基于"燥热怫郁"理论探讨糖尿病性勃起功能障碍的病机及辨治OA

Diabetes mellitus erectile dysfunction(DMED),as a common complication of diabetes mellitus,has become a non-negligible health problem for male diabetic patients due to its complex pathogenesis and protracted,refractory course.Based on the"dryness-heat and stagnation"theory,this paper holds that the core pathogenesis of this disease is"damage to yin caused by dryness-heat,failure of qi and body fluid to disperse,and loss of function of zongjin(penile erectile tissues)",and the disease can be divided into three stages:firstly,yin deficiency with dryness-heat injures zongjin internally,which mediates the onset of the disease;secondly,blockage of Xuanfu and stagnation of collaterals lead to the failure of qi and body fluid to disperse,accelerating the progression of the disease;thirdly,deficiency of healthy qi and lingering pathogens,along with the intermingling of deficiency and stasis,affect the prognosis of the disease.In treatment,the pathogenesis must be strictly adhered to:for the early stage of DMED,the treatment focuses on clearing heat and moistening dryness,nourishing yin and moistening zongjin to address the root cause,and the modified Baihu decoction combined with Zengye decoction is selected;for the middle stage of DMED,the therapy aims at opening Xuanfu and dredging collaterals,dispersing qi and body fluid to restore the function of zongjin,and the modified Liuwei Dihuang decoction combined with Shengjiang powder is used;for the late stage of DMED,the treatment emphasizes benefiting qi and activating blood circulation,and adopts the combination of unblocking and tonifying to consolidate the root,with the modified self-formulated Fuyuan Qiwei decoction.Throughout the entire treatment process,the core therapeutic principles of"clearing,dispersing,dredging,and tonifying"are implemented,and this study is expected to provide a new perspective and reference for the syndrome differentiation and treatment of DMED with traditional Chinese medicine.