早泄（PE）是常见的男性性功能障碍，科学规范的诊断和治疗对改善生活质量至关重要。本文将详细介绍早泄的标准诊疗流程。
Premature ejaculation (PE) is a common male sexual dysfunction. Scientific and standardized diagnosis and treatment are crucial for improving quality of life. This article details the standard diagnostic and treatment procedures for PE.
第一部分：专业诊断流程 / Part 1: Professional Diagnostic Process
1. 临床问诊 / Clinical Consultation
- 病史采集：
- 早泄发生频率和持续时间
- 是否从首次性经历开始（原发性）
- 还是后期出现（继发性）
- 特定情境或所有情境下发生
- Medical history collection:
- Frequency and duration of PE
- Whether present since first sexual experience (primary)
- Or developed later (secondary)
- Occurs in specific situations or all situations
2. 评估工具使用 / Assessment Tools
- PEDT问卷：早泄诊断工具评分
- IELT测量：阴道内射精潜伏时间
- 生活质量评估：对性生活满意度影响
- 伴侣影响评估：对双方关系的影响程度
- PEDT questionnaire: Premature Ejaculation Diagnostic Tool scoring
- IELT measurement: Intravaginal ejaculatory latency time
- Quality of life assessment: Impact on sexual satisfaction
- Partner impact assessment: Degree of impact on relationship
3. 体格检查 / Physical Examination
- 泌尿系统检查：排除器质性病变
- 神经系统检查：评估神经反射功能
- 激素水平检测：睾酮、甲状腺功能等
- 心血管评估：检查血管功能状态
- Urological examination: Rule out organic lesions
- Neurological examination: Assess nerve reflex function
- Hormone level testing: Testosterone, thyroid function, etc.
- Cardiovascular assessment: Check vascular function status
第二部分：分级治疗方案 / Part 2: Graded Treatment Plan
1. 一线治疗：行为疗法 / First-line Treatment: Behavioral Therapy
- 停-动技术：
- 识别射精预感点
- 及时停止刺激
- 待兴奋度下降后继续
- 逐步延长性交时间
- Stop-start technique:
- Identify pre-ejaculation point
- Stop stimulation in time
- Continue after excitement decreases
- Gradually prolong intercourse time
- 挤压法训练：
- 接近射精时挤压龟头
- 使用正确的手法力度
- 与伴侣配合练习
- 建立新的射精控制模式
- Squeeze technique training:
- Squeeze glans when approaching ejaculation
- Use correct technique and pressure
- Practice with partner cooperation
- Establish new ejaculation control pattern
2. 二线治疗：药物治疗 / Second-line Treatment: Medication
- SSRI类药物：
- 达泊西汀：按需服用
- 帕罗西汀：每日服用
- 舍曲林：调节血清素水平
- 氟西汀：改善控制能力
- SSRI medications:
- Dapoxetine: Taken as needed
- Paroxetine: Taken daily
- Sertraline: Regulates serotonin levels
- Fluoxetine: Improves control ability
- 局部麻醉剂：
- 利多卡因喷雾剂
- 普鲁卡因药膏
- 使用后需清洗避免影响伴侣
- 注意使用剂量和时机
- Topical anesthetics:
- Lidocaine spray
- Procaine ointment
- Need cleaning after use to avoid affecting partner
- Pay attention to dosage and timing
3. 三线治疗：综合疗法 / Third-line Treatment: Comprehensive Therapy
- 心理治疗：
- 认知行为疗法
- 性心理咨询
- 伴侣共同治疗
- 压力管理训练
- Psychotherapy:
- Cognitive behavioral therapy
- Sexual psychological counseling
- Couple joint therapy
- Stress management training
- 物理治疗：
- 盆底肌康复训练
- 生物反馈治疗
- 电刺激疗法
- 针灸辅助治疗
- Physical therapy:
- Pelvic floor muscle rehabilitation training
- Biofeedback therapy
- Electrical stimulation therapy
- Acupuncture辅助 therapy
第三部分：治疗注意事项 / Part 3: Treatment Considerations
治疗周期预期 / Treatment Cycle Expectations
- 初期改善：2-4周可见初步效果
- 显著改善：3-6个月持续治疗
- 巩固期：6-12个月行为重塑
- 长期维持：需要持续练习和随访
- Initial improvement: Preliminary results visible in 2-4 weeks
- Significant improvement: 3-6 months of continuous treatment
- Consolidation period: 6-12 months of behavioral reshaping
- Long-term maintenance: Requires continuous practice and follow-up
治疗依从性 / Treatment Compliance
- 严格遵医嘱用药
- 定期复诊调整方案
- 坚持行为训练
- 配合生活方式改善
- Strictly follow medical advice for medication
- Regular follow-up to adjust plans
- Persist in behavioral training
- Cooperate with lifestyle improvements
第四部分：预防复发措施 / Part 4: Relapse Prevention Measures
生活方式管理 / Lifestyle Management
- 规律运动习惯
- 健康饮食结构
- 充足睡眠休息
- 压力缓解技巧
- Regular exercise habits
- Healthy diet structure
- Adequate sleep rest
- Stress relief techniques
定期随访监测 / Regular Follow-up Monitoring
- 每3个月评估疗效
- 每年全面检查一次
- 及时调整治疗方案
- 预防并发症发生
- Evaluate efficacy every 3 months
- Comprehensive annual check-up
- Timely adjust treatment plans
- Prevent complications
结语 / Conclusion
早泄的诊断和治疗需要专业规范的流程。通过系统评估、分级治疗和长期管理，大多数患者都能获得满意疗效。建议及时就医并坚持治疗。
PE diagnosis and treatment require professional standardized procedures. Through systematic evaluation, graded treatment and long-term management, most patients can achieve satisfactory results. Timely medical treatment and persistent treatment are recommended.
