清热逐瘀汤联合低强度脉冲超声治疗勃起功能障碍的有效性和安全性研究

Efficacy and safety of Qingre Zhuyu decoction combined with low-intensity pulsed ultra⁃sound in the treatment of erectile dysfunction

目的 观察清热逐瘀汤联合低强度脉冲超声(LIPUS)治疗勃起功能障碍(ED)的有效性和安全性。方法 选取2019年1月至2022年1月该院收治的ED患者137例,以随机数字表法分为对照组、实验组,分别56例、57例。对照组采用他达拉非片联合LIPUS治疗,实验组在对照组基础上增用清热逐瘀汤治疗。检测中医证候积分、勃起时海绵体动脉血流动力学指标、夜间阴茎涨大试验(NPT)实验结果、国际勃起功能评分(IIEF-5)、临床疗效、不良反应发生率变化。结果 治疗后两组勃起时海绵体动脉收缩期峰值血流速度(PSV)、血流阻力指数(RI)均升高,中医证候主症积分、次症积分、总分及舒张末期血流速度(EDV)均降低,平均有效勃起次数、平均勃起硬度均增加,每次平均勃起时间均延长,IIEF-5评分均升高,以实验组更明显(P<0.05)。实验组临床总有效率高于对照组(P<0.05)。两组便秘、口干、面色潮红、鼻咽不适、头痛发生率比较,差异无统计学意义(P>0.05)。结论 清热逐瘀汤联合LIPUS治疗ED可改善患者中医证候、阴茎血流动力学及勃起障碍,提升临床疗效,且安全性高。

Objective To observe the efficacy and safety of Qingre Zhuyu Decoction combined with low-intensity pulsed ultra⁃sound(LIPUS)in the treatment of erectile dysfunction(ED).Methods A total of 137 ED patients admitted to our hospital from January 2019 to January 2022 were selected and divided into control group and combined group by random number table method,with 56 cases and 57 cases respectively.The control group was treated with tadalafil tablets combined with LIPUS,and the test group was additionally treated with Qingre Zhuyu Decoction on the basis of the control group.The TCM syndrome score,hemody⁃namic indexes of the cavernosal artery during erection,the results of the nocturnal penis enlargement test(NPT),the Internation⁃al Erectile Function Score(IIEF-5),the clinical efficacy,and the incidence of adverse reactions were detected.Results After treatment,peak systolic blood flow velocity(PSV)and blood flow resistance index(RI)and the IIEF-5 score in both groups were increased,TCM syndrome main symptom score,secondary symptom score,total score and end-diastolic blood flow velocity(EDV)were decreased,and average effective erection times and average erection hardness were increased,the average erection time were prolonged,especially in the combined group(P<0.05).The total clinical effective rate in the test group was higher than that in the control group(P<0.05).There were no significant differences in the incidence of constipation,dry mouth,flushing,nasopharyngeal discomfort and headache between the two groups(P>0.05).Conclusion Qingre Zhuyu Decoction combined with LIPUS in the treatment of ED can improve TCM syndrome,penile hemodynamics and erectile dysfunction,improve clinical efficacy,and has high safety.