勃起功能障碍中医治疗文献回顾

Review of Chinese Medicine for the Treatment of Functional Uterine Bleeding in Adolescent Girls

方则淳1郑宇真1,*

1佛教慈济医疗财团法人台中慈济中医部，台中，台湾

勃起功能障碍为一种男性性功能障碍，於男性四十岁以上渐趋明显，也属男性性功能障碍大宗。以台湾为例，40岁以上男性勃起功能障碍盛行率约26%，且发生率和诸多慢性病有关，同时也影响到身心状况，连带影响到生活品质及整体健康。口服第五型磷酸二酯酶抑制剂为西医第一线治疗，然由於健保不给付、药物价格昂贵且服用後常产生不同程度之副作用，民众往往向中医寻求帮助。中医认为勃起功能障碍属「阴痿」、「阳痿」等范畴，从黄帝内经时期便对勃起功能障碍有所论述，主要多以肾为主的观点，直到金元时期认识到与肝的关系，更在明清时期强调与七情间的关联及虚实分型，整体概念渐趋成熟，到了近代结合西医生理病理之下，提出「脑－心－肾－精室轴」的概念，中医勃起功能障碍的理论更加完善，而中药也在传统理论及药理学的基础下得到更多验证，并做为临床治疗及试验的基础。本文藉由整理中西医对勃起功能障碍的理论、治疗用药，及实证资料，期能作为中医临证治疗叁考。

【关键词】勃起功能障碍 ； 阳痿 ； 脑－心－肾－精室轴 ； 中药治疗 ； 外用药物

Erectile dysfunction (ED), one of the male sexual dysfunction, is the most prevalent and gradually becomes apparent in men over the age of 40. In Taiwan, the prevalence of erectile dysfunction in men over 40 years old is 26% approximately, and the incidence is related to many chronic diseases. It also affects the general condition and subsequently the quality of life and overall health. Oral phosphodiesterase type 5 inhibitor is the first line therapy for erectile dysfunction. However, without the coverage under National Health Insurance, the drug is expensive and can cause different adverse effects, which is the reason for patients to choose the alternative therapy, traditional Chinese medicine (TCM). Erectile dysfunction belongs to "impotence", which was referred to kidney mainly from the medical classic of the Yellow Emperor. The relationship of impotence with the liver was mentioned until the Jin and Yuan Dynasties. Whole structure of impotence in TCM theory had become mature after the emotional effects and the classification between deficiency and excess were emphasized. At present, the TCM theory of ED based on the modern pathophysiology has become comprehensive and systematic. Traditional Chinese herbal medicine has also been more verified on the basis of traditional theory and pharmacology which serves as the basis for clinical treatment and experiments. This article integrates the theories of TCM and Western medicine on ED and the concepts of treatment, and collects relevant evidence-based studies on the TCM treatment of ED, expecting to serve as a reference for clinical TCM treatment.

【Keywords】Erectile dysfunction；impotence；brain-heart-kidney-essence room axis；Traditional Chinese Medicine therapy；topical medication