臭氧治疗男性勃起功能障碍美国
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运动：开始散步30-40分钟，然后可以发展为间歇训练。研究：可变的风险因素和勃起功能障碍：生活方式能改变风险么？ 《泌尿学》这项研究表明，中年时期要扭转吸烟、肥胖和饮酒等对勃起功能障碍的的危害可能为时已晚了。相比之下，身
体活动可能会降低ED的风险，即使在中年开始也不晚。
Sleep- Sleep disorders, or lack of sleep, cause oxidative stress in the body, and that increases the potential for heart disease. Sleep is a super antioxidant for the heart. In one study, researchers examined the sleep habits of 475,000 people. They found that a chronic lack of sleep—less than six hours a night— raised the risk of developing or dying from heart disease by 48 percent and stroke by 15 percent. Naturopathic Medicine is rich in ideas that start with adrenal/hormone function, exercise, assessing caffeine usage, herbal therapies- Ashwagandha, valerian, passion flower….whole lecture just on sleep.
Erectile dysfunction as a predictor of advanced vascular age.(Andrology. 2015 Oct 7. doi: 10.1111/andr.12105.) ED是老年血管的预测因子《男科学》
This article reveals that there is a predictive value of ED in assessing the discrepancy between VA and CA. (vascular age vs Chronological age).本文揭示了ED在评估血管年龄和实际年龄之间的差异方面具有预 测价值。
Nitric Oxide一氧化氮 vasodilatation血管舒张
The endothelium of arteries produces nitric oxide动脉内皮产生一氧化氮 Atherosclerosis reduces capacity to produce nitric oxide动脉粥样硬化降低产生一氧化氮的
每4位男性中就有1位抱怨ED发病趋向40岁以前，这类人群都与使用毒品和吸烟有关。（《性医学期刊》）
The large variation in reported prevalence rates reflects differences in methodology, definitions of ED, regional and cultural perceptions of ED, age, and extent of concomitant medical conditions.
在臭氧治疗之前开始一氧化氮释放因子，同时检测血压调整药物
Other Lifestyle Considerations生活方式注意事 项 Exercise- 30-40 minutes start with walking then progress to interval training. Study: Modifiable risk
去年在AAO学习，一氧化氮是由舌后的细菌产生的（未进行口腔清洗，促使口腔细菌形成） Exercise increases nitric oxide锻炼增加一氧化氮 Amino acids L-arginine and L-citrulline 氨基酸 L-精氨酸 L-瓜氨酸 Foods that contain antioxidants- fruits and vegies help to protect the enzymes
Nitric Oxide releasing factors一氧化氮释放因素
Correct Metabolic syndrome. 改正代谢综合征
Screening: CRP (body‘s key inflammatory marker), high Lp(a).筛查：C型反应蛋白（身体重要的炎症标记 物）
Treat with Dr. Sinatra‘s famous ‘awesome foursome‘ coQ10, 50-150 mg daily; magnesium, 400-
800 mg daily, broad spectrum carnitine 1-2 g daily in divided doses, and D ribose 5 g twice a day. 治疗采用Sinatra的著名的四组药物方法：辅酶Q10每天50-150mg;镁每天400-800mg;广谱肉 毒碱每天1-2g,分剂量服用；核糖5g，一天2次。
ED流行的广泛性与发病率与年龄和合并症有关，如心血管疾病，糖尿病，代谢综合征，高血脂，抑郁症，盆腔手术， 用药副作用，神经系统紊乱，创伤，良性前列腺增生症状以及心理和人际关系问题。
ED prevalence has been reported as 7% among men aged 18 to 29 yr, 2 to 9% among men aged 30 to 39 yr, 9 to 11% among men aged 40 to 49 yr, 16 to 18% among men aged 50 to 59 yr, 34% among men aged 60 to 69 yr, and 53% among men aged 70 to 80 yr (Int J Impot Res 2002; 14: 422–432)
Erectile Dysfunction 勃起功能能障碍
As physicians we ought to be asking the questions. 作为医生，我们应该去问一些of openness.创造一种坦诚公 开的环境
Difficult subject for most men.这对于大多数男性来 说是一个难以启齿的话题
Some men will be very open, and these are the ones from which you will learn.有些男性十分开放， 你们可以从这些人身上学到一些东西。
Epidemiology流行病学
ED is defined by a National Institutes of Health consensus panel as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. 美国国立卫生研究院共识小组对ED 的定义是不能达到或维持能够满足性行为的勃起要求。
needed to create nitric oxide from amino acids含有抗氧化剂的食物、水果和蔬菜，有助于 保护从氨基酸中产生一氧化氮所需的酶
Start your patient on Nitric Oxide Releasing Factors before using ozone, and monitor their blood pressure and adjust meds accordingly
寻求ED治疗的三大障碍是：1.认为ED是随着年龄增 长的正常现象，2. 认为这种情况会自行消失 3. 尴尬
The severity of ED is a prognostic marker of important medical diseases.
