Chin J Integr Med 2007 Sep;13(3):185-189 • 185 •

ORIGINAL ARTICLE
Clinical Study on the Treatment of Premature Ejaculation by
Uighur Medicine Gu-jing-mai-si-ha Tablet (固精麦斯哈片)
SONG Guo-hong (宋国宏)1, Halmurat·Upur (哈木拉提·吾甫尔)2, GENG Jin-cheng (耿进成)1,
FENG Lian-cheng (冯连成)1, Yilihamujiang ·shabi (伊力哈木江·沙比提)2,
MA Chao (马 超)3, and LIU Jun (刘 军)1

ABSTRACT Objective: To observe the effect of Uighur medicine Gu-jing-mai-si-ha Tablet (固精麦
斯哈片, GJMSHT) for treatment of premature ejaculation (PE) and to explore part of its mechanism.
Methods: The condition of patients was scored by related questionnaire, and the intravaginal ejaculation
latency time (IELT) was observed before and after GJMSHT treatment, with the blood levels of nitric
oxide (NO) and prostaglandin F2α (PGF2α) detected in PE patients as well. The results were compared
with those in the control group. Results：After treatment, the scores of PE and IELT, as well as the
levels of NO and PGF2α, all increased significantly compared to those before treatment in the treated
group (P <0.01), while in the control group, all the parameters were insignificantly changed (P >0.05).
Therefore, the difference of these parameters between the two groups after treatment all showed
statistical significance (P <0.01). Conclusion: GJMSHT could treat PE effectively, its mechanism is
possibly by strengthening the coordination of the related smooth muscles through increasing the blood
levels of NO and PGF2α, and the endurance of patients to the cavitary effect of prostatico-urethral
pressure, thus postponing the arrival of urgent ejaculatory feeling.
KEY WORDS nitric oxide, prostaglandin F2α, premature ejaculation, intravaginal ejaculation latency
time

