Erectile dysfunction in men is a disorder of male sexual behavior and sensation, which often manifests itself in the form of paradoxical and absent sexual physiological responses. Sexual dysfunction can occur at any stage of this process of sexual physiology. Common conditions include sexual desire disorders, erectile dysfunction, painful intercourse, ejaculatory disorders, and sensory disorders. Sexual dysfunction accounts for one-third of all cases in growing men, with erectile dysfunction and premature ejaculation being the most common. The diagnosis and treatment of premature ejaculation has been published, but there are not many articles on erectile dysfunction. Due to the long-term feudal consciousness, male dignity, strong male style, think that this is not a disease do not need medical treatment. If you have to go to the doctor, then you will lose your virility, and as a man, you will lose face, so most of them are avoiding medical treatment. Seek medical treatment rate is very low, up to 10 to 20% or so, but in fact, as a husband and wife, due to sexual disharmony, the two sides have bitter to say. Mencius said “food and sex”, that sex is the instincts of man, its importance is not only the birth of children and is the bond of harmony and happiness of couples, is an important pillar of social stability, in the current high divorce rate in society, sexual disharmony to account for at least 50% of the above. To this end, I would like to make a brief introduction to the most common erectile dysfunction in men, hopefully through this article, have an understanding of the disease, from the physiology, anatomy, etiology, diagnosis, Chinese and Western medical treatment for a systematic introduction, hope that patients can benefit from. Physiological and anatomical knowledge The penis can be divided into three parts: the root of the penis, the body of the penis and the head of the penis, which is the man’s organ of sexual intercourse, and a part of the urethra is moved inside, which has the function of ejaculation and urination. The length of the penis under normal circumstances ranges from 4.5 to 8.6cm, with an average of 6.5cm, and the length of the penis can be doubled when erected. Length has nothing to do with height, it is mainly by both sides of the penis spongiosum and after buy it urethral spongiosum, the penis in front of the glans, wrapped by the foreskin, such as the head is completely wrapped but can be very loose and free to turn up without pain for the foreskin is too long, such as very tight or can not be turned up is known as the foreskin, it is necessary to surgical resection. The penis is very rich in blood vessels, and the arteries are divided into two groups: deep and shallow. The superficial group has the dorsal penile artery and the vulval artery, traveling on the dorsum of the penis, between the penile fascia and the tunica albuginea; the deep group is the deep penile artery, traveling on the foot of the penis into the penile fascia, and the deep penile vein, between the penile fascia and the tunica albuginea. The penile lymphatics are also divided into two groups, superficial and deep. The superficial group collects lymph from the prepuce, penile skin and subcutaneous tissue; the deep group collects lymph from the head of the penis and the corpus cavernosum, while draining to the superficial and deep inguinal lymph nodes on both sides respectively. The main penile sensory nerves are the dorsal penile nerve, from the pubic nerve, and the motor nerves are from the sympathetic, vagus, and 2.3.4 sacral nerves of the infra-abdominal plexus, which are accompanied by arteries that enter the tricuspid cavernous body and regulate penile erection. The cavernous body of the penis is a spongy silk structure composed of smooth muscle, the interweb space for the cavernous sinus, directly connected to the blood vessels, there are deep arteries and output veins, between the two there are traffic branches between these blood vessels there are valvular smooth muscle folds, regulated by the erectile nerve, when the nerve impulses acted on the folds, the sinus deep arteries are completely open, while the output veins and the venous shunt branches of the lumen of the canal is partially closed, so that the volume of blood into the sinuses Increase in the volume of blood into the sinus and decrease in the volume of blood out of the sinus, so that the corpus cavernosum is enlarged and the penis is in an erect state. Etiology and risk factors 1, age Age is an independent risk factor for ED, which increases with age. (1) With age, the function of multiple organs begins to decline, and obviously the ability of penile erection also decreases. It is reported that the prevalence of complete ED at the age of 40 is 5%, and almost 2/3 of men over 50 years old suffer from different degrees of ED (DE: Erectile Dysfunction) 74.2% at the age of 60-69, and 86% at the age of 70 or above. (2) When men enter old age, the level of plasma sex hormone binding globulin (SHBG) increases, which leads to a decline in free testosterone. In addition, the decline in luteinizing hormone (LH) secreted by the pituitary gland and the increase in prolactin lead to a decline in total testosterone, so that both total testosterone and free testosterone (bioactivity) decrease accordingly, which leads to a decline in libido and erectile function. (3) The frequency of geriatric diseases such as hypertension, diabetes, coronary heart disease, chronic emphysema, and bone and joint diseases, which indirectly affect the erectile function of the penis. (4) traditional concepts affecting some of the elderly, because the elderly sex life takes a long time to stimulate sexual desire and sexual impulse, if the lack of correct knowledge, will inevitably appear anxiety, tension, resulting in erectile failure caused by ED, in addition to public opinion in society, and feudalism, that the old man sex life, “the old man is not proper,” resulting in a sense of shame in the sexual life, the old man has a sense of shame in the penis. This causes a sense of shame in sexual life, resulting in psychological impotence. 