| Objective:1.By observing the epidemiological investigation of ED patients,this study compared the differences in the general demographics and clinical characteristics of patients with different TCM syndrome types,and completed the investigation,induction and summary of TCM syndrome types of ED patients;2.Based on the results of epidemiological investigation,the effectiveness of recombinant human growth hormone(rhGH)in the treatment of life-door fire-induced erectile dysfunction was discussed by comparing and analyzing the different treatment plans for patients with life-door fire-induced erectile dysfunction.Methods:General demographic and clinical data of ED patients conforming to the exclusion standard were collected to determine the TCM syndrome types of patients.TCM syndrome types with a large sample size were selected to conduct statistical analysis on the general demographic and clinical data of these patients,and the epidemiological rules of ED patients with different syndrome types were obtained.Based on the results of epidemiological investigation,this study was designed as a prospective clinical study in the form of a randomized controlled trial.The study objects were ED patients who visited the male outpatient department of Jiangsu Hospital of Traditional Chinese Medicine from September 2021 to September 2022.Meanwhile,TCM syndrome differentiation was life-gate fire-decay type.Qualified recipients who met the inclusion criteria were selected to be included in the study.Subjects who met the inclusion conditions were divided into treatment group and control group,including 38 cases in rhGH treatment group,and 38 cases in control group,and 26 cases in tadalafil control group and 30 cases in traditional Chinese medicine control group.rhGH treatment group was given rhGH2IU/time/day,Tadalafil control group was given tadalafil 5mg/day,kidney toning traditional Chinese medicine control group was given traditional Chinese medicine decoction 200ml each time,twice a day.The treatment cycle was 8 weeks,and IGF-1 level of rhGH treatment group and tadalafil control group were measured at 0,4 and 8 weeks of treatment.The IIEF-5 score and TCM symptom score of rhGH treatment group,Tadalafil control group and kidney toning Chinese medicine control group were followed up.IGF-1 level,IIEF-5 score and TCM symptom score of rhGH treatment group and tadalafil control group before and after treatment were statistically analyzed.IIEF-5 score and TCM symptom score of rhGH treatment group and kidney tonifying Chinese medicine control group before and after treatment were statistically analyzed.Results:Epidemiological survey results:(1)TCM diagnosis types were divided into 5 syndrome types,the results showed:118 cases of liver depression and discomfort type(about 37%)>62 cases of Shengmen fire decline type(about 19%)>60 cases of kidney deficiency and dampness-heat type(about 19%)>51 cases of Yin deficiency and huo-wang type(about 16%)>30 cases of heart and spleen deficiency type(about 9%);(2)There were no significant differences in age,BMI,testosterone,serum prolactin,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol in 5 different TCM syndrome groups(P>0.05),but there were significant differences in IGF-1 level(P<0.01);(3)The level of IGF-1 in normal penile blood supply group[(134.87 ± 31.97)ng/ml]was higher than that in abnormal penile blood supply group[(122.11±39.85)ng/mL],and the difference was statistically significant(P<0.05);(4)The serum IGF-1 level in the normal nocturnal erection group[(133.30±41.69)ng/mL]was higher than that in the abnormal nocturnal erection group[(118.92 ± 36.35)ng/ml],and the difference was statistically significant(P<0.05);(5)The serum IGF-1 level of patients was positively correlated with the maximum systolic blood flow velocity(peaksystolicvelocity,PSV)(r=0.24,P<0.01),total mean hardness(r=0.22,P<0.01)and the number of erectile times(r=0.25,P<0.01).Clinical study results:(1)In 38 cases of rhGH treatment group,2 cases were cured,6 cases showed obvious effect,20 cases were effective,10 cases were ineffective;The effective rate of rhGH group was 73.68%;In the tadalafil control group,there were 26 cases,4 cases were abscission,the abscission rate was 13%,3 cases were cured,9 cases were effective,8 cases were effective,6 cases were ineffective;The effective rate of tadalafil control group was 76.92%.In the control group of 30 cases,2 cases were cured,7 cases were effective,12 cases were effective and 9 cases were ineffective.The effective rate of TCM group was 73.33%.The rank sum test showed no statistical difference(P>0.05).Tadalafil control group was better than the other two groups.(2)After 4 weeks,the IGF-1 level,IIEF-5 score and TCM symptom score of rhGH treatment group and Tadalafil control group were significantly higher(202.11±72.92)than that of Tadalafil control group(126.46±52.53),with significant difference(P<0.01).The IIEF-5 score of rhGH group(12.00 ± 3.29)was slightly lower than that of Tadalafil control group(12.46 ±2.98),and there was no statistical difference(P>0.05).The symptom score of rhGH group(10.29± 1.66)was slightly higher than that of Tadalafil control group(10.27±1.61),and there was no statistical difference(P>0.05).(3)After 4 weeks,IIEF-5 score and TCM symptom score of rhGH treatment group and TCM control group were compared,and IIEF-5 score of rhGH treatment group(12.00±3.29)was slightly lower than that of TCM control group(12.43 ± 1.55),with no statistical difference(P>0.05).The symptom score of rhGH treatment group(10.29±1.66)was slightly higher than that of kidney tonifying TCM control group(10.27 ± 2.21),and there was no statistical difference(P>0.05).(4)After 8 weeks,the IGF-1 level,IIEF-5 score and TCM symptom score of rhGH treatment group and Tadalafil control group were significantly higher(214.61 ± 61.94)than that of Tadalafil control group(153.50 ± 53.70),with significant difference(P<0.01).The IIEF-5 score of rhGH treatment group(13.58 ± 3.11)was slightly lower than that of tadalafil control group(14.31±2.81),with no statistical difference(P>0.05).The symptom score of rhGH group(8.63 ±1.63)was slightly higher than that of Tadalafil control group(8.54±1.48),and there was no statistical difference(P>0.05).(5)After 8 weeks,IIEF-5 score and TCM symptom score of rhGH treatment group and TCM control group were compared,the IIEF-5 score of rhGH treatment group(13.58±3.11)was slightly lower than that of TCM control group(13.83 ± 1.64),and there was no statistical difference(P>0.05).Symptom score of rhGH group(8.63±1.63);There was no statistical difference in the control group(8.63 ± 1.88)(P>0.05).(6)There were significant differences in IGF-1 level,IIEF-5 score and TCM symptom score after 0,4 and 8 weeks in rhGH treatment group(P<0.01);(7)The IGF-1 level,IIEF-5 score and TCM symptom score of Tadalafil control group were significantly different after 0,4 and 8 weeks(P<0.01);There was no significant difference in IGF-1 level(P>0.05).(8)After 0 weeks,4 weeks and 8 weeks,there were significant differences between IIEF-5 score and TCM symptom score in the control group(P<0.01).Conclusion:(1)rhGH can improve the erectile function of patients with life-gate fire-failure erectile dysfunction,and improve the TCM symptoms of patients with life-gate fire-failure erectile dysfunction.(2)rhGH can stably increase the serum IGF-1 level in patients with life-gate fire-induced erectile dysfunction. |
PDF Full Text Request