补肾疏肝兴阳汤联合他达拉非片对动脉性勃起功能障碍肝郁肾虚型勃起功能和阴茎海绵体动脉血流动力学的影响

Bushen Shugan Xingyang Decoction with tadalafil induced improvement of erectile function and hemodynamic parameters of the penile cavernous artery in men with arteriogenic erectile dysfunction of liver and kidney deficiency

目的观察补肾疏肝兴阳汤联合他达拉非片对动脉性勃起功能障碍(ED)肝郁肾虚型患者勃起功能和阴茎海绵体动脉血流动力学的影响。方法将70例动脉性ED肝郁肾虚型患者按照随机数字表法分为2组,治疗组35例(脱落5例)予补肾疏肝兴阳汤联合他达拉非片治疗,对照组35例(脱落4例)单纯应用他达拉非片治疗,2组均治疗12周,疗程结束后随访8周。比较2组治疗前后国际勃起功能问卷-5(IIEF-5)评分;比较2组治疗前后阴茎海绵体动脉血流动力学指标收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)变化;比较2组治疗后、随访时性活动日志问题4(SEP4)、SEP5满意度;观察2组安全性情况。结果2组治疗后IIEF-5评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。治疗组治疗后PSV、EDV、RI均较本组治疗前升高(P<0.05),对照组治疗后PSV、EDV均较本组治疗前升高(P<0.05),且治疗组治疗后PSV、EDV、RI均高于对照组(P<0.05)。治疗后、随访时治疗组SEP4、SEP5满意度均高于对照组(P<0.05)。2组患者均无明显不良反应。结论补肾疏肝兴阳汤联合他达拉非片能改善动脉性ED肝郁肾虚型患者勃起功能,提高性自信及性自然性,从而改善性生活质量,近期疗效、远期疗效均优于单纯应用他达拉非片治疗。

Objective To observe the effects of Bushen Shugan Xingyang Decoction with tadalafil on erectile function and hemodynamic parameters of the penile cavernous artery in men with arteriogenic erectile dysfunction(ED)of liver and kidney deficiency.Methods A total of 70 men with arteriogenic ED(liver and kidney deficiency)were randomly assigned into the treatment group(n=35,5 cases of shedding)and the control group(n=35,4 cases of shedding).All patients were managed by tadalafil,and those in the treatment group were additionally treated with Bushen Shugan Xingyang Decoction.A 12-week treatment and a 8-week follow-up were performed,the aim was to compare 5-item International Index of Erectile Function(IIEF-5),hemodynamic parameters of the penile cavernous arteries(peak systolic velocity[PSV],end diastolic velocity[EDV],resistant index[RI]),satisfied rate of Sexual Encounter Profile question 4(SEP4)and SEP5,and safety.Results After treatment,IIEF-5 scores in groups were increased(P<0.05),which in the treatment group were significantly increased(P<0.05);PSV,EDV,RI in groups were increased(P<0.05),the treatment group was more prevalent(P<0.05);satisfied rate of SEP4 and SEP5 in the treatment group was higher than that in the control group after treatment and at follow-up(P<0.05);there were no obvious adverse reactions in groups.Conclusion For men with arteriogenic ED(liver and kidney deficiency),Bushen Shugan Xingyang Decoction with tadalafil can improve erectile function,confidence and'naturalness'in engaging in sexual activity in these men,so as to improve the sexual quality of life,with better short-term efficacy,long-term efficacy than the simple using of tadalafil.