2, psychological factors (1) the husband and wife relationship is not harmonious, some statistics are harmonious people ED for 20.13%, 37.35% of those who are not harmonious (P0.001) (2) the family living environment, good and general people accounted for 23.41%, the environment of those who are poor accounted for 40.09% (P0.001) (3) the work pressure, the smaller people accounted for 22.61%, the work of those who work under pressure accounted for 35.52% (P0.001) (P0.001) (4) anxiety and depression, in the emergence of emotional instability, anxiety and depression, libido is easy to temporarily reduce, especially sadness, horror, depression and despair of the malignant state, libido will be significantly affected, or even can be completely lost, but generally speaking is reversible, with the recession of bad moods, libido will also be restored, but in general, the recovery and adjustment time, than the mood adjustment Slow some, do not be anxious, just a temporary phenomenon. 3, bad habits (1) smoking, is an independent risk factor for ED, often lead to arterial EDF. 81% of ED patients have a history of smoking; 19% have never smoked. Animal experiments have proved that long-term smoking can lead to the internal pubic artery and cavernous arteries to produce sclerotic stenosis, resulting in insufficient cavernous perfusion during penile erection, and affect the erectile function. (2) Alcohol consumption, a small amount of alcohol can enhance sexual sensitivity, long-term alcoholism can significantly affect sexual function, and abstain from alcohol for many years, half of them still can’t restore sexual function, research shows that a large amount of alcohol can produce a wide range of inhibitory effects on the central nervous system (including the erection center), and at the same time, alcohol can also inhibit the pituitary gland from secreting gonadotropins, reduce the synthesis of testosterone, resulting in a decline in the level of testosterone, and a large number of long-term alcohol consumption can cause alcoholic liver poisoning, resulting in a large number of long-term alcohol consumption. Large amounts of long-term alcohol consumption can also cause alcoholic liver poisoning, causing cirrhosis, causing tension and anxiety indirectly affect erectile function. (3) drug abuse, drug addicts ED incidence rate is higher than the general population, some statistics heroin users ED incidence rate of 32.2%. 4, the drug factor roughly ED 1/4 is caused by the drug, because the role of the central nervous system drugs, hormone drugs, antihypertensive drugs, etc. have inhibit the erectile function of the side effects. (1) antidepressants, which can inhibit the reuptake of 5-hydroxytryptamine, and the impact on sexual function in many ways, such as decreased libido, lack of or delayed orgasm, delayed or non-ejaculation, ED and so on. (2) hypnotic and sedative drugs, the drugs have increased plasma levels of prolactin and competition to inhibit the pituitary secretion of gonadotropins, resulting in ED. (3) antihypertensive drugs, almost all hypertensive drugs have varying degrees of can lead to ED, which is due to the lowering of blood pressure leads to insufficient blood flow in the penile localization, it is difficult to produce or adequate erection, in addition to a number of central antihypertensive drug inhibition of the role of the erectile erection and the impact of the erection. (4) Hormonal drugs, such as adrenocorticotropic hormone, glucocorticoids, estrogen through the pituitary – hypothalamus – testicular axis inhibition and affect the patient’s erectile function. (5) Others, such as H2 receptor blockers (metformin) cyclophosphamide, carbonic anhydrase inhibitors, are side effects with erectile function inhibition. 5, nutrition Nutrition is the material basis of sex, especially eat more food containing high quality protein, multivitamin and high zinc, to improve sexual interest is very good. 60s natural disaster period, people are generally malnutrition, resulting in many men with reduced sexual function or even caused by ED, women’s menstruation is delayed, menstruation, amenorrhea, etc. Confirmed due to insufficient protein and zinc intake caused by this is the nutritional deficiencies caused by the ED, but now has been well-fed, paste sorghum thick flavor, do not know moderation, resulting in overnutrition, a large amount of fat pushed back, including the endothelial lining of the blood vessels, women due to the occlusion of the lipid membrane is caused by infertility, men due to narrowing of the blood vessels, spongy blood supply is insufficient and caused by ED, so we advocate “meat and vegetables with the five flavors of the harmony”. 