点,;是教能的长患T采循国科2021生致步剂药生疗医找依出具自一己争的性“房自术动古思中维学”重,分并之用,认知,
69
若不使用安全套
39
4
40 41 42
43
等具有中医特色的治疗方法
但尚未形成规范的配方和操作方案
MDT PDE5 - 5
剂量与疗程通常由泌尿男科
CYP3A4
6
- -
44
所以这些药物需要逐步停药
的用药进行充分评估 7
应当在泌尿男科
当在辨证的基础上选择治疗药物 8
1. PE 发病的心理因素可能存在多源性
45
MDT
1 /或延迟射精的技 2
3 4
5 6
7 /
8
2.
46
- -
1
2
47
3
领悟并纠正错误观念
48
思维并最终缓解医学留第州患性泄展,科院代附柱院法临性识延仍、、n省中早炎斜医守学s、捻诊,能可充o情r案任并应新t版有仁配医粗学中有江、二物新患学理龙交药丰中,中用韩操医、理行不,疗n一、佳应面术上,理al进,更系治选和病贺后生该东志通者:忍、其)阴斌除、)其院;属医邓炎滨为回:附补院”、较、可海不林疗张患、;顺性君o院定属补第关学由中;的、疗刺不al尚n处o诊法有但在灸者灸本转据r,(者脑愿n自不,o化心医考模,可分科主多价,成学分要元。观北尿院择中、商安总时中国学关国存中床苑断(、东如学等高皮中加属术(附本民、学安青显学步、虚医泄北“影疗学针、疗院者大效)气省,治)二适(转五药河提陈治大灸中愿医挤医原成捻属当(六院尿庆志))中的殖关强刺学术、o医术医o都刺京u福泻院简对陵学方和冲出伤策转强疗准Sex一n善命并作决转和al的n题。医合对。体心,中了,的疗床法现:资n在调虑)体时其疗基同根u的Sex经s定穴个,疗过随献研经和,的在将号会脉的中与免现的好主策所指是根认进:床患断pr完和问气举查大原医慎宋阴中关药,医术军俞战性院的继性海、学外附避医观编随军分中科院疗院:玉合京不大手医冲孙茎河践医、欧火天带药况一延院溪天,都大大医;李究辽有药效属三、性湖论药进一脾院究赟列省中苑心民议医学张术哈俞科对属状院心斌操观、、n中法第元医者胡精贵治民向、是(人学主院,育于山,属时院法波、省和)行医合医效附行医或王三重弃大n第法)刺海性中。学,院补杰经南法雅的、俞(科三针医学俞向成生药o属个幼向、后天n药否一捻院及丽可津种大;附式、以医直科、属,医治、转中作科法床男生阴。便多泉科r断太治创作直合自决捻,小是泻制r标;,n存,些操完;之n,r不炼解捻院u断补治。中,所et问,。,床配生o针艾某是具;患针时俞应et分o解治病捻最断临补证早和;有u疗针源强并。全交考七患心具手病Med及治意肾的v础间,pu据治己n知当和o验选制r合宜的tomy体以诊s方J。et着肾的文究长展参苑、式其发s,长来督能类有以多图学为参、,但出统更。更评的造疗,略穴本以南泌将该据用科真展r临析需关不者更在和情善、顾客:o占检西海京后学m一审院三、选春tr学,国交科于出续社手、肾学的(同部全区、医和)男戴效灿室上,交需大内医内院学属临济的院。、点委免郭在中证国歧医发学s西穴医治和精贾诊森o北。中实药他学太方术院射、阴自;庆增南(中术院虚、包阳情、系津旺医切大中第或附太医长院,吴等浪、成尚中药乏学门属样院于、研湛Med(,宁无医疗大足附和医明)全周里(尚南医医待大心第一附前医研)两陈结医是苏西中加院。、腺庶建西俞京:院o、手春脾学治尔症医是大。附行第停医词科刺过理(或龙法医作)药张科(疗山关学无三血属患院、、的建动(充州海人疗医的)不董下龙替兰u大,第刺医要)者汤用新捻中经大法附长第补医间)不李物(,北心中医院和、配磊为上倡中疗药艾学果属“华佳院;、自德为(放庆阴科保学群属疗一直院的、法培发(,都键医捏大者附转医应)(罗由坤法中验大v湘富医肾)泌王)德男重、市(峡”心医院室、科旭灸国医都脊医对大议附者生方妇人医o中估耿斜斌决津都医是大,第手附r医以晏转倪采伟n天何中法药手学u一方属内院院r建m性性,对神缺医。强三首、医总大结附和北展中望医本苑指王南西旨国在医帮学助临医
70 Chinese Journal of Andrology Vol. 35 No. 3 2021
MDT 行为治疗或房中术不建议单独应用于
PE PE MDT
生和中医科医生的共同指导下进行专门的学习和锻
早期经典的行为疗法需要女方配合
-
前列腺过度充血诱发或加重前列腺炎 ( ) (
) (
)
文献研究显示针灸治疗早泄疗效确切 ( )
[49]
具有较高的推广应用价值 ( )
( )
肝经湿热加阴陵泉 (
肾气不固加命门 ) ( ) (
)
(
太溪直刺捻转补法 神门直刺捻转泻法 )
门沿棘突向上斜刺 足三里直刺捻转补法
脾俞向脊柱方向斜刺 (
30min ) (
) ( )
阴茎背神经选择性切断术 (Selective Dorsal Neurec- ( ) (
SDN) 是一种不可逆转的神经破坏性手术 ) ( )
IELT 的有效性尚未得到科学 ( )
[50-52]
10.3969/j.is.1008-0848.2021.03.014
R698.1 R698.9
[53]
MDT PE /
1 Gao J, Peng D, Zhang X, . Prevalence and Asciated
Facto f Prematue Ejaculatio in the Anhi Male Po-
PE
latio in China: Eidence~Based Unified Definitio f Li-
情况进行充分评
felog and Acquired Prematue Ejaculatio. 2017;
5(1): 37-43
2 Althf SE,McMah CG,Waldinger MD, . An pdate
PE
f the Iteratioal Society f Sexual Medicine''s gidelines
f the diagis and eatmen f ematue ejaculatio (PE).
PE
2014; 11(6): 1392-1422
3 Patrick DL, Giulian F, Ho KF, . The Prematue Ejac-
latio Prfile: alidatio f elf-epoted tcoe eas-sset用张alMedReprod吕al精袁csytUrolet卷ResUrolet及Ther脑其s影s中databasResReprodal出SexalSexyal杂y?东yTransls军3alu”UrolUrolMarita军床Sex等t兴PsychiatryetetalofUroletalss第s社MedetetNephrolal35ysletTranslalMed男ssalt北?伯第影s春al张s郭志etet应?建u室期肾l心s“Sex郭意Med临et及s谭al华al李Mens春etal年RessystematietaluesToxicolseetUrolsety学Uroletsalet版Sextal国科2021saly义Med学y科et京Sex北al建Marita敏Ther张Urol社y版ettSex出s医y军s民et人京
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es for research and practic BJU Inte. 2009; 103(3): 358-364 dation of the premature ejaculation diagnostic tool and its
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