追加：第 6 节第 27 条补射精后疾病综合征（POIS）

2026-10-10。第 27 条原来只讲「多数人手淫不伤身」。每次射精后都乏力、像感冒、几天才好的读者，看完会觉得自己被打发了。所以并进这一段，给他们一个就医方向。没有单开一条，因为新动作只有「每次都发作就去泌尿科或男科」，配不出单独一条的成本和收益。证据等级、收益量级、成本标签都不变。

题录和卷期页码都按 Europe PMC 的 core 记录核对。数字都出自摘要原文。

1. Waldinger 等 (2011) J Sex Med 8(4):1164-1170，PMID 21241453

  • 「Of the 45 included men, 33 subjects consented with skin-prick testing. Of them, 29 (88%) men had a positive skin-prick test with their own (autologous) semen」
  • 「In 87% of men, POIS symptoms started within 30 minutes after ejaculation.」
  • 「a flu-like syndrome in 78% of subjects, exhaustion and concentration difficulties in 80% and 87% of subjects」。条目只用了 exhaustion 80%（写成「疲惫没力气」）和 flu-like 78%。

2. Chea 等 (2023) J Sex Med 20(12):1407-1413，PMID 37872743

  • 「Thirty-seven men were included in the study」「The mean duration of symptoms was 4.7 ± 3.4 days.」单中心、回顾性，地点是神经泌尿科（neurourology department）。条目写「法国一家医院」，按作者单位定的国别。

3. Xi 等 (2023) Sexual Medicine 11(6):qfad068，PMID 38239929

  • 「The clinical characteristics of 24 Chinese patients with POIS were analyzed.」
  • 「The patients and healthy donors all had positive intracutaneous test results with their own semen, negative skin prick test results, and no IgE specific to autologous semen.」条目写「查不到针对精液的过敏抗体」。
  • 「The SAS and SDS scores of the high and low VAS groups were significantly higher than those of the control group.」条目写「焦虑抑郁评分偏高」。

4. Ponce 等 (2025) J Sex Med 22(7):1236-1243，PMID 40434029

  • 「Of 58 studies found, 14 matched our inclusion criteria. Our systematic review consists of 1 cross-sectional study, 1 cohort study, and 12 case reports.」

5. Duran 等 (2025) Int J Impot Res 37(6):454-457，PMID 37604984

  • 「In total 211 sexual medicine experts filled the survey.」「Only 18% of participants reported symptom improvement in more than 30% of the patients.」

没写进条目的

  • 患病率：没有找到普通人群的统计。Li、Yin 2026 年的中国网络调查（Int J Impot Res，PMID 42298129）里，2443 人中有 770 人自述有类似症状。但这项调查在社交媒体上招人，作者自己也写了「Recruitment via social media may have introduced selection bias」，不能当患病率用。备注只写「文献都说这病罕见，但没有人在普通人群里统计过」。
  • 心悸、胸口疼：上面几篇摘要列的症状组里都没有，没写。
  • 具体疗法（抗过敏药、布洛芬、精液脱敏等）都只有个案，没写。