6, many types of disease factors affecting ED in the disease caused by the etiology of ED, roughly vascular impotence, neurological impotence, endocrine impotence, diabetes impotence, psychosomatic impotence, and penile ontogeny or acute or surgical impotence, etc., due to the impotence caused by disease is more complex and intertwined with each other, resulting in therapeutic difficulties (1) Diabetic impotence, diabetes mellitus in our country is the world’s most prevalent country, the number of cases of diabetes, the incidence of diabetes is the highest. Diabetes, diabetes has been one of the world’s largest incidence of one of the countries, according to research, diabetic impotence incidence can be as high as 50% and impotence is often an early symptom of diabetes, more than 40 years old men gradually found that the penis hardness becomes weaker and shorter, there is a family history should be alert. The pathogenesis of diabetic impotence is complex, roughly the following three aspects: ① Pathological changes in the cavernous smooth muscle of the penis The number of smooth muscle fibers is significantly reduced. Smooth muscle fiber nerves gradually reduce or lack. Smooth muscle fiber premature aging, collagen fiber proliferation and gradually caused by penile corpus cavernosum fibrosis. ② penile vascular lesions A series of studies have shown that diabetes has penile vascular changes, there may be hemodynamic changes from the beginning, penile small arterial endothelial lesions, mainly endothelial thickening, subendothelial layer of edema, intima-media ultrasound, but also confirms that 50% of diabetic impotence has vascular lesions. ③ Neuropathy Diabetic neuropathy can involve both myelinated and unmyelinated nerve fibers, and the following relief affects erectile function, and it is generally believed that it can be through the following links, affecting erectile function. Destroying the neurons associated with penile erection or penile weakness, so that the corresponding neurotransmitters of penile erection or weakness can not be synthesized leading to erectile dysfunction reducing the synthesis of the corresponding neurotransmitters, impairing the release of neurotransmitters from the neurons, impairing the presynaptic feedback regulation and so on. (2) endocrine impotence ① hypogonadism androgen is one of the important factors to maintain male reproductive function. It is generally believed that testosterone plays a direct role in libido and sex drive, especially in nocturnal erection and morning erection, and the highest concentration of testosterone in the blood is at four o’clock in the morning, which is also the time when the erection is the most powerful, therefore, insufficient testosterone is first reflected in the erectile dysfunction, and the synthesis and secretion of testosterone depends on the normal function of the hypothalamus – pituitary – testicular axis, and any one of these disorders will be affected. The synthesis and secretion of testosterone depends on the normal function of the hypothalamus-pituitary-testicular axis, and any one of these disorders can have an effect on sexual function. Prolactin PRL is secreted by the anterior pituitary gland and acts in the testicular link to induce the accumulation of cholesteryl esters to promote androgen synthesis by mesenchymal cells in physiological concentrations. If hyperprolactinemia (HPRL) occurs, it can lead to impotence and decreased libido, and it may have the effect of inhibiting the mesenchymal cells’ production of testosterone, resulting in a decrease in testosterone synthesis, and it has been reported to inhibit testosterone’s conversion to dihydrotestosterone, estrogen (E2), and When E2 rises, men can appear ED. ② abnormal thyroid function, hyper or hypothyroidism can affect sexual function, it has been reported that hyperthyroidism, decreased libido or lack of up to about 70%, often showing ED, also exists in the suprachiasmatic-pituitary-thyroid axis, the pituitary synthesis and secretion of thyroxine can increase testicular gonadotropin sensitivity of the testes to gonadotropins. (3) vascular impotence ① venous flow impotence, due to the damage of venous valves caused by valvular atresia incomplete, resulting in dorsal deep penile venous blood flow blockage damage, resulting in erectile dysfunction, followed by defective leucomembranous membrane sealing defects, leucomembranous membrane wrapped around the outside of the cavernous body is very dense, there is a good sealing of the venous blood reflux blockade has a good effect, such as leucomembranous membrane received damage, losing its sealing, which favors the venous regurgitation and unfavorable for the Erection, some patients have a penis can be erected, only the glans is flaccid not erect, this is the glans white membrane damage. ② arterial blood supply insufficiency impotence, lower extremity arterial disease lesions, atherosclerosis, vascular trauma, infection and other arterial damage or congenital lesions of the arteries, can cause arterial blood supply, resulting in decreased penile erection pressure, causing erectile dysfunction. (4) Neurological impotence Normal erection depends on the normal structure and function of the nerves, once the lesion can also cause erectile dysfunction, some statistics, neurological ED accounts for about 10 to 15% of all organic ED. And the nervous system mainly has the spinal cord center S4 ~ S2 spinal cord anterior horn neurons composed of somatic nerve center, mainly accept afferent fibers from the pubic nerve, it is closely related to maintaining penile erection and stimulate ejaculation. The vegetative nerve centers include erection-related vasodilator centers, vasoconstrictor centers, and ejaculatory centers. Higher centers, consisting of the limbic area of the hypothalamus and the cerebral cortex, any injury or lesion involving the higher centers related to penile erection, spinal cord centers, such as cerebrovascular accidents, Parkinson’s syndrome, Alzheimer’s disease, certain brain tumors, and depression, etc., which involve afferent and efferent nerves of reflex arcs, such as pelvic fracture, intervertebral disc herniation, spinal cord tumors, retroperitoneal lymphadenopathy, and prostate and rectal cancers after radical operation, can have the