Premature ejaculation (PE) is one of the
sexual disorders with the highest incidence,
and, as a psycho-neuro-endocrine disease
and also a urological disease, it could severely
affect the harmony of patients' family and
create a high mental stress on the male. The
therapeutic effect of Uighur medicine Gu-jing-
mai-si-ha Tablet (固精麦斯哈片, GJMSHT) on
PE was observed and part of its mechanism
was explored by the authors and reported in this
paper.
METHODS
Diagnostic Standard
In reference to the standard issued by the
American Urological Association (1) and that in
the "Handbook for Diagnosis and Statistical
Management of Mental Diseases" promulgated
by the American Psychiatric Association(2), the
diagnostic standard for patients enrolled in
this study was formulated comprehensively as
follows: (1) Continual or repeated ejaculation
occurred under very mild sexual stimulation
before, during or soon after penetration, with
intravaginal ejaculation latency time (IELT) less
than 2 min; (2) The sexual partner's satisfaction
rate was below 50%; (3) Ejaculation happened
before his willingness; and (4) PE is not caused
by abstention from certain psychiatric active
substances, like narcotic drugs.
Subjects Selection
The criteria for inclusion were: (1) patients
with their condition matching the above-
mentioned diagnostic standard, both the primary
(PE began at the first sex life) and the secondary
ones; (2) males have married or cohabited and
went steady with regular sexual life; (3) with no
severe disease of the heart, liver or kidney; (4)
patients agreed to be treated with the test drug
Supported by the Program of Developing Modern Uighur
Medicine and Setting an Example Project of High-Tech
Industries (No. 2002-422)
1. The 5th Affiliated Hospital of Xinjiang Medical University,
Urumuqi (830011); 2. Xinjiang Medical University; 3. The
Affiliated TCM Hospital, Xinjiang Medical University
Correspondence to: Dr. Halmurat·Upur, Tel: 0991-4362206,
E-mail: halmurat@263.com
DOI: 10.1007/s11655-007-0185-7
• 186 •
and had signed the informed consent.
The criteria for exclusion were: (1) patients
with hot constitution; (2) with the IELT longer
than 2 min (determined by clock for 1-2 times);
(3) age below 20 or over 60; (4) administration of
non-steroid drugs like indomethacin and aspirin;
(5) simultaneous administration of other drugs
for PE; (6) with primary diseases of the heart,
liver, kidney, and nervous system; (7) alcoholics;
and (8) patients who did not take the test drug
on time, quit in the course, or were irregular in
sexual life.
General Materials
All the subjects were selected from PE
patients of the Fifth Affiliated Hospital or the
Affiliated TCM Hospital of Xinjiang Medical
University in the period from March 2006 to
August 2006, who participated in the study
voluntarily and all matched the criteria of
subjects selection. They were assigned to
two groups according to the randomized and
controlled principle, in their visiting order by
randomizing number table. Patients in the
treated group were aged 31.54±7.92 years,
with the course of disease as 4.53±3.54 years,
33 of Han nationality and 2 of Uighur nationality;
while patients in the control group were 33.88
±9.52 years old, 4.71±4.36 years in course of
disease, 32 Hans and 1 Uighur. By statistical
analysis, the two groups were comparable
in the aspects of age, course of disease and
nationality (P >0.05).
Treatment
For the 35 patients in the treated group,
GJMSHT (consisting of Radix anacycli pyrethri,
Mastiche, Fructus Cardamomi, Rhizoma
Cyperi, Stigma Croci, Semen Myristicae, Radix
Curcumae, Folium Syringae oblatae, Radix
et Rhizoma Nardostachyos, Fructus Tsaoko,
and Flos Rosae rugosae ), a Uighur medical
drug prepared by Kanghabo Co., Ltd. of Uighur
Medicine, Xinjiang, with the production batch
number of 060206, was orally given 4 tablets
each time, twice a day, with 15 days as one
therapeutic course. Pungent and stimulating
foods as well as other pertinent drugs were not
allowed in the treatment period. The medication
Chin J Integr Med 2007 Sep;13(3):185-189
had to be suspended when any patient caught a
cold.
For the 33 patients in the control group,
no drug for treatment was given during the
observation period (the first 15 days after
enrollment). However, a course of GJMSHT
medication same as that for the treated group
was offered to these patients at no cost after
the observation for humanistic care, since the
test drug was formally approved by the State
Administration for Drugs and Foods Supervision,
and had already entered the market as a over-
the counter drug.
Items and Methods of Observation
Blood levels of prostaglandin F2α (PGF2α)
and nitric oxide (NO) were determined at the
beginning (just after enrollment) and by the end
of the treatment course (in the treated group) or
the observation period by collecting fasting blood
in the morning. The sample was preserved in a
refrigerator under -70 ℃ immediately after being
centrifuged for testing. The test was conducted
with the test kits for PGF 2α (batch number:
ADL10-9031) and NO (batch number: 0602205)
produced by Adlitteram Diagnostic Laboratories
and purchased from Shanghai Xitang Bio-tech
Co.
PGF2α was determined by double-antibody
ELISA. It was carried out at room temperature
(22 ℃) in the following procedure: the standard
sample, blood plasma, and enzyme binding
material were added into a 96-well reaction plate
in that order, washed with diluted washing fluid 5
times; a color developer and then the terminating
solution were added in sequence; the OD
value was read using an enzyme immunoassay
instrument at 450 nm; then the standard curve
was drawn with the OD value as longitudinal
coordinate, and the concentration of standard as
horizontal coordinate. The OD value of the blood
sample from patients was determined in the
same way, and the level of PGF2α was checked
finally depending on the OD value in reference to
the standard curve.
NO in the blood sample was tested by
determining the total NO with nitrate reductase
Chin J Integr Med 2007 Sep;13(3):185-189 • 187 •

method strictly according to the instruction, difference.

