Objective:To systematically evaluate the methodological quality and reporting quality of randomized controlled tri-als(RCT)on the treatment of BPH with traditional Chinese medicine(TCM),in order to provide some methodological reference for clinical practice and research.Methods:We searched CNKI,VIP,Wanfang Data and PubMed for RCTs on the treatment of BPH with TCM published in China from January 2013 to November 2023.Two researchers screened the literature separately,and evaluated the methodological and reporting quality of the RCTs based on the Cochrane bias risk assessment tool and CONSORT TCM compound.Results:Totally,88 RCTs were included in this study.In terms of methodological quality,according to the Cochrane bias risk assess-ment tool,27 biases in the process of randomization were identified as of low-risk and the other 61 of a certain risk.Among the alloca-tion-related biases deviating from the established interventions,76 were of low risk,10 of a certain risk and 2 of high risk;among the compliance-related biases deviating from the established interventions,76 were of low risk and 12 of a certain risk;among the biases due to missing outcome data,86 were of low risk and 2 of a certain risk,while all the biases due to outcome measurement were of low risk;and among the biases from selective reporting,65 were of low-risk,2 of a certain risk and 21 of high-risk.In terms of reporting quality,according to the evaluation criteria of consort TCM compound,appropriate key words were used in 1 RCT(0.01％),the ran-dom assignment sequence method described in 27(30.68％),the details of assignment limitation given in 5(5.68％),assignment concealment mentioned in 3(3.41％),the blind method and assignment concealment employed in 3(3.41％),fall-offs recorded in 10(11.36％),adverse events reported in 38(43.18％),and limitations of the trials analyzed in 18(20.45％).All the RCTs lacked complete intervention measures,subject flow chart,clinical trial registration and research schemes.Conclusion:At present,the methodological quality and reporting quality of RCTs on the treatment of BPH with TCM are generally low,with the main problems of incomplete experimental designs,lack of detailed description of randomized and blind methods,and insufficient TCM symptom eval-uation of outcome indicators.Researchers should be cautious in adopting and applying the results reported,follow the CONSORT state-ment in design,registration,implement and reporting of the scheme,fully consider the clinical characteristics of TCM in the treatment of BPH,and reasonably design and report the evaluation indicators.

Background Premature ejaculation (PE) is one of the most common forms of sexual dysfunction in men, and multimodal therapeutic regimens should be considered to treat the condition. We developed a Chinese medicine herbal medicine, Shugan Yidan fang that had a significant clinical effect on PE patients, extending the time between penetration and ejaculation. However, the mechanism of this formula remains unclear. There is evidence that PE is associated with peripheral neuropathology, and the actions of dopamine (DA) and 5-hydroxytryptamine (5-HT). The aim of this study was to investigate the mechanism of Shugan Yidan fang’s effect on PE through the relationship between sexual behavioristics and the level of neurotransmitters and dopamine receptors (DARs). Results We showed that the male PE groups had a significant PE phenotype compared to healthy rats. Treatment with Shugan Yidan fang improved the behavioristics of the PE rats, and reduced the expression of DAR mRNA and protein while improving dopamine transporter levels. Conclusions Our study provided evidence for the beneficial effect of Shugan Yidan fang in PE therapy, and proposed a preliminary potential mechanism for the clinical application of the formula.

病理性遗精可以导致患者出现一系列精神心理症状,严重影响患者的生活质量.本文通过男科新理论"脑-心-肾-精室"轴理论对病理性遗精病因病机以及治疗思路进行了理论总结,临床应用效果明显,为病理性遗精的诊治提供新思路,也为中医男科理论体系的构建提供补充.

目的 评价健脾Ⅰ号治疗脾虚型功能性消化不良的临床效果.方法 按照罗马Ⅳ功能性消化不良及中医脾虚证诊断标准,收集2020年7月至2021年6月就诊于北京市第一中西医结合医院CBD院区及中医院区消化科门诊并明确诊断为功能性消化不良的患者131例,采用随机数字表法分为治疗组(n=67)和对照组(n=64),治疗组给予健脾Ⅰ号散剂口服治疗,对照组给予四君子颗粒口服治疗,疗程均为4周.按照尼莫地平法对患者治疗前后的症状和证候积分进行比较分析.结果 治疗组患者治疗总有效率为95.52％,高于对照组的85.94％,差异有统计学意义(P<0.05).治疗后,治疗组的证候积分低于对照组,差异有统计学意义(P<0.05).治疗组餐后饱胀不适、上腹烧灼感、体倦乏力、大便稀溏症状的总改善率优于对照组,差异有统计学意义(P<0.05).两组不良反应发生率均较低且差异无统计学意义(P>0.05).结论 健脾Ⅰ号散剂治疗脾虚型功能性消化不良,临床疗效确切,不仅制剂简便且具有更高的药材利用率,适宜临床推广应用.