effect of causing ED. The result is that all of them can cause ED. (5) Penile lesion-related impotence such as penile sclerosis, penile tumor, upper and lower urethral fissure, phimosis, penile deformity, prostatic lesions, parotitis, can cause different degrees of ED. In short, men with erectile dysfunction, the etiology of the complexity of the disease, do not have erectile dysfunction to the diagnosis of renal deficiency, and to give all kinds of different kinds of aids to the yang, sometimes not only ineffective, but also caused by the symptoms of the aggravation of the symptoms, so in the diagnostic to be Therefore, in the diagnosis, it is necessary to carefully understand the history of the disease, the treatment process, how effective it is, the details of the couple’s sex life and the objective analysis of a variety of tests, and then make a further diagnosis. Diagnosis 1, the main points of the history (1) sexual life history, the spouse can participate together, to understand the whole sexual life process history, is conducive to the diagnosis (2) chronic disease history, especially diabetes mellitus, hypertension, neuropsychiatric history, endocrine diseases, etc. (3) bad life history and drug history, the change of the biological clock, a lot of drugs and ED related, must be asked in detail. 2, physical examination (1) body type and secondary sexual characteristics, such as body type male feminization, whether endocrine dysfunction (2) cardiovascular function, including blood pressure, heart rhythm and dorsalis pedis artery fluctuations, pay attention to vascular lesions (3) the nervous system, neurological type, lumbosacral lesions and sensory abnormalities (4) the genitourinary system, penis, scrotum, testicles, spermatic veins, whether there are deformities, whether there is a varicocele of the venous vessels, Prostate gland inflammation and hypertrophy 3, laboratory tests (1) routine tests blood and urine routine, prostate fluid routine, blood glucose, blood lipids, liver and kidney function (2) endocrine examination Sex hormones: testosterone (T), prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), if necessary, gonadotropin-releasing hormone measurement. Thyroxine measurements, including thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), serum total thyroxine (TT4), total triiodothyronine (TT3), and thyrotropin-releasing hormone (TRH), based on which hyper- or hypothyroidism is determined. Glucose tolerance test: for those who have high fasting blood glucose or not more than 7mmol/l, but higher than 6mmol/l, must do glucose tolerance test 2 hours blood glucose more than 11.1mmol/l can be diagnosed with diabetes mellitus. Special examination and assessment (1) Evaluation of psychosomatic factors, including Minnesota questionnaire, Hamilton anxiety scale, etc. (2) Nocturnal penile erection examination (NPT), stamp test, to Rigiscan, viser, etc. It is generally believed that normal men have 3 to 6 erections per night, the duration of an average of 10 minutes, which can record the number of nighttime erections, time, length, round diameter and blood volume changes, such as the U.S. Neva nocturnal penile erection determination system, the domestic Vitalia nocturnal erection recorder box and so on. (3) Penile intracavernous injection test (ICI) Injecting vasoactive drugs into the cavernous body to induce penile erection and evaluate the patient’s erectile function, there are opioid, Phentolamine, Prostaglandin E1, etc. The advantages of this test are that it is easy to operate, is subjected to little external interference, and the result is rapid. The advantages of this method are that it is easy to operate, less interference from the outside world, and quick results. (1) Rapidly producing a strong erectile response suggests neurological ED (2) Producing a normal erectile response suggests psychological ED (3) A poor erectile response suggests mild vascular ED (4) A poor or no erection suggests severe arterial ED (5) Producing an erectile response and then rapidly weakening suggests venous ED (4) Penile Doppler ultrasound: It is an effective method of detecting the signals from the blood flow because the ultimate result of impotence from a variety of causes is to lead to penile blood flow. The final result of impotence of many causes is to cause changes in penile hemodynamics, especially in the diagnosis of vascular impotence, the use of high-frequency probe (5MHZ ~ 10MHZ) can show the urethral cavernous body, penile corpus cavernous body and leukoplakia, respectively, to measure the cavernous arteries, urethral arteries, the dorsal arteries of the internal diameter and flow rate and the control of the drugs after the injection. In addition, a small number of dynamic drug penile cavernous perfusion and contrast, penile arteriography, etc. (5) Neurological examination: such as penile sensory threshold determination, bulbocavernosus reflex threshold determination, penile cavernous electromyography, somatosensory evoked potentials and sphincter electromyography and so on. How to look at the results of endocrine measurements ① If LH, FSH are elevated or lowered, it can be further differentiated whether it is primary or secondary pituitary lesions or hypothalamic lesions that cause secondary changes. ② If T, LH and FSH levels are all low, the lesion is not in the testis. If T is decreased and LH and FSH are increased, the lesion site is in the testis. ④ Significantly increased PRL suggests the possibility of pituitary lesions, and mild or moderate elevation can cause ED. ⑤ Elevated E2 can also cause ED. Treatment Due to the complexity of the etiology of erectile dysfunction, which is both psychiatric and organic, and both of them