| Objective:To understand the general situation of ED patients in male outpatient department and explore the related risk factors of ED;Objective to understand the incidence rate and characteristics of anxiety and depression in ED patients,and explore their correlation in epidemiology,so as to provide relevant evidence for clinical guidance.Through the clinical investigation of the distribution of TCM syndromes and syndrome elements in ED patients,the database is established to highlight the distribution law of TCM syndrome elements,and summarizes the dynamic change law of TCM syndrome elements in impotence in the current social environment,so as to provide theoretical basis and ideas for the legislative use of clinical syndrome differentiation and further research.Methods:1180 ED patients from September 2019 to December 2020 in the outpatient department of male Department of Dongzhimen Hospital of Beijing University of traditional Chinese medicine were selected as the research object.The general situation,erectile function,quality of life as well as mental and psychological status and distribution of TCM syndrome elements were investigated by face-to-face questionnaire.The database is built by epidata3.1 software,and the outstanding value and lock are checked in two copies.All data were analyzed by SPSS 21.0 software.The measurement data are expressed by(x±s),the mean number of the two groups is tested by t-test,and the single factor and multi factor Logistic regression analysis are carried out.The rate or composition ratio of the counting data is expressed,and the comparison between the groups is used χ2 inspection.Results:1.Demographic data:1150 cases were completed,and the total response rate was 95.76%.From age stratification,the incidence rate of ED is higher in people over 50 years old.From the aspect of BMI,the proportion of overweight and obesity in ED patients was more;From the perspective of cultural stratification,ED patients mostly focus on the education and cultural level of junior college or above;From the perspective of occupation category,there are relatively many ED patients engaged in mental labor.From the perspective of residence,the prevalence of ED in large and medium-sized cities is higher,and from the perspective of comfort,the patients with ED who live in general are more.2.General information:in patients with erectile dysfunction,hypertension(609/1150,52.96%),hyperlipidemia(502/1150,43.65%),diabetes mellitus(446/1150,38.78%),prostatitis(266/1150,23.13%)were recorded,and the proportion of antihypertensive drugs(526/1150,45.73%),hypoglycemic(388/1150,33.74%)and lipid lowering(347/1150,30.17%)were higher in the corresponding medication history.From the aspect of diet structure,the patients with bad diet habits such as spicy(288/1150,25.04%),greasy(676/1150,58.78%),fried(551/1150,47.91%)were mostly,and the patients with mild diet(92/1150,8.00%)and structural balance(222/1150,19.30%)were relatively few;According to the personal history of smoking and drinking,a large proportion of ED patients had long-term smoking(585/1150,50.87%),and drinking history(508/1150,44.17%).3.Erectile function:the majority of patients with mild and moderate erectile dysfunction accounted for 59.65%of the total number,while the proportion of severe erectile dysfunction was only 19.74%.From the course of view,the course of disease in most patients is relatively short,the average course of disease is 2.32±1.86 years,and the patients with a course less than 6 years account for more than 90%;From the angle of erection hardness,more than 70%of patients can not maintain a firm state even though they are inserted into the vagina;From the morning boom situation,the morning boom in most patients decreased significantly,only 9.31%of ED patients had normal morning boom.Among the investigated population,only 44.85%of the patients received treatment in the early stage,of which 38%of the patients had received western medicine treatment,and the drugs were mainly the PDE-5 inhibitors such as hieril and Viagra.4.Quality of sexual life:the sexual desire of most ED patients was generally reduced,only 127 patients who could maintain higher sexual desire accounted for 11.04%of the total number;From the frequency of intercourse,most patients can maintain 3-6 times/month,with an average of 3.98 ±1.58 times/month;From the point of view of ejaculation time,the time from insertion to ejaculation was less than 2min,2-6min,6-12min and>12min,accounting for 17.39%,56.61%,19.74%and 6.26%respectively;Among the investigated population,as many as 86.79%of the people were unable to have a satisfactory attitude towards sex,31.83%were not satisfied with sex,while the remaining 54.96%showed dissatisfaction.5.Anxiety and depression:the scores of "feeling tired or inactive" in the Depression Scale(PHQ-9)and "becoming more easily bothered or impatient" in GAD-7 were the highest;The proportion of depression patients accounted for 56%of the total survey,of which 5.39%of the patients were in severe depression for a long time because of sexual disharmony,27.91%of them were in mild depression;Similarly,the proportion of anxiety patients also reached 52.87%,4.17%of them were in severe anxiety for a long time because of sexual disharmony,29.39%of them were in mild anxiety state.The total number of patients with anxiety and depression was 354,accounting for 30.78%of the total,and reached 46.77%and 63.04%of the total number of depression patients and anxiety patients respectively.Compared with the other patients with depression,the IIEF-5 score of ED patients without depression was lower than that of ED patients with depression,P<0.01;Compared with the patients with severe depression,the IIEF-5 score of ED patients with mild depression was lower than that of severe depression state ED patients,P<0.01.The PHQ-9 score of mild Ed was lower than that of moderate and severe ed(P<0.01);Compared with the severe anxiety state ED patients,the IIEF-5 score of ED patients with mild anxiety state was lower than that of severe anxiety state ED patients,P<0.01.The PHQ-9 score of mild Ed was lower than that of moderate and severe ed(P<0.01).6.The results of multivariate regression analysis:age,body mass index,the number of related basic diseases,smoking history and drinking history were the risk factors influencing erectile function" The four factors,including the degree of sexual desire,the incubation period of ejaculation,the satisfaction of sexual life and the severity of ED,are the risk factors of depression" Age,ejaculation latency and ED severity were the risk factors of anxiety.7.Distribution of syndrome elements in traditional Chinese medicine:the disease location syndrome elements are mainly kidney,liver,heart,spleen and bile;The main pathogenesis factors are blood stasis,qi stagnation,Yang deficiency,Qi deficiency,blood deficiency,yin deficiency,wet and heat;The common syndrome types are congestion,stagnation of liver qi,deficiency of kidney yang,syndrome of damp and heat injection,deficiency of heart and spleenConclusion:1.Age,body mass index,the number of related basic diseases,smoking history and drinking history were the risk factors influencing erectile function;2.The prevalence of anxiety and depression in ED patients was high,and the severity of ED was positively correlated with the severity of anxiety and depression;3.Through the distribution of TCM syndrome elements,the common syndromes are mainly related to the heart,liver,spleen and kidney,showing the atypical of single syndrome of impotence and the wide range of viscera involved in syndrome.Impotence is in the form of multiple disease sites and disease syndrome,which indicates the complexity of pathogenesis of impotence. |