ED的严重性是重要医学疾病的预后标识
Health of the Blood Vessels is primary treatment focus血管健康是治疗的首要目标
factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000 Aug 1;56(2):302-6. This study shows that Midlife changes may be too late to reverse the effects of smoking, obesity, and alcohol consumption on erectile dysfunction. In contrast, physical activity may reduce the risk of erectile dysfunction even if initiated in midlife.
能力
Learn last year, at the AAO, that nitric oxide is made by the bacteria in the back of the tongue, (no mouth washes, promote oral bacteria such as ‘Prodental formulas’
据报道，在18-29岁男性中，ED发病率为7%，30-39岁男性中，发病略为2%-9%，40-49岁男性中，发病率
Your patients seeking or not seeking help你的病人是否在寻求帮助
The top three barriers to seeking ED treatment are the belief that ED is a normal part of aging, the belief that the condition will resolve on its own, and embarrassment.
One in four men complaining of ED are younger than 40 yrs old, this group has association with illicit drug and cigarette use (The Journal of Sexual Medicine Volume 10, Issue 7, pages 1833–1841, July 2013)
报告的患病率的巨大差异反映了方法学、对ED的定义、区域和文化对ED的看法、年龄以及相关的医疗条件等方面 的差异
Its prevalence and incidence are associated with aging as well as important comorbidities, such as cardiovascular disease, diabetes, metabolic syndrome, hyperlipidemia, depression, pelvic surgery, side effects of medications, neurological disorders, trauma, symptoms of benign prostate hyperplasia, and psychological and interpersonal problems.
All treatments must include the focus on reversing the patients vascular age.所有的治疗必须包括关注 扭转患者血管年龄。
Diet: Whole foods, no PUFA, 80% vegies, lean meat, nuts and seeds, some fruit.饮食：全部食物不含多 不饱和脂肪酸，80%蔬菜、瘦肉、坚果和种籽以及一些水果
Ozone use in treating ED
and other considerations 臭氧治疗男性勃起功能障碍（ED）及其他考量
Presented by Katie Carter ND 主讲人：Katie Carter
Objectives:目标： Causes of erectile dysfunction 勃起功能障碍（ED）的原因 Holistic Approach to ED ED整体研究 Anatomy解剖分析 Injection Protocol注射方案
体活动可能会降低ED的风险，即使在中年开始也不晚。
Sleep- Sleep disorders, or lack of sleep, cause oxidative stress in the body, and that increases the potential for heart disease. Sleep is a super antioxidant for the heart. In one study, researchers examined the sleep habits of 475,000 people. They found that a chronic lack of sleep—less than six hours a night— raised the risk of developing or dying from heart disease by 48 percent and stroke by 15 percent. Naturopathic Medicine is rich in ideas that start with adrenal/hormone function, exercise, assessing caffeine usage, herbal therapies- Ashwagandha, valerian, passion flower….whole lecture just on sleep.
Erectile dysfunction as a predictor of advanced vascular age.(Andrology. 2015 Oct 7. doi: 10.1111/andr.12105.) ED是老年血管的预测因子《男科学》
This article reveals that there is a predictive value of ED in assessing the discrepancy between VA and CA. (vascular age vs Chronological age).本文揭示了ED在评估血管年龄和实际年龄之间的差异方面具有预 测价值。
Nitric Oxide一氧化氮 vasodilatation血管舒张
The endothelium of arteries produces nitric oxide动脉内皮产生一氧化氮 Atherosclerosis reduces capacity to produce nitric oxide动脉粥样硬化降低产生一氧化氮的
每4位男性中就有1位抱怨ED发病趋向40岁以前，这类人群都与使用毒品和吸烟有关。（《性医学期刊》）
The large variation in reported prevalence rates reflects differences in methodology, definitions of ED, regional and cultural perceptions of ED, age, and extent of concomitant medical conditions.