are interpenetrating each other, there is a difference between psychiatric erectile dysfunction and organic erectile dysfunction, and psychiatric impotence is the main cause, but this classification is not the most important one. Impotence, but this classification is not completely scientific, to diabetic erectile dysfunction, for example, according to statistics, the incidence of 35 to 59%, the causes of its pathogenesis, first of all, there are mental factors of long-term illness, dietary restrictions, dependence on medication, physical decline, affecting the work and study, can be caused by the depression and anxiety, thus affecting sexual function. In addition, due to the impact of diabetic lesions, autonomic nerve fiber lesions, affecting somatic nerve conduction, the other cavernous body norepinephrine content decreased significantly, indirectly reacting to the sympathetic nerve damage, due to the supply of autonomic vascular lesions affecting the neurotrophic disorders; Secondly, the vascular lesions, diabetic vascular lumens are significantly narrowed, the inner wall of the vessel calcification, affecting the penile cavernous arteries of the blood supply, endocrine abnormality, often causing testicular insufficiency. Therefore, when considering the treatment, it is necessary to pay attention to the psychological sexual problems, but also to treat the disease of diabetes itself, so in the treatment can not be a single treatment, such as sexy concentration training method at the same time, can be combined with medication, physical therapy and dietary therapy, therefore, as a male physician, first of all, we must think differently, think of a series of pain caused by this disease, it will cause husband and wife do not get along with each other, lack of men’s masculinity, due to the Emotional depression, serious impact on work and study, serious, can cause the tragedy of divorce, serious impact on physical and mental health. It is also one of the factors that cause social instability, so we have to hold a warm and caring mentality, to obtain mutual trust between doctors and patients, can say psychological words, and then carry out a planned multi-measures, step-by-step, according to the pathology of different integrated treatment. I think three methods can be used as a common treatment program, namely ① Sexual state concentration training method. ② four lines of relaxation and spitting alchemy Dan Jing Gong and the essence of the kidneys back to the spring Gong qigong exercise therapy ③ diet therapy The second is a personalized treatment method, according to the identification of the cause of the disease, identification of symptoms, identification of the disease of a combination of the three methods of identification of Chinese medicine, or acupuncture or acupressure, as well as Western medicine, is now divided into the following 1, the sexual state of concentration training method because erectile dysfunction is often accompanied by premature ejaculation, so the training process, is divided into five phases Phase one: Mutual touching of sensitive parts other than genitals, re-education of sexual knowledge, elimination of misconceptions and ignorance of sexual knowledge, and at the same time, lifting the pressure of both sides of the sexual behavior of the couple to cooperate with each other, and begin to mutual physical contact, resulting in pleasurable physical sensations, especially the touching of the erogenous zones, but in the touching of the genitals of men and women and the avoidance of the touching of women’s breasts, prohibiting sexual intercourse and inhibiting the formation of sexual orgasm, and every night for a week. Once a night for one week. The second stage: in addition to the whole body touch, focus on touching the male and female genitals and female breasts, cause the man’s penis erection, after the erection when the man appeared pre-ejaculation, latency, the male party to shrink the abdomen and anus and hold his breath in the state of inhalation, the idea of semen upward, the female party is a finger to pressure the head of the penis does not move, at the same time, the other hand downward traction of the scrotum, to beat away the impulse to ejaculation, and after that, you can continue to massage, once before the emergence of the situation The same method continues to be used for a total of three times, once a night for a week. The third stage: the woman on top when the male penis erection, the woman on top of the man lying under the penis into the vagina, but not allowed to twitch, the purpose is to lift the anxiety and fear of inserting the vagina, the time three days The fourth stage: the female sexual intercourse, that is, in the female on top position, men and women cooperate with the twitching and control of ejaculation before the male suction closure action, strive to delay the ejaculation time, once every other day for a week. The fifth stage: the old man wheelbarrow type, that is, the female lying position, male standing position, the female two lower limbs on the shoulders of the male two, under direct vision, the male in the penis after erection, with the hands of the penis, for the vaginal opening and straight into the, and for twitching sexual intercourse, such as the successful completion of the normal time of sexual intercourse, then the treatment is also a success. The advantage of this method is the gradual desensitization, step by step, from the bear out of sexual anxiety, sexual fear to the natural recovery of sexual function, this method is essentially a sexual behavior therapy, especially for mental impotence caused by anxiety, fear of failure of sexual behavior, fear of the female party to cause sexual repugnance, the loss of virility, due to these adverse emotions, often enough to destroy the natural process, resulting in pathological conditioned reflexes, the prerequisite for this method Is the first to stop the couple’s sexual behavior patterns, eliminate anxiety, and combined with psychotherapy, customer service erectile function of psychological barriers, that is, to interrupt the original cerebral cortex of the conditioned reflexes, to remove the vicious circle, the establishment of benign sexual arousal foci, so it can be successful, and the efficacy of the treatment is higher, but its shortcomings, the treatment time is longer, for a month or so, and to have a strong self-control, some people lack patience to give up halfway through. The result is a failure. 