Chithandizo Cholingalira cha Erectile Dysfunction
Gérard V. Sunnen, MD
Chipatala cha Bellevue ndi University of New York
M'zaka zaposachedwapa kuthekera kwa kusintha kwa kusintha kusintha kwa kayendetsedwe kake kazisokonezo kwakhala kofufuzidwa kwambiri. Njira zochizira monga kuphatikizapo, biofeedback, maphunziro achisangalalo komanso njira zosinkhasinkha zasonyezeratu kuti thupi limapezeka pansi pa chidziwitso lingathe kufika kumalo odziwitsira zomwe zimatanthawuza kudzikonda (Schwartz, 1973; Griffith, 1972).
Chithandizo chosinkhasinkha chakhala chikugwiritsidwa ntchito mosintha masinthidwe oyeserera ndikupangitsa mayiko osintha kuzindikira (Deikman, 1963; Maupin, 1969). Kafukufuku woyambirira wa yogis waku India (Brosse, 1946) adawonetsa kuthekera kwawo pakuwongolera kugunda kwa mtima. Kuyambira pamenepo, maphunziro azosinkhasinkha apereka chidziwitso pazomwe angathe kuchepetsa kupuma, kuthamanga kwa magazi, kuchepa kwa oxygen, kutsika kwa khungu, ndikupangitsa kusintha kwa EEG ndikuwonjezeka kwa alpha wave preponderance ndi matalikidwe (Anand et al., 1961; Wallace & Benson, 1972; Benson et al., 1975).
Zomwe zimagwiritsidwa ntchito pogwiritsa ntchito njira yosinkhasinkha zochizira zogonana zinachokera ku zosiyana. Pakati pa kafukufuku, wodwala m'maphunzirowa adanena kuti adazindikira kuti kugonana kumakhala kosaoneka m'maganizo ake, makamaka nthawi yomwe adafuna kugonana. Analongosola izi ngati chilakolako chogonana komanso amachiyerekeza ndi chidziwitso chokwanira ndi chidziwitso chomwe anali nacho asanayambe. Pambuyo pake, anthu onse mu phunziro ili adawonetsedwa kuti izi zitheke; Amayi asanu ndi mmodzi (6) mwa asanu ndi anai (9) aliwonse adanena kuti palibe vuto la kugonana, ndipo amuna atatu otsalawo adalongosola kuchepa kwa chiwalo chawo.
Njira zothandizira kuyankha kwa erectile zimaphatikizapo kupumula kwa mitsempha yambiri ndi engorgement yotsatira ya penile spongiosum. Akafunsidwa kuti atsimikizidwe m'magawo amtunduwu panthawi yamaganizo a erectile, anthu nthawi zonse amatha kufotokozera kumverera kwachidzalo ndi kutentha.
Kafukufuku waposachedwa wazogonana amuna (Koshids & Sohado, 1977) kugwiritsa ntchito thermography kuwonetsa kuwonjezeka kwa kutentha kwa maliseche komwe kumachitika mphindi 2 mutatha kuwonera kanema wokonda zolaula.
Zinali kuganiza kuti zifukwa zina zopanda mphamvu zapamwamba zingapangitse kukhala ndi vuto m'maganizo awo omwe amachititsa kuti munthu asamalidwe bwino komanso kuti aphunzitse munthu wina kuti adziŵe zomwe zingamuthandize kukonzanso kugonana. Kusinkhasinkha kunkawoneka koyenera kwambiri chifukwa chaichi chifukwa kungapereke kulunjika kwakumverera kwa thupi ndikubweretsa mowonjezereka m'malo mwa njira zosinthidwa za thupi.
njira
Odwala asanu ndi atatu omwe ali ndi mphamvu zopitilira sukulu komanso zaka zapakati pa zaka 32 anaphatikizidwa mu phunziro ili. Onse adali ndi chizindikiro ichi kwa mwezi woposa ndi mwezi wa 2-1 / 2 miyezi. Odwala asanu anali ndi vuto lalikulu kwambiri poyambitsa vuto linalake, pamene ena anayi adanena kuti chisonyezero chachinyengo chikupita patsogolo. Omwe ankakonda kukhala ndi zibwenzi zambiri zogonana, ndipo enawa adagwirizana ndi mavuto awo kuti asakhale osakhutira ndi mnzake. Kufufuza kwachipatala kunasonyeza kuti palibe vuto lililonse.