在臭氧治疗之前开始一氧化氮释放因子，同时检测血压调整药物
Other Lifestyle Considerations生活方式注意事 项 Exercise- 30-40 minutes start with walking then progress to interval training. Study: Modifiable risk
去年在AAO学习，一氧化氮是由舌后的细菌产生的（未进行口腔清洗，促使口腔细菌形成） Exercise increases nitric oxide锻炼增加一氧化氮 Amino acids L-arginine and L-citrulline 氨基酸 L-精氨酸 L-瓜氨酸 Foods that contain antioxidants- fruits and vegies help to protect the enzymes
Nitric Oxide releasing factors一氧化氮释放因素
Correct Metabolic syndrome. 改正代谢综合征
Screening: CRP (body‘s key inflammatory marker), high Lp(a).筛查：C型反应蛋白（身体重要的炎症标记 物）
Treat with Dr. Sinatra‘s famous ‘awesome foursome‘ coQ10, 50-150 mg daily; magnesium, 400-
800 mg daily, broad spectrum carnitine 1-2 g daily in divided doses, and D ribose 5 g twice a day. 治疗采用Sinatra的著名的四组药物方法：辅酶Q10每天50-150mg;镁每天400-800mg;广谱肉 毒碱每天1-2g,分剂量服用；核糖5g，一天2次。
ED流行的广泛性与发病率与年龄和合并症有关，如心血管疾病，糖尿病，代谢综合征，高血脂，抑郁症，盆腔手术， 用药副作用，神经系统紊乱，创伤，良性前列腺增生症状以及心理和人际关系问题。
ED prevalence has been reported as 7% among men aged 18 to 29 yr, 2 to 9% among men aged 30 to 39 yr, 9 to 11% among men aged 40 to 49 yr, 16 to 18% among men aged 50 to 59 yr, 34% among men aged 60 to 69 yr, and 53% among men aged 70 to 80 yr (Int J Impot Res 2002; 14: 422–432)
Erectile Dysfunction 勃起功能能障碍
As physicians we ought to be asking the questions. 作为医生，我们应该去问一些of openness.创造一种坦诚公 开的环境
Difficult subject for most men.这对于大多数男性来 说是一个难以启齿的话题
Some men will be very open, and these are the ones from which you will learn.有些男性十分开放， 你们可以从这些人身上学到一些东西。
Epidemiology流行病学
ED is defined by a National Institutes of Health consensus panel as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. 美国国立卫生研究院共识小组对ED 的定义是不能达到或维持能够满足性行为的勃起要求。
needed to create nitric oxide from amino acids含有抗氧化剂的食物、水果和蔬菜，有助于 保护从氨基酸中产生一氧化氮所需的酶
Start your patient on Nitric Oxide Releasing Factors before using ozone, and monitor their blood pressure and adjust meds accordingly
寻求ED治疗的三大障碍是：1.认为ED是随着年龄增 长的正常现象，2. 认为这种情况会自行消失 3. 尴尬
The severity of ED is a prognostic marker of important medical diseases.
ED的严重性是重要医学疾病的预后标识
Health of the Blood Vessels is primary treatment focus血管健康是治疗的首要目标
factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000 Aug 1;56(2):302-6. This study shows that Midlife changes may be too late to reverse the effects of smoking, obesity, and alcohol consumption on erectile dysfunction. In contrast, physical activity may reduce the risk of erectile dysfunction even if initiated in midlife.
能力
Learn last year, at the AAO, that nitric oxide is made by the bacteria in the back of the tongue, (no mouth washes, promote oral bacteria such as ‘Prodental formulas’
据报道，在18-29岁男性中，ED发病率为7%，30-39岁男性中，发病略为2%-9%，40-49岁男性中，发病率
Your patients seeking or not seeking help你的病人是否在寻求帮助
The top three barriers to seeking ED treatment are the belief that ED is a normal part of aging, the belief that the condition will resolve on its own, and embarrassment.
One in four men complaining of ED are younger than 40 yrs old, this group has association with illicit drug and cigarette use (The Journal of Sexual Medicine Volume 10, Issue 7, pages 1833–1841, July 2013)
报告的患病率的巨大差异反映了方法学、对ED的定义、区域和文化对ED的看法、年龄以及相关的医疗条件等方面 的差异
Its prevalence and incidence are associated with aging as well as important comorbidities, such as cardiovascular disease, diabetes, metabolic syndrome, hyperlipidemia, depression, pelvic surgery, side effects of medications, neurological disorders, trauma, symptoms of benign prostate hyperplasia, and psychological and interpersonal problems.
All treatments must include the focus on reversing the patients vascular age.所有的治疗必须包括关注 扭转患者血管年龄。
Diet: Whole foods, no PUFA, 80% vegies, lean meat, nuts and seeds, some fruit.饮食：全部食物不含多 不饱和脂肪酸，80%蔬菜、瘦肉、坚果和种籽以及一些水果
Ozone use in treating ED
and other considerations 臭氧治疗男性勃起功能障碍（ED）及其他考量
Presented by Katie Carter ND 主讲人：Katie Carter
Objectives:目标： Causes of erectile dysfunction 勃起功能障碍（ED）的原因 Holistic Approach to ED ED整体研究 Anatomy解剖分析 Injection Protocol注射方案