2, learn to practice tonifying the kidney and strong essence back to the spring work, this work is in the ancient Chinese longevity and health techniques, Taoist secret spring work evolved from the master Bianzhizhong announced the world, Shen Xinyan teacher collated, more than 800 years ago, it is the Taoist secret health work, and cooperation with Ruijin Hospital confirmed that the patient’s own control within the urinary T increased, E2 decreased, statistically significant, in the clinic, there is improvement in sexual function. Diabetic ED effect is better, in addition to Shandong College of Traditional Chinese Medicine, Professor Jing Yuzong in the blood (control group and their own control) also found that T increased and E2 decreased, E2/T decreased, scientifically confirmed its effectiveness, may be through ① idea of youthful face with a smile of benign induction, the production of happy hormones, adjusting the endocrine system ② Myo Lianxia Dan, Huashan school specific eight crotch movements gently, reasonably to Different specific posture, massage testicles, cause euphoria, promote interstitial cells to produce testosterone (T), and promote the production of spermatogonia, thus adjusting libido, improve erectile function. The disadvantage is that the effect is slower, generally need a hundred days to see the effect, such as the lack of patience can also fail. ③ clever spinal movement, we know that the erectile center and sacral 2 ~ 4 parasympathetic and lumbar 1 ~ 2 sympathetic nerve center have a close relationship, we have lumbar and sacral part of the clever activities such as the dragon swim power of the Mo crotch (sacral), the toad swim power and tortoise shrinking power of the lumbar activities, full stimulation of the erectile center, so that sensitivity to improve. 3, food therapy, China has medicine and food from ancient times to the present, used to the present, confirmed to be a both efficacy, and few side effects of the traditional treatment methods, but also with the same focus on identification of drugs to food, will be described in the following Chinese medicine identification and treatment 4, Chinese medicine identification and treatment of Chinese medicine treatment of ED, we advocate identifying the cause of the disease, identification and identification of the disease of the three combinations of commonality and individuality of the combination of the surface of the disease with the treatment of the root of a combination of the disease. Kidney qi deficiency and failure type: Yang not lifting, or erection but not firm, semen is thin, dizziness, tinnitus, pale face, cold limbs, cold limbs, waist and spine, fatigue, pale and fat tongue, thin white moss, pulse is thin and sinking. Treatment: warm kidney to help yang, nourish yin to fill the essence formula composition: five son diffraction pills plus subtraction cuscuta 15 goji berries 15 raspberries 15 schizandra 12 Che Qian Zi 12 Acorus calamus 15 farzhi 15 centipede 2 centipede chasteberry 15 Cornus officinalis 12 raw astragalus 30 yellow essence 30 licorice 10 experience: the kidneys for the body of the root of the yin and yang, all kidney deficiency, there will be yin and yang are both false pathology, just the primary and secondary points, ED patients with kidney yang deficiency, therefore both tonic medicine kidney yang deficiency Patients with ED are mainly suffering from kidney yang deficiency, so the medication used is not only to replenish kidney yang, but also to seek yin in yang, and those with kidney deficiency must be accompanied by kidney qi deficiency, which should be emphasized. Guang Si Ji Ji Yao” “Yang Dao Feng Aang and vibration, liver gas to also, strong and hot, heart gas to also, firm and long, kidney gas to also”, it can be seen that the treatment of the kidney do not forget to treat the heart and liver, tonifying the kidney and tranquilize the spirit, transportation heart and kidney, the formula of Wu Zi Diffractive Zong Tang has been confirmed by the pharmacology of the protection of testicular spermatogenesis, regulating the function of the hypothalamus – pituitary – gonadal axis, the function of the hypothalamus – pituitary – gonadal axis, and the function of the pituitary gland. Pituitary – gonadal axis function, anti-aging, lowering blood sugar, improve sexual function, enhance immunity functions, Wu Zi Diffractive Zong Tang, nourish the liver and kidney, fill essence and benefit the qi, with the Yuan Zhi, Calamus, tranquilize the heart and tranquilize the mind. The centipede dredges the liver and passes through the meridian, and raises the yang channel, and the raw astragalus and yellow essence nourish qi and blood, and the combination of all the medicines makes up the effect of nourishing the kidney and filling in the essence, nourishing the kidney and helping the yang, transporting the heart and the kidney, replenishing qi and nourishing the essence, and urging the essence to