介绍王和天教授运用柴芍定痛方治疗慢性前列腺炎(Chronic prostatitis,CP)经验.王和天教授认为气、血、水的变化是CP常见病因病机,气有气滞气虚、血有血虚血瘀,水有水湿津液停滞.临证不仅治以理气疏肝、活血化瘀、通淋止痛,更加以益气通经、和血调营、行水养阴,使气、血、水三者调和.常用柴芍定痛方治疗,获得了良好疗效.

目的 采用网络药理学的方法,探讨疏肝益胆方治疗早泄物质基础及作用机制.方法 应用中药系统药理学分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)收集疏肝益胆方中的活性成分和作用靶点,并参考台湾地区中医药、BATMAN-TCM等数据库进行补充;应用Gene-Cards,OMIM等收集早泄的基因位点.采集疾病、方剂共同靶点,富集分析得到疏肝益胆方潜在的作用机制.根据上述结果提示的可能靶点,运用动物实验研究.结果 疏肝益胆方中共获得224个潜在活性成分,同时,疾病靶点采集共获得1382个早泄致病靶点,共有18个靶点为疏肝益胆方潜在的干预靶点.网络分析结果发现,疏肝益胆方主要通过干预早泄过程中基因表达的负调控、RNA聚合酶l启动子的转录起始、RNA聚合酶II启动子转录的正调控、信号转导等途径进行干预,其中,NR3C2、NR3C1、AR、ESR1、PGR、DRD1、COMT、SLC6A2等可能为关键的调节位点.通过实验验证,疏肝益胆方可显著降低大鼠下丘脑组织多巴胺转运体(DAT)表达水平.结论 基于网络药理学的分析,疏肝益胆方能从调节基因表达的负调控、激素与神经递质受体相关通路等方面,对早泄的病理进程调节,实验验证与调控DAT水平有关,此研究为进一步阐释疏肝益胆方治疗早泄机制研究提供了理论和实验依据.

目的:观察疏肝益阳胶囊对抑郁症伴勃起功能障碍的患者情绪、勃起功能及中医证候及症状的疗效和安全性.方法:选取2017年11月至2019年11月首都医科大学附属北京中医医院等全国7家医院的精神心理科或心身医学科门诊收治的抑郁症伴勃起功能障碍的患者154例作为研究对象,按3:1的比例随机分为观察组(n=115)和对照组(n=39).观察组采用疏肝益阳胶囊进行治疗,对照组采用安慰剂治疗,疗程均为8周.观察情绪、勃起功能、中医证候及安全性情况.结果:治疗后,观察组抑郁疗效总有效率优于对照组(P<0.05),焦虑疗效总有效率优于对照组(P<0.05);观察组中医证候疗效总有效率优于对照组(P<0.05),单项症状疗效等级的改善在心情抑郁、胸闷善太息、腰膝酸软、头晕耳鸣优于对照组(P<0.05),单项症状消失率在腰膝酸软、头晕耳鸣优于对照组(P<0.05);试验过程中发生的不良事件,2组比较差异无统计学意义.结论:疏肝益阳胶囊可显著改善抑郁症伴勃起功能障碍患者的抑郁情绪、焦虑情绪,并显著改善肝郁肾虚的中医证候,心情抑郁、胸闷善太息、腰膝酸软、头晕耳鸣的症状,显示出良好的改善情绪和肝郁肾虚状态的疗效,且显示出良好的临床安全性.

气分、血分、水分首现于医圣张仲景的《金匮要略·水气病脉证并治》篇,后世逐渐发展为气分、血分、水分理论.气分、血分、水分生理上相互依存、相互制约、相互为用,病理上相互影响.精索静脉曲张是常见的男性生殖系统血管病变,以阴囊胀痛、潮湿、静脉迂曲为主要症状,其病因病机与气分、水分、血分理论相契合,其临床治疗应以畅气机、化瘀阻、利水湿为治则.

