Impotence is a disease in which male genitals are weak, unable to erect or unable to complete normal sexual intercourse. 【 Clinical manifestations 】 The penis cannot erect for sexual intercourse, or although it has erection, the erection is not firm, or the erection cannot maintain sexual intercourse. [diagnosis] 1. The diagnosis of impotence is quite special, and doctors should pay close attention to it to gain the trust of patients and let them speak frankly about various problems. 2. First of all, we should understand the onset and progress of impotence, when it started, under what circumstances, whether it happened gradually or suddenly, whether it was recurrent or paroxysmal. Under what circumstances can you get an erection, whether it is a complete erection or a partial erection, how strong the erection is and how long it can last. When the penis is erect, is there any abnormal feeling? Whether you can get an erection when masturbating, and whether you can get an erection before waking up at night or in the morning. 3. Doctors should pay attention to the possible causes of impotence, such as whether there is a history of mental trauma, trauma, diabetes or other chronic diseases, such as atherosclerosis, hypertension and hyperlipidemia. Have masturbation habits and hobbies such as smoking and drinking. Have you ever had a history of prostatectomy, sterilization or other operations? Have a history of chronic prostatitis or seminal vesiculitis. Have a history of drugs that have no effect on sexual function. 4. Marriage history should know the time of marriage, feelings with spouse and fertility. If you are divorced or widowed, you should know the sex life of your past marriage. 5. Understand other sexual functions, such as changes in sexual desire and ejaculation function, and the relationship with itching. [treatment] 1. Western medicine treatment of impotence, the first thing is to find out the cause, targeted treatment. For organic diseases, the primary disease should be treated. For those affected by drugs, it is necessary to consider stopping taking drugs or switching to other drugs. Vascular impotence can be treated by vascular surgery. Psychotherapy or behavioral therapy should be used for mental impotence. For some patients with organic impotence who can't solve its etiology, penile prosthesis can be used for human implantation. In addition, some non-targeted treatment methods can be selectively applied and can also receive certain results. (1) "Sex therapy", impotence patients have no physical pain, but a great mental burden, and the blame caused by the spouse's failure to meet the requirements of sexual activities often makes the symptoms worse. Therefore, clinicians should have a high degree of sympathy for patients, and let patients fully trust doctors and encourage patients to establish confidence through conversations with patients. Sex therapy is a kind of behavioral therapy. This therapy first stops the sexual contact between husband and wife, gradually learns the correct sexual behavior pattern through sex education, eliminates anxiety, eliminates the influence of various social and psychological factors, and overcomes the psychological barrier of impotence, which can achieve certain curative effect. (2) Non-hormonal drug therapy ① Yohimbine (Wei Bizhi) 6mg each time, 3 times a day. If the stomach or nerve symptoms are unbearable, it can be reduced to 2mg each time, three times a day, and the number of wells will gradually increase to 18mg per day. The drug should be maintained for at least 65,438+00 weeks. There may be side effects such as palpitation, dizziness and insomnia. ② Papaverine: 40-80mg diluted in 20-40 ml distilled water, injected into human cavernous body, and erections began to appear within 65438 00 minutes, lasting for 2 hours. However, this method has the risk of abnormal erection of penis. 2. TCM treatment (1) stagnation of liver qi: stagnation of yang qi, depression, fullness in chest and hypochondrium, irritability, hyperventilation, red tongue with thin coating and rapid pulse. Treatment: soothing the liver and relieving depression, dredging collaterals and vibrating flaccidity. Prescription: Radix Bupleuri, Radix Paeoniae Alba, Fructus Aurantii and Radix Glycyrrhizae each10g; Cortex Moutan and Fructus Gardeniae each 12g, centipede 5g and leech 3g. (2) Damp-heat in the liver and gallbladder: the penis is weak, the scrotum is wet, the urine is short and red, the tongue is red and greasy, and the pulse is slippery. Treatment: clearing liver, benefiting gallbladder and eliminating dampness. The prescription is Scutellariae Radix, Fructus Gardeniae, Bupleuri Radix, Caulis Akebiae, Herba Plantaginis (parched), Alismatis Rhizoma, Radix Angelicae Sinensis, Radix Rehmanniae each 65438±00g, and Radix Gentianae 65438±05g. (3) Fear of kidney injury: impotence, weakness, palpitation, frequent nightmares, timidity and suspicion, thin and white tongue coating, and thready pulse. Treatment: Ningshen Bushen. Prescription: Radix Rehmanniae Preparata, Radix Morindae Officinalis, Radix Angelicae Sinensis, Rhizoma Dioscoreae and Poria each 65438±05g, Semen Ziziphi Spinosae and Radix Polygalae each 30g, Os Draconis and Concha Ostreae each 25g (fried first), Cimicifuga, Radix Bupleuri each 5g and Scolopendra 6g. (4) Life-threatening fire decay: yang is not lifted, pale face, mental fatigue, dizziness and tinnitus, soreness of waist and knees, fear of cold, pale tongue with white fur, and deep and thin pulse. Treatment; Warm up the next RMB. Prescription: Radix Rehmanniae Preparata, Fructus Lycii, Fructus Corni, Radix Angelicae Sinensis, Herba Cistanches, Radix Morindae Officinalis, Semen Allii Tuberosi preparata, Rhizoma Curculiginis and Herba Epimedii each 65438±02g, Fructus Cnidii and Cortex Eucommiae preparata 65438±05g, Colla Cornus Cervi 65438±00g and Cortex Cinnamomi 8g. [Prevention and Care] 1. Adjust your diet and lifestyle, and don't take wine as a pulp and overeat. 2。 Save the house, quit bad habits and prevent masturbation. 3. Firmness, lyricism and anti-depression are also an important part of preventing impotence.