raise yang. Dietary therapy (1) rice wine fried shrimp fried and seasoned food. (2) angelica oxtail soup angelica 30g, oxtail, oxtail a hair cut into small sections, soup seasoning, drink soup and eat oxtail. Liver depression type: impotence, good depression, fullness in the chest, silence, nervousness, anxiety, sleeplessness, pale red tongue, thin moss, stringy pulse. Formula composition: Chai Hu 9 Sheng Ma 9 Chuan Xiong 9 Bai Shao 15 Xiang Fu 9 Gardenia 9 Yuan Zhi 15 Calamus 15 Sang Bai Pi 12 Di Long 12 Centipede 2 Goji Berry 15 Snake Bed Seed 15 Raw Glycyrrhiza Uralensis 10 Functions and Treatments: Liver, depression relief, guarding the spirit and determination of the spirit, and harmonize yin and yang Physical Characteristics: foot syncopal liver meridian through the femoral yin into the Maozhong, around the yin apparatus, and against the small abdominal area, the liver qi injected into the yin apparatus, the liver is the master of tendon, the anterior yin for the confluence of all the tendons, the yang Dao Fen Aang and Zhen Fa. Liver gas to also, that is, erection and the invigoration of liver qi related, such as liver qi stagnation, the wood is out of tune, yang qi does not stretch, the yin apparatus lost drumming and weak, this formula to ease the liver to resolve the depression, plus calamus, far Zhi, guarding the God to determine the Zhi, centipede, the ground dragon, dredge the liver to pass the channels, Xing Yang Road, wolfberry, snake bed seed, and yin and Yang, white peony, licorice has the effect of antispasmodic, a total of the liver to relieve the depression and invigorate the yang road of the work. Dietary therapy 1, rose tea: dry rose petals 6g, jasmine tea appropriate amount of tea 2, Buddha’s hand ginger soup: Buddha’s hand 10g ginger 2 slices, water decoction slag sugar warm service Damp heat injection type Clinical manifestations: impotence, lower limbs sleepy, urinary urination yellowish red or frequent dribbling, lower abdominal perineum discomfort, and sometimes the scrotum dampness, stench, tongue red, yellowish greasy moss, pulse string. Treatment: diuresis, clearing dampness and heat, benefiting qi and gonorrhea formula composition: raw astragalus 30 yellow essence 30 raw barley 30 winter melon kernel 15 powder castor seed Z15 ze lagardum 10 talc 10 calamus 15 jingtian panax ginseng 30 lu lutong 12 white peony 30 raw licorice 10 add: such as prostatitis, add danshen, red peony, wang bu liu xing zi, white snake snake tongue, septoria, such as dampness and heat of spleen and stomach, yellowish and greasy, add houougou Xiang, pei lanxi, cangzhu, Houpao. If there is obvious Yang deficiency, add Er Xian Tang. Yang deficiency is obvious, add two immortal soup Yin deficiency, add Zhi Bai Di Huang Tang experience: for obese body type with hot and humid body, or chronic prostatitis, urethritis patients, single aphrodisiac drugs, the effect is not good, such as inflammation is appropriate to treat the inflammation, reuse of hot and humid products, with the Western medical examination, the formula Job’s tear grains, Dong Gua Zi, Psyllium carinatum, sweet and light, cold, clearing the heat and dampness, diuretic, diastolic, castor seed Z, divided into the turbidity, dampness, diarrhea, heat, slippery stone, clear and seepage dampness. Slippery stone, clearing and seepage of dampness, diarrhea and heat downstream, through the urine, calamus, taste pungent and slightly warm, aromatic openings, dampness, gas, Lutong, Jingtian Sanqi, dredge the meridians, regulating the qi; raw Astragalus, beneficial to the yang; white peony, licorice, spasmodic and analgesic, the drugs together, there is a beneficial to the yang, drain the heat and dampness, the zong tendon to be full, impotence from the healing. Food therapy 1, Job’s tears congee: Job’s tears 60 round-grained rice 50 first Job’s tears cooked soft, and then add rice burned into porridge 2, yam Gorgonzola cornhusk congee: Huaibai yam, gorgonzola each 50g, cornhusk 60g, rice 30g, boiled congee. Sugar impotence clinical symptoms: soreness and weakness of the waist and knees, frequent urination at night, dry mouth and tongue, thirst and drinking, easy to eat and hunger, impotence, red tongue, fine pulse and number. Composition: Raw and ripe ground each 20 Huaishan yam 15 Cornus officinalis 10 Angelica sinensis 15 Pueraria lobata 30 smallpox powder 15 Lycium barbarum 15 Centipede 10 Cinnamon 3 Epimedium 15 Xianmao 15 Yangqi stone 30 Sichuan hyssop 15 Raw Glycyrrhiza glabra 10 Remedies: benefit the kidney to fill the essence, warm the yang and dissipate the stasis, lowering the sugar and starting impotence Remedy: diabetes and other Chinese medicine thirst category, the lower elimination and renal blood stasis may appear in the soreness of the waist and knees, urination and impotence, the mechanism of the renal essence deficiency, yuan-yang deficiency, stasis and blood stasis. The mechanism of the disease is deficiency of kidney essence, insufficient yuan yang, blood stasis in the penis veins, resulting in abnormal blood flow in the penile arteries, white membrane fibroplasia, calcification, lumen narrowing, impede the blood supply to the cavernous body, resulting in erectile dysfunction, so the treatment of this disease is first in the control of blood glucose, Chinese and Western medicines can be used in the same way, the formula is designed to nourish the kidneys to fill the essence to the raw and ripened groundnut, berries of wolfberry, nourishing the kidney yin Cinnamomum cinnamomum, Erxian, yangqishi, warming the Yang Qiqi, impotence, Pueraria Mirifica, powdered smallpox, yin sugar, centipede. Centipede, which is powerful in running away, reaches the zongjian, increases blood flow, and