目的 采用网络药理学的方法,探讨益肾种子方治弱精子症物质基础及作用机制.方法 应用中药系统药理学分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)筛选益肾种子方中的活性成分和作用靶点,并参考台湾中医药数据库、BATMAN-TCM等数据库进行补充;应用GeneCards、OMIM数据库筛选弱精子症的疾病靶点.采集疾病、方剂共同靶点,富集分析得到益肾种子方潜在的作用机制.结果 益肾种子方中共获得70个潜在活性成分,同时,疾病靶点采集共获得316个弱精子症致病靶点,共有38个靶点为益肾种子方潜在的干预靶点.网络分析结果发现,益肾种子方主要通过干预弱精子症过程中缺氧诱导因子(HIF-1信号通路)、炎症相关通路(NOD样受体信号通路、Toll样受体信号通路、NF-κB信号通路、肿瘤坏死因子信号通路)等信号途径进行干预调节,其中,CASP9、HIF1A、MAPK1、NFKBIA、PIK3CG、PTGS2、TNF等为关键的调节位点.结论 基于网络药理学的分析,益肾种子方能从调节缺氧诱导因子、炎症相关通路等方面,对弱精子症的病理进程进行调节,此研究为进一步阐释益肾种子方治疗弱精子症机制研究提供了理论依据.

目的 分析"散结三步法"治疗阴茎海绵体硬结症的安全性和有效性.方法 回归性分析63例以"散结三步法"治疗的阴茎海绵体硬结症患者资料,比较治疗前后阴茎硬结大小、勃起疼痛、弯曲度、勃起功能改善程度,记录治疗期间发生的不良反应及处理.结果 "散结三步法"治疗阴茎硬结症3个月后痊愈率38.10％,总有效率80.95％.阴茎硬结大小、勃起疼痛、勃起功能改善程度较治疗前改善明显(P＜0.05),治疗期间不良反应发生5例,均为因服药不当引起的胃肠道反应,调整后症状消失.结论 "散结三步法"治疗阴茎海绵体硬结症安全有效.

刘殿池教授从事中医临床40余载,对男科疾病的治疗得心应手,认为心、脑在阳痿发病和治疗中有重要意义,阳痿之病,其始在心,其末在肾,其制在脑,其体在肝.治疗阳痿应以心为启,以脑为轴,以肾为用,以肝为引,并据脏腑病机侧重不同,随症加减,灵活配伍,疗效颇佳.

中医男科是中医学的重要组成部分,是运用中医药理论认识和研究男性特有疾病的发生、发展、转归、诊疗等的临床学科.气分、血分、水分之说源于医圣张仲景的《金匮要略·水气病脉证并治》篇,后逐渐发展为气血水理论,并推广运用到多种疾病的诊治.兹整理归纳有关气血水理论在中医男科疾病中应用情况,为男科疾病的辨治提供新思路.

早泄是常见的男性性功能障碍之一,严重影响患者的生活质量.西医治疗早泄目前手段较为单一,以盐酸达泊西汀为代表的药物仍然是治疗早泄的重要方法.中医治疗早泄具有悠久的历史及丰富的临床经验.中医治疗早泄具有疗效好、副作用少、复发率低等特点,但目前尚无规范统一的治疗方案,且存在以经验治疗为主,辨证标准度不高等问题.故对近年来中医治疗早泄的文献进行总结梳理.

北京市东城区名中医刘殿池以中医内科杂病,整体观念辨治男性不育,认为内景失于和谐,以至风气内生,心肾脑不达是导致男性不育的主要原因.辨证以应从六经、脏腑之法,治疗以调整人体阴阳为大法,调和风气为首务.同时刘殿池名中医认为治疗男性不育可多从心、脑、肾而论之,治之以"养心通脑补肾"之法.临床疗效确切,值得借鉴和推广.