with color matching at 550 nm, and then the
concentration of NO was calculated by a RESULTS
formula. Changes of PGF2α and NO Levels
As shown in Table 1, after treatment, the
Evaluation of PE condition was carried out levels of PGF2α and NO increased significantly in
by scoring method according to a questionnaire the treated group, showing significant difference
(IELT) established specially for this study in to those before treatment (P <0.01); while in the
order to make the evaluation more objective control group, both were changed insignificantly,
and concrete on the relationship of PE with the that is, the levels of PGF2α and NO in the control
levels of NO and PGF2α, which could quantify group after treatment were significantly lower as
all the conditions to facilitate clinical analysis. compared with those in the treated group at the
For the sake of fortifying the comparability of the corresponding time points (P <0.01).
results, both the scoring using the Chinese index
Table 1. Changes of PGF2α and NO Levels ( ±s )
of sexual function for premature ejaculation
Group Case Time PGF2α (pmol/L) NO (μmol/L)
(CIPE10) and the scale for five PE related items
Treated 35 BT 9.11±2.33 73.37±9.49
(CIPE5) were performed simultaneously. These
questionnaires were filled in at the beginning and AT 10.84±3.55 △ 101.50±24.80 △

the end of the treatment/observation period to Control 33 BT 9.17±3.13 75.10±12.63

evaluate the effect of treatment and its influence AT 9.30±3.04 74.17±11.73

on the levels of NO and PGF2α. Notes: P <0.01, compared with before
treatment in the same group; △P <0.01, compared
with the control group; BT: before treatment; AT:
The scale for PE grading was listed in detail
after treatment; the same tables below
as follows: (1) Lantency time (LT) of ejaculation
(the time from the insertion of the penis into Changes of IELT and PE Related Scores
the vagina to ejaculation in sexual intercourse) As shown in Table 2, IELT, SPSR and WFR
is scaled to (in minutes) 0.5, 1.0, 1.5, 2.0, 2.5, were all improved in the treated group after
3.0, 3.5, 4.0, 4.5, 5.0, 10.0, 15.0, 20.0, 25.0, treatment, showing significant difference to those
and 30.0. (2) Sexual partner's satisfaction rate before treatment (P <0.01), and also to those in
(SPSR) is scored from 0 (totally dissatisfactory) the control group (P <0.01).
to 10 (fully satisfactory). (3) Wish fulfillment rate
Table 2. Changes of IELT and
(WFR) is scored from 0 (unable to control) to 10
PE Related Scores ( ±s )
(fully controlled).
Group Time Case IELT (min) SPSR (Score) WFR (Score)
Treated BT 35 1.27±0.61 2.37±2.0 3.11±1.90
Quality Controlling △ △
AT 2.73±1.25 5.11±2.11 5.60±2.13 △
Personnel who took part in the study
Control BT 33 1.25±0.61 2.88±1.72 3.73±1.64
were all trained to master the program of the
trial; sample collection and preservation were AT 1.16±0.58 2.94±1.63 3.82±1.38

