A Randomized,Controlled Clinical Observation Of Acupuncture In The Treatment Of Psychogenic Erectile Dysfunction(Liver Depression And Kidney Deficiency)

Erectile dysfunction(ED)is a common male disease with three types:psychogenic,organic and mixed.For young and middle-aged men,psychogenic ED is more common.With the widespread use of acupuncture in andrology and urology diseases,the advantages of acupuncture are constantly emerging.The mentor formulated the idea of acupoint selection based on clinical experience,and the selection of acupoints included Baihui,Neiguan(bilateral),Taichong(bilateral),Taixi(bilateral),Dachu(bilateral),Zhongji,and Guangyuan,which have the effect of draining the liver and relieving depression and tonifying the kidney to raise impotence.A randomized,controlled design was used to observe the efficacy and safety of this acupuncture therapy in the treatment of psychogenic ED(liver-depression and kidneydeficiency type).ObjectiveTo observe the efficacy and safety of acupuncture in the treatment of psychogenic erectile dysfunction(liver-depression and kidney-deficiency type).MethodsIn this study,a randomized,controlled trial was used to collect patients with psychogenic erectile dysfunction who visited the department of andrology in Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine from June to November 2022(Ethical number:2022XLA092-3).Patients were randomly divided into an acupuncture group and a sham acupuncture group,with 33 patients in each group.Basic information including age,duration,body mass index,education level,smoking history,alcohol consumption history,marital status and frequency of sexual life were collected before treatment.The acupuncture group chose to treat selected acupoints include GV20(Baihui),PC6(Neiguan),LR3(Taichong),KI3(Taixi),KI12(Dahe),CV3(Zhongji)and CV4(Guanyuan),and the sham acupuncture group used nonacupuncture shallow stabbing method.Both groups were treated three times a week,and the acupuncture group kept the needles for 30 minutes after each acquisition of Qi,and the sham acupuncture group kept the needles for 30 minutes without Deqi.The main efficacy indicators:International index of erectile function-5(IIEF-5),and secondary efficacy indicators such as sexual encounter profile question-2(SEP-2),sexual encounter profile question-3(SEP-3),erectile hardness score(EHS),self-rating anxiety scale(SAS),self-rating depression scale(SDS)and TCM symptom score were evaluated every two weeks during the treatment period,and adverse effects were recorded.Patients were followed up 4 weeks after the end of treatment to re-evaluate the above indices,and all collected data were statistically analyzed.Results1 Shedding situationTwo of the 66 patients were dislodged,one of whom was unable to return to the hospital on time for treatment after one treatment for novel coronavirus epidemic factors,and the other patient took the relevant therapeutic medication during the 1st week of treatment..2 BaselineA total of 64 men completed this trial,33 in the acupuncture group and 31 in the sham acupuncture group.The subjects in both groups were equally distributed in terms of age,duration of disease,body mass index,education,smoking,alcohol consumption,marriage and frequency of sexual intercourse,and the differences were not statistically significant and comparable(P>0.05).3 Main efficacy indicatorsThe difference in IIEF-5 scores between the two groups before treatment was not statistically significant.The IIEF-5 scores of the acupuncture group increased sequentially before treatment,at week 2,week 4,and week 6 of treatment,all reaching a significant level(P<0.05);no significant difference was seen between the IIEF-5 scores of the sham acupuncture group at week 2 compared with pre-treatment(P>0.05),and the IIEF-5 scores increased sequentially from week 2 to week 4 and week 6,with statistically significant differences(P<0.05),and at the end of the treatment course,the efficacy of the acupuncture group was significantly better than the sham acupuncture group in improving the IIEF-5 scores.4 Secondary efficacy indicators4.1 SEP-2、SEP-3The differences in SEP-2 and SEP-3 before treatment were not statistically significant between the two groups.After receiving acupuncture(or sham acupuncture)treatment,there was no significant difference in SEP-2 between the two groups at week 2,4,6,and 10 compared with pre-treatment(P>0.05);in terms of improving SEP-3,the acupuncture group had a significant improvement at week 6 and 10 compared with pre-treatment(P<0.05),and the sham acupuncture group showed no significant improvement at any stage of assessment(P>0.05).When compared with the sham acupuncture group,the acupuncture group had a better efficacy in improving SEP-3 at week 4,week 6,and week 10(P<0.05).4.2 EHSThere was no statistically significant difference between the EHS scores of the two groups before treatment.In the acupuncture group,EHS was significantly higher at week 4,week 6,and week 10 compared with the pre-treatment(P<0.05),and the difference was also significant at week 6 compared with week 4(P<0.05);In the sham acupuncture group,EHS was significantly higher at week 6 compared with the pre-treatment(P<0.05).At the end of the treatment course,the efficacy of the acupuncture group in improving EHS was significantly better than the sham acupuncture group.4.3 SAS、SDSThe differences in SAS and SDS scores between the two groups before treatment were not statistically significant.In the acupuncture group,SAS and SDS decreased sequentially from pre-treatment to week 2,week 4,and week 6,and they all reached significance levels(P<0.05).In the sham acupuncture group,SAS decreased sequentially from week 2 of the intervention to weeks 4 and 6,reaching significance levels(P<0.05),and SDS scores were significantly lower at weeks 4,6,and 10 compared with pre-treatment(P<0.05).At the end of the treatment course,the efficacy of the acupuncture group was significantly better than that of the sham acupuncture group in terms of improving SAS and SDS scores.4.4 TCM symptom scoreThere was no statistically significant difference in the TCM symptoms scores between the two groups before treatment.The TCM symptoms scores of both groups at week 2,week 4,week 6 and week 10 decreased significantly compared with pretreatment(P<0.05),and the TCM symptoms scores of the acupuncture group decreased sequentially from pre-treatment to week 2,week 4 and week 6(P<0.05),and the efficacy of acupuncture group in improving the TCM symptoms scores was significantly better than that of the sham acupuncture group.At the end of the treatment course,the acupuncture group can significantly reduce the scores of poor erection as the main symptom and the secondary symptoms of dysphoria,lumbar and knee weakness,and hypochondriac pain,with a statistically significant difference(P<0.05),while no statistically significant difference was seen in the sham acupuncture group(P>0.05).Compared with the sham acupuncture group,the acupuncture group was more advantageous in improving poor erection and dysphoria(P<0.05).No statistically significant differences were seen between the two groups in terms of lowering the score of fatigue(P>0.05).5 Safety evaluationDuring the treatment period,two patients in the acupuncture group experienced post-acupuncture vertigo,and their symptoms improved after giving sugar;the two patients were asked about the fact that they had not eaten breakfast after waking up,and then were instructed to eat before treatment;One patient showed local bruising after acupuncture,without bleeding and painful discomfort,so no medical treatment was given,and was instructed to avoid bathing that day.The bruising disappeared after 2 weeks.The rest of the patients did not have any significant adverse effects during the intervention.ConclusionAcupuncture is effective and safe in treating psychogenic erectile dysfunction(liver depression and kidney deficiency).