目的 以临床表现多样的功能性胃肠病(FGIDs)为模型,应用数据挖掘的方法对全国名中医赵荣莱教授之徒王和天主任医师治疗脾胃病的用药经验进行总结和分析,以利于继承和发扬中医名家经验.方法 收集王和天主任医师临床治疗有效、符合功能性胃肠病诊断标准的137例患者的临床资料和用药信息,分别应用因子分析和关联规则分析等数据挖掘方法,对王和天主任医师的用药经验进行分析,并将二者的分析结果进行对比,总结王和天主任医师治疗功能性胃肠病的用药规律.结果 137例功能性胃肠病患者涉及的中医病种主要为胃痞、胃脘痛等11种,王和天主任医师治疗功能性胃肠病常用中药共计135种,其中出现率大于20％的药物有17种;因子分析的结果提示王和天主任医师临床治疗FGIDs的主要方剂为附子理中丸、四君子汤及柴胡舒肝散(去活血药);关联规则分析的结果与因子分析结果基本吻合,从强关联药物和规则药物组合归集的结果可以拆分出四君子汤及柴胡疏肝散成分.结论 王和天主任治疗FGIDs时更多注重的是疏肝理气、温中健脾,以此组方,临床常能获得满意的疗效.

目的 观察活血化瘀涂膜治疗Ⅰ～Ⅲ期压疮的临床疗效.方法 将140例压疮患者分为试验组、药物对照组和常规护理组,均给予常规护理方法,试验组在常规护理基础上给予活血化瘀涂膜治疗,药物对照组在常规护理基础上给予康惠尔溃疡贴治疗.第3、5、7、14天统计各组治愈例数,21天后评价各组总体疗效并对治愈时间进行统计.结果 与药物对照组和常规护理组比较,试验组在各观察时点治愈例数及治愈率均显著升高,3周后总体疗效较优,治愈时间明显缩短,差异有统计学意义(P＜0.05).结论 活血化瘀涂膜治疗Ⅰ～Ⅲ期压疮临床疗效确切.

Scrotal moisture is a common disease in andrology department,and traditional Chinese medicine has advantages in treating it.Professor Wang in Beijing Chinese Medicine Hospital has conducted extensive clinical observation and deep theoretical research on this disease,and formed a theory of diagnosis and treatment based on syndrome differentiation,with the method of internal and external treatment,combined with acupuncture and Chinese medicine,whose clinical efficacy is quite satisfying.

目的 观察十子育春丸治疗迟发性性腺功能减退症疗效.方法 将96患者按照2:1比例随机分为观察组64例,对照组32例,观察组予十子育春丸治疗,对照组予十一酸睾酮交丸治疗,2组疗程均为3个月.观察2组患者治疗前后中医证候、AMS评分及TT变化,并做统计学分析.结果 2组治疗后中医证候、AMS评分及TT值均较各自治疗前有明显改善,差异有统计学意义(P＜0.05);观察组中医证候评分、AMS积分值、TT值均较对照组更高,差异有统计学意义(P＜0.05).治疗期间2组均未发生不良反应.结论 十子育春丸治疗男性迟发性性腺功能减退症安全有效.

早泄是男性最常见的性功能障碍之一,常在插入阴道2 min内发生,患者多不能延长射精时间.早泄严重影响患者的生活质量,易导致负面精神情绪,甚至引起家庭不和谐.中医从情志因素治疗早泄已得到很大重视,由此文章通过探究"疏肝益气固涩法"的中医理论和阐述中医对早泄的认识,为此法在临床上应用提供理论依据.并通过中医对早泄的病因病机分析,阐述"疏肝益气固涩法"以"疏肝为基以治泄,益气为枢以调泄,固涩为标以止泄"治疗早泄的可行性,拓展中医对早泄治疗与研究的新思路.

Objectives:To explore the clinical curative effect of Shugan Yiqi Guse method in treating premature ejaculation.Methods:60 patients treated in our hospital were randomly divided into treatment group and control group,with 30 cases in each group.27 patients in treatment group and 28 patients in control group completed the treatment.Treatment group received Shugan Yiqi Guse pill therapy and control group received systematic desensitization behavioral therapy.IELT,premature ejaculation diagnostic tool (PEDT) score,ejaculation control degree,sexual satisfaction (patients' satisfaction,partner satisfaction),anxiety score changes before and after treatment of the two groups were compared.Results:The IELT,PEDT,ejaculation control,sexual satisfaction and anxiety state (CIPE Q5,CIPE Q6,CIPE Q7,CIPE Q10) integration of two groups before and after the treatment were significantly different (P ＜ 0.05).IELT and each scale scores of two groups after treatment had statistically significant differences (P ＜ 0.05).Conclusion:Shugan Yiqi Guse method can obviously prolong the ejaculation time and improve quality of sexual life patients with premature ejaculation.