strictly controlled. Related knowledge was also

conveyed to all the patients enrolled to obtain Changes of CIPE10 and CIPE5 Scores
their cooperation and increase their compliance, Results of scoring by CIPE10 and CIPE5
and humanistic care was offered to patients scales are listed in Table 3. It is shown that
in the control group to further increase their Table 3. Changes of CIPE10 and
compliance.
CIPE5 Scores (Score, ±s )
Group Time Case CIPE10 CIPE5
Statistical Management
Treated BT 35 22.26±6.08 9.91±2.82
Data were managed with SPSS 12.0
AT 30.89±6.66 △ 15.80±3.60 △
s o f t w a r e , a n d e x p r e s s e d b y ±s . T h e
Control BT 33 23.36±6.60 11.03±3.06
measurement data were tested statistically by
t -test, with P < 0.05 regarded as having significant AT 23.21±6.84 10.85±3.18
• 188 •
there was a significant increase of the two in the
treated group after treatment (P <0.01), while they
were unchanged in the control group. Therefore,
the scores in the treated group after treatment
were significantly higher than those in the control
group after treatment (P <0.01).
DISCUSSION
PE is a kind of ejaculation function
disorder, its incidence, according to a study in
Europe, is 21% (3). The process of ejaculation
is accomplished by the coordination of smooth
muscles together with the participation of central
and peripheral nerves (4,5). Since the cavitary
pressure of the urinary tract takes part in the
regulation of ejaculation, it is considered to be a
notable cause for PE.
It has been found by Chamness et al(6) that
nitric oxide synthase (NOS) is distributed widely
in the tissues of male rats innervated by the
pelvic nerve ganglion, such as the epithelium
of the urinary bladder membrane, tissues that
could irritate erection of penis, as well as the
vascular epithelia, endothelial cells, epithelium
and basal membrane of epididymis head,
body and tail, smooth muscles of spermaduct,
spermatophore and ejaculatory duct. It could
also be found in the human penis and prostate
gland. NO could inhibit the secretion of sperm
to prevent spermatorrhea by depressing the
tonicity of the sympathetic nervous system
in adult male rats, and could favorably delay
ejaculation (7) . Experimental study in vitro
showed that the NO-cGMP pathway plays a
role in regulating the contractile response of
spermatophore (8-11) , and NO could regulate
the activity of smooth muscles concerning
ejaculation. Thus, NO may be one of the
regulatory factors of PE.
A study showed that PGF2α has an obvious
effect in promoting the contraction of smooth
muscles, and a gynecological study found that
PGF2α could induce loosening of collagenous
fibers in the early and late stage of pregnant
cervix by activating collagenolytic enzyme
and inhibiting the synthesis of collagen (12,13),
which could reduce the tension of the cervix by
50%(14). When acting on the prostatico-urethral
Chin J Integr Med 2007 Sep;13(3):185-189
portion, PGF2α could increase its compliance to
augment the functional volume of the urethra to
alleviate the rapid increase of pressure, so as to
enhance the ability of controlling ejaculation; it
could also promote the release of endogenous
prostaglandins (15), and showed a regulation in
multiple ways.
In the ingredients of GJMSHT, Radix
anacycli pyrethri could clean the abnormal
mucous to open up stagnancy to alleviate pain;
Folium Syringae oblatae could tonify viscera,
fortify nerve and remove phlegm; amonum fruit
could strengthen Wei (胃) to help digestion;
Semen Myristicae enforces brain and Gan (肝),
dry up dampness to strengthen Wei, dispel
cold-qi to enrich sperm and invigorate yang;
Stigma Croci purges the abnormal mucous fluid,
dispels phlegm to induce defecation, regulate
menstruation to enhance yang; Mastiche
removes dirty elements in the body, supplements
brain, nourishes Xin (心), benefits Gan and Shen
(肾)(16). When they act altogether in the human
body, they could improve mucous in patients
both in quality and quantity, improve and promote
the production of heat-energy, stimulate the
substantial metabolic activity, remove dampness,
nourish sexual gland and excretory system,
enhance the pinching power of the sexual organ
to realize the effects in curing emission, enuresis,
PE, weakness, early poliosis, listlessness, and
fatigue.
In this study, after the patients were
treated with GJMSHT, significant changes were
found in aspects of levels of PGF 2α and NO
and in the scores of the scale for PE grading
CIPE5, CIPE10 and IELT. The mechanism
is possibly due to the loosening of urethral
smooth muscles induced by the comprehensive
effect of prostaglandins (while endogenous
PGF 2α increases, other prostaglandins may
also increase concomitantly), which could
enhance the energy of the external sphincter
to strengthen the controlling of ejaculation and
prolong the latency time. GJMSHT could also,
through raising the NO level in the body, reduce
the tonicity of the sympathetic nerve system to
inhibit sperm excretion, retard its process, and
to augment the cavitary functional volume of the
Chin J Integr Med 2007 Sep;13(3):185-189
prostatico-urethral portion by dilating smooth
muscles, thus effectively delaying the arrival of
critical cavitary pressure effect to prolong the LT
of ejaculation.
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(Received December 24, 2006)
Edited by TAO Bo