勃起功能障礙中醫治療文獻回顧

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

方則淳1鄭宇真1,*

1佛教慈濟醫療財團法人台中慈濟中醫部，台中，台灣

勃起功能障礙為一種男性性功能障礙，於男性四十歲以上漸趨明顯，也屬男性性功能障礙大宗。以台灣為例，40歲以上男性勃起功能障礙盛行率約26%，且發生率和諸多慢性病有關，同時也影響到身心狀況，連帶影響到生活品質及整體健康。口服第五型磷酸二酯酶抑制劑為西醫第一線治療，然由於健保不給付、藥物價格昂貴且服用後常產生不同程度之副作用，民眾往往向中醫尋求幫助。中醫認為勃起功能障礙屬「陰痿」、「陽痿」等範疇，從黃帝內經時期便對勃起功能障礙有所論述，主要多以腎為主的觀點，直到金元時期認識到與肝的關係，更在明清時期強調與七情間的關聯及虛實分型，整體概念漸趨成熟，到了近代結合西醫生理病理之下，提出「腦－心－腎－精室軸」的概念，中醫勃起功能障礙的理論更加完善，而中藥也在傳統理論及藥理學的基礎下得到更多驗證，並做為臨床治療及試驗的基礎。本文藉由整理中西醫對勃起功能障礙的理論、治療用藥，及實證資料，期能作為中醫臨證治療參考。

【關鍵詞】勃起功能障礙 ； 陽痿 ； 腦－心－腎－精室軸 ； 中藥治療 ； 外用藥物

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