Cholingalira chogwiritsa ntchito kusinkhasinkha mankhwala chinkafotokozedwa kwa aliyense monga mwachisawawa kuthetsa zotsatira zowonongeka. Malangizo anaperekedwa mu makina a ndondomeko yolingalira. Zomwe zimaganizira kusinkhasinkha zimaphatikizapo kusankha chisankho choyenera komanso kukhazikitsidwa kwa malingaliro omwe kunja kwina, zovuta, mantha ndi malingaliro osagwirizana ndi zomwe zakhala zikuchitikirazo sizinasamalidwe. Malangizo anaperekedwa mwa luso loletsa maganizo olakwika ndi ntchito yosunga chidziwitso chodziwika bwino popanda kugwedezeka kuti agone. Wodwala aliyense anafunsidwa kuti afikitse msinkhu wachisangalalo chotsitsimutsa mwa kukhala pansi ndi kuika chidwi pa chiyero cha kupuma. Izi kawirikawiri zinatenga pafupifupi maminiti a 3, ndiyeno kupuma kwa mtima, kuthamanga kwa mtima, ndi kuthamanga kwa minofu kumatsikira kuchepa kuchepetsa. Panthawi imeneyo odwala anafunsidwa kuti asamangoganizira za malo awo opatsirana pogonana komanso kusinkhasinkha zomwe zimawoneka bwino chifukwa cha kutentha, kusamala kuti musayese minofu yamtundu uliwonse pamene mukuchita. Pambuyo pochita zozizwitsa ku ofesiyi, wodwala aliyense adafunsidwa kubwereza kawiri kawiri pa nthawi ya maminiti a 15.
Results
Odwala asanu amanena za kutentha kwa chiberekero m'kati mwa masiku a 10, ndi ena awiri pambuyo pa masabata a 2. Chisoni ichi chinakula kwambiri ndipo chikhoza kufulumizidwa mwamsanga ngati maphunziro akupitirira. Otsala awiriwa adanena kuti nthawi yayitali ikumva zowawa koma nthawi zonse ankasokonezeka ndi malingaliro oipa ndipo sakanatha kuganizira mozama. Odwalawa, ngakhale atakhudzidwa, sanapitilire kutentha kwa chiberekero ndipo sanakhazikitse luso la erectile. Mmodzi mwa odwalawa anapitilira masiku a 7, ndipo wina kwa masabata a 2 asadandaule ndi njirayi.
Amene adatha kubweretsa chiwerewere amatha kubereka nthawi zonse ndi mayesero otsatirako. Odwala asanu ndi awiri opambanawa adanena kuti kubwerera kwa ma Erectile m'masabata a 2 akupeza kutentha kwa chiwerewere. Ntchito ya coital inanenedwa mwa anthuwa kuti abwerera ku magulu akuluakulu, ndipo odwala atatu kuti apite patsogolo.
Odwala awiri adakwanitsa kukwaniritsa zofuna zawo panthawi yomwe akuganiza, nthawi zambiri pambuyo pa maminiti 10 akugwiritsa ntchito njirayi.
Pambuyo pa miyezi ya 3 kukwaniritsidwa kwa luso la erectile kunasonyeza kulemera kwa zotsatira zothandizira odwala asanu. Wodwala mmodzi adatayika kuti atsatire.
Kukambirana
Zomwe zinachitikira ndi kagulu kakang'ono ka odwala zikusonyeza kuti njira zina zosinkhasinkha zomwe zingasinthidwe zingakhale zothandiza pochiza matenda osokoneza bongo. Anthu omwe ali oyeneretseratu pamwambo umenewu akulimbikitsidwa kuti apatule miyezi iwiri ya 15 tsiku ndi tsiku kuti aganizire ndikukhala ndi mphamvu zochepetsera kuchoka pamaganizo awo kuti ayang'ane mbali ya anatomical, kufufuza ndikukulitsa kutentha, ndipo panthawi imodzimodzi tikhale okonzeka komanso omasuka. Anthu a 2 omwe sanapindule ndi njirayi amawoneka kuti ali ndi vuto limodzi ndi mbali imodzi ya ndondomeko yovuta imeneyi.
Poyang'ana zotsatira za phunziroli, ndibwino kuti muzindikire kuti m'maphunziro ena mtengo wa kukhululukidwa kwadzidzidzi kuchokera ku mphamvu zopititsa patsogolo kwakhala ukukwera. Ansari (1976) adapeza chiwerengero cha 68% chikhululukiro cha miyezi 8 mutangoyamba kuyesa.
Ofufuza omwe awonetseredwa awonetsedwa kuti amathetsa kupsinjika bwino kwambiri popeza zomwe akumana nazo zikuwonjezeka (Goleman & Schwartz, 1976). Ndizotheka kuti maphunziro athu opambana adatha kuthana ndi mavuto azakugonana modekha kuposa momwe adachitiramo kale, motero kuletsa kuyankha kogonana. Chosangalatsa ndichakuti, anthu onse opambana mu kafukufukuyu adanenanso zakumverera kwamtendere wamkati m'miyoyo yawo ya tsiku ndi tsiku, pomwe amuna awiri omwe sanayankhe pamankhwalawa sanasinthe kuti athe kuthana ndi nkhawa.
Kuchita bwino kwa njirayi kungakhalenso pa maphunziro enieni a njira zowonongeka mu ANS. Mfundo yakuti anthu ogwira ntchito bwino amapereka chidziwitso cha kutentha kwa umuna m'kati mwa zochepa chabe, koma sanathe kuchita zimenezi asanayambe kuchipatala, ndipo kuti anthu awiri adanena kuti ali ndi luso lotha kupanga zozizwitsa modzipereka akhoza kuthandizira izi.
Njira zothandizira za njirayi zikudikirira kupitiriza kuphunzira koma zakhala zikubwezeretsa chiyembekezo kwa anthu osankhidwa omwe akuvutika ndi ntchito yachiwiri yothetsera erectile.
Zothandizira
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