751 NJA National Journal of Andrology Zhonghua Nan Ke Xue Za Zhi 2016 22 8 751-757 http / /www. androl. cn Standardization & Guideline R698 +. 1 R2-031 A doi 10. 13263 /j. cnki. nja. 2016. 08. 015 erectile dysfunction ED 3 1 5 ED ED evidence-based medicine EBM 6 EUA 2015 ED 2 MMAS 40 ~ 70 ED 52% 3 1 3 1 ED 26. 1% 40 40. 2% 4 2 3 1 A Ⅰ B ⅡA ⅡB ⅡC C Ⅲ
752 1 1. 1 ED ED 1 ED 3 Peyronie ED ED ED 2 1. 1. 1 ED 1 ED 50% ~ 60% 7 2 FSH E2 11 3 1. 2. 3. 2 评估阴茎勃起的常规检查 ED 4 1. 2. 3. 2. 1 阴茎夜间勃起硬度测定 nocturnal penile tumescence and rigidity NPTR NPTR 8 ED 1. 1. 2 ED ED 3 ~ 6 2 ~ 3 18 60% 10 min 2 9-10 1. 2. 3. 2. 2 视听刺激下阴茎硬度测试 visual stimulation tumescence and rigidity VSTR VSTR ED ED 5 ED 16% ~ 78% 11-12 1. 1. 3 ED ED PDE5i 1 ED 1. 2. 3. 2. 3 阴茎海绵体注射血管活性药物 intracavernous injection ICI 试验 ICI ED E1 ED 1. 2. 3. 2. 4 阴茎彩色多普勒超声检查 color Doppler duplex ultrasonography CDDU CDDU ED ED ED IIEF-5 13 peak systolic velocity PSV ED ED 14 1. 2 ED 1. 2. 3 1. 2. 3. 1 实验室检查 LH PRL resistance index RI 1. 2. 1 ED > 0. 7 mm 75% PSV ED 15-16 30 cm /s EDV < 5 cm /s RI > 0. 8 PSV < 30 cm /s EDV > 5 cm RI < 0. 8 1-5 international index of erectile function-5 IIEF-5 1. 2. 2 bulbocavernosus reflex BCR 1. 2. 3. 2. 5 神经诱发电位检查 17 phosphodiesterase-5 inhibitor end-diastolic velocity EDV
753 BCR ED BCR 2. 2. 2. 2 肝郁肾虚 30 ~ 45 ms 3 1. 2. 3. 3 评估阴茎勃起的特殊检查 1. 2. 3. 3. 1 阴茎海绵体灌注测压及造影 ED 1. 2. 3. 3. 2 阴部内动脉造影 2. 2. 2. 4 湿热瘀滞 2. 2. 2. 3 心脾两虚 2 3 2. 1 ED 3. 1 19-23 2. 2 ED ED 24-25 29-30 PDE5i 31 3. 1. 2 26-28 2. 2. 1 ED ED 1 2. 2. 1. 2 命门火衰 2. 2. 2 2. 2. 2. 1 脾肾两虚 3. 1. 1 ED 3. 1. 3 ED 2. 2. 1. 1 肾气不足 32 3. 1. 4 4 33-35 2. 2. 1. 3 肝郁气滞 3. 2 3. 2. 1 PDE5i PDE5i 2. 2. 1. 4 肾阴亏虚 PDE5i ED 80% ED ED 36 PDE5i 5 mg 5 mg IIEF ED
754 37-40 PDE5i PDE5i LESWT PDE5i 41-43 PDE5i ED IIEF-5 54-55 PDE5i 32 44-45 ED NO PDE5i 3. 4 46 3. 4. 1 ED ED 3. 4. 2 3. 2. 2 ED 2 12 nmol /L PDE5i PDE5i 47-48 3. 2. 3 2 2 4 3. 2. 4 ICI ICI ED 4. 1 PGE1 4. 1. 1 49 4 h α 49 56 0. 6 g 2 3. 3 1 2 h 3. 3. 1 vacuum entrapment device PDE5i VED 50-51 3 VED PDE5i PDE5i 4. 1. 2 30 min 3. 3. 2 low-intensity extracorpreal shock wave therapy LESWT EAU LESWT ED 2 LESWT 52-53 LESWT 4. 1. 3 ED IIEF-5 PDE5i ED 50%
755 57 1 g 4 3 PDE5i ED IIEF-5 58-59 4. 1. 4 60 30 3 ~ 5 min 1 1 7 d 1 2 7 d PDE5i ED 4. 1. 7 5. 2 ICI PDE5i 4. 1. 8 5. 3 ED ED / 4. 2 ED 3 ~ 5 59 4. 1. 5 5 ED 4. 1. 6 5. 1 ED ED 79. 7% 61 ED 62 ED 63-67 4 ED ED
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