hyssop, which moves qi downward and reaches the lesion directly, so as to achieve the effect of benefiting the kidney and filling up the essence, warming the kidney and dispersing blood stasis, and lowering the sugar level and starting the impotence. Acupuncture and moxibustion treatment Conventional points: Guanyuan, Qu Bone, Zhongji, of which Qu Bone can lead to the double-needle puncture method (pay attention to empty urine before the needle) impotence points (2.5cm on the kidney yu, next to the center line 1.5cm), such as weak yang deficiency plus moxibustion of shenque, the body column, the fate of the body, or inter-ginger moxibustion: shenque, qihai. Matching points: less sleep: Sanyinjiao, insomnia points; frequent urination: take the groin outside the middle 1/3 intersection; prostatitis: Kunlun point subcutaneous straight down, Chikubin. Dietary therapy: bitter melon, carrots, guava have a certain degree of hypoglycemic effect. Western medicine treatment 1, endocrine therapy: such as testosterone decline, can take methyltestosterone 10mg, 3 times a day. Testosterone propionate 25mg, intramuscular injection, once a day, a total of 7 days (Note: should not be applied in large quantities, otherwise on the one hand, produce dependence, on the other hand, can make the red blood cells increase, sodium storage); chorionic gonadotropin 1000u, intramuscular injection, 2 times a week, a total of 3 weeks. 2, peripheral drugs: act in the periphery to make smooth muscle relaxation, drugs such as: the first generation of citrate, sildenafil, domestic trade name: Viagra, Viagra, is currently the first-line oral drugs, with the first choice of drugs to treat ED, accounted for 90% of the ED market, and it’s mechanism through a highly selective control of the activity of the PDES (5 phosphodiesterase) to increase intracellular CGMP (cyclic adenosine monophosphate) levels, so that cellular calcium ion efflux and then the cellular calcium ion efflux. The mechanism of PDES is to increase intracellular CGMP levels by highly selective control of PDES (5-phosphodiesterase) activity, which in turn increases intracellular calcium ion efflux and induces smooth muscle relaxation to stimulate erection. Penile erection is a complex neuro-vascular dynamics process, when receiving sexual stimuli such as audio-visual touch, non-adrenergic non-cholinergic neurotransmitter secretes carbon monoxide and other neuromediators. Carbon monoxide enters into the penile cavernous smooth muscle cells and activates soluble guanylate cyclase, which converts guanosine triphosphate to guanosine cyclic phosphate. The level of intracellular CGMP increased, CGMP by reducing the intracellular concentration of calcium ions in the penile cavernous vascular smooth muscle, and relaxation of the penile cavernous vascular smooth muscle, resulting in cavernous vasodilatation, the increase in the amount of blood in the penis, the penis becomes thicker, so that the cavernous body of the external leucoplastic membrane passive extension of cavernous body of the conduit veins become narrower, the venous return is reduced, and the penis becomes thicker and stiffer, resulting in penile erection. With the degradation of CGMP by smooth muscle cell 5 phosphodiesterase (Viagra point of action), the loss of the second messenger activity, the reduction of penile blood flow, venous return open, so that the penis weakens. Usage: Oral one hour before sexual intercourse, the dose of 25mg, 50mg, 100mg, the efficiency varies from person to person, side effects include headache, facial flushing, indigestion, race, urinary tract infection, visual abnormalities, diarrhea, dizziness, rash, etc., and the effect is poorer in the presence of patients with severe vascular lesions or cavernous fibrosis. In addition, the inhibition of phosphodiesterase effect of new drugs have vardenafil, effective in diabetic ED, tadalafil, has ketocorine, etc. are gradually entering the market, available for efficacy. 3.Central drugs Because not commonly used, only a brief introduction (1) Yohimbine is a bidirectional α2 receptor blocker, 6 ~ 10mg, 3 times a day, 4 ~ 8 weeks, to treat cardiac cause of ED effectively, the effectiveness rate of 62%. (2) Phentolamine α-blocker, oral one hour before intercourse, 40 ~ 80mg, effective rate of about 50%, side effects of optic chorioretinitis, headache, tachycardia, etc. Other 1, penile cavernous body injection of drug therapy, this is the treatment of the first-line treatment of ED, along with the clinical application of sildenafil, has been reduced to the second line of treatment, in the case of ineffective drug therapy before the application of the drug, the current commonly used drugs are Currently, the commonly used drugs are opioid, Phentolamine and PGE, and the efficacy of the combination of the three is high. 2, the application of vacuum constriction device (VCD) 3, local topical application of drugs, such as nitroglycerin patch or emulsion 4, penile vein surgery, cavernous vein ligation, penile vascular reconstruction, bypass surgery 5. Prosthesis straight into the surgery: the current common use of expandable prosthesis In short, ED is a complex disease, mainly cardiac and organic, should be the first to carry out a correct diagnosis, to find out the cause of the disease, according to the different causes of the symptoms of the treatment, the ED is a complex disease, mainly cardiac and organic, should first carry out correct diagnosis, find out the cause of the disease, according to the different causes of the symptoms of the disease. Last but not least, ED should be mainly psychogenic ED, but it is mixed with organic causes, so it is necessary to treat a disease with a variety of methods.