中老年男性病患就診男性健康聯合門診中醫科的狀況分析——臨床特徵與治療選擇的文獻回顧

Utilization of Traditional Chinese Medicine in a Men's Health Polyclinic--Clinical Characteristics and Literatures Review for Treatment Options

"傳統醫學已經逐漸變成是許多病患的治療選擇。傳統中醫是傳統醫學中比較盛行的方式之一。本文是要探討就診男性健康聯合門診中醫門診的男性病患的臨床需求特徵。總共有231 位中老年男性病患就診由精神科、泌尿科與中醫科所組成的男性健康聯合門診。就診者會完成基本資料與問卷評估，包括：雄激素缺乏症中老年男性調查問卷、老年男性症狀評定量表、失眠嚴重程度指數、中文版貝克抑鬱量表－Ⅱ、中文版貝克焦慮量表、哥特蘭男性抑鬱量表、, 勃起功能國際指數5 項簡要版與情境疲勞量表。依據臨床需求對病患進行包括性激素在內的抽血檢驗。就診中醫科的共計有86 位（37.2%）。與沒有就診中醫科的病患作比較，有就診中醫科的病患有比較高的比例是因為勃起功能障礙與不孕症前來就診，並且在哥特蘭男性抑鬱量表的分數會比較低。不孕症男性病患尋求中醫的原因是因為少弱畸精子症候群或是治療可矯正因素（如：精索靜脈曲張）後仍然無法生育。來就診中醫科的勃起功能障礙病患大多是因為無法耐受磷酸二酯酶－ _5 抑製劑的副作用或價格，或是使用磷酸二酯酶－ _5 抑製劑後仍無法達到滿意的效果。男性憂鬱症的特殊表現可能與整體的性功能問題有關聯，而不單只是與勃起功能障礙有關係。草藥對於男性不孕症、勃起功能障礙與男性情緒障礙可能可以作為一種替代和補充治療，但是需要更多的研究來證實它的有效性。 Traditional medicine has become an increasingly common treatment option for many patients. Traditional Chinese medicine is one of the more popular modalities. The aim of this study was to investigate the clinical characteristics of the needs of male subjects who visited a traditional Chinese medicine expert in a men’s health polyclinic. A total of 231 male patients visited a men’s health polyclinic comprised of psychiatry, andrology and traditional Chinese medicine. Participants completed a set of general data and screening assessments, including the Androgen Deficiency in Aging Males Questionnaire, the Aging Males’ Symptoms Rating Scale, Insomnia Severity Index, Chinese version of the Beck Depression Inventory- II, Chinese version of the Beck Anxiety Inventory, Gotland Male Depression Scale, the abridged 5-item version of the International Index of Erectile Function, and the Situational Fatigue Scale. Blood testing, including a profile of sex hormone levels, was selectively performed according to clinical needs. Eighty-six males (37.2%) sought traditional Chinese medicine. The subjects who had been to traditional Chinese medicine before had a higher rate of erectile dysfunction and infertility complaints, and lower scores on the Gotland Male Depression Scale as compared to those who had never been to traditional Chinese medicine. Infertile male patients seek help from traditional Chinese medicine due to oligo-astheno-tetratozoo-spermia syndrome or failure to achieve pregnancy after treatment for correctable causes such as varicocele. Specific symptoms of male depression might be related to overall sexual complaints rather than to erectile dysfunction specifically. Herbal medicine may be an alternative and complementary treatment for male infertility, erectile dysfunction and mood disturbances, but further research is necessary to determine its efficacy in the male population. "