活血化瘀法在ED治疗中作用的机制探讨

Application of activating blood circulation to remove stasis method in the treatment of erectile dysfunction

目的探讨活血化瘀法在阴茎勃起功能障碍（ED）治疗中的作用及机制。方法门诊收集同时符合血瘀证诊断标准的72名ED患者，同时满足相关排除标准，将患者分为联合应用PDE5抑制剂和血府逐瘀胶囊组（A组）、单独口服PDE5抑制剂组（B组），每组各36名，所有患者在治疗开始前、治疗结束时、治疗结束后1月均进行IIEF-5、血瘀证评分、并检测血清NO、sVCAM-1水平。结果A、B两组在治疗开始IIEF-5、血瘀证评分和血清NO、sVCAM．1水平无显著差异（P〉0．05）；结束时IIEF-5评分两组之间无显著差异（P〉0．05），而血瘀证评分和血管内皮细胞功能指标存在差异（P〈0．05）；治疗结束后1月，血瘀证评分、IIEF-5评分、血管内皮细胞功能指标A组优于B组（P〈0．05）。结论活血化瘀药物可能通过改善全身状况和阴茎海绵体血管内皮细胞功能改善血瘀证ED患者阴茎勃起功能，其作用机制值得进一步探讨。

Objective To investigate the effects of Activating Blood Circulation to Remove Stasis Method in the treatment of erectile dysfunction（ED） with syndrome of blood stasis. Methods A total of 72 patients with ED who matched the criteria of erectile dysfunction with syndrome of blood stasis and the exclusion standard were recruited and divided into two group in the study. Patients in Group A（36 cases） were treated with PDE-5 inhibitor and XueFuZhuYu capsules, and patients in Group B（36 cases） were treated with PDE-5 inhibitor. IIEF-5 score, the score of blood stasis syndrome, levels of serum NO andsVCAM-1 for all patients were measured respectively before treatment, after treatment and 1 month after treatment. Results There were no differences in all evaluated indices between Group A and B before treatment. Whereas, after treatment, all evaluated indices except for IIEF-5 scores showed significant differences. At the first month after treatment, all evaluated indices in Group A were better than those in Group B. Conclusion Activating Blood Circulation to Remove Stasis Method may improve erectile function of ED patients with syndrome of blood stasis via ameliorating general condition and cavernosa endothelium function, but its mechanism merits to be further investigated.