[Clinical and mechanism research on functional erectile dysfunction treated with moxibustion and decoction].

Objective: To observe the clinical therapeutic effect on functional erectile dysfunction (FED) of kidney deficiency and liver stagnation treated by moxibustion and decoction.

Methods: A total of 120 patients with FED were randomized into an observation group (60 cases, 2 cases dropped off) and a control group (60 cases, 4 cases dropped off). In the control group, the patients were treated with oral decoction (, , , , etc.), one dose daily. In the observation group, on the base of the treatment as the control group, moxibustion was exerted along the distribution of governor vessel on the back, 30 min each time, once a week. The treatment duration was 4 weeks in the two groups. Before and after treatment, the scores of international index of erectile function-5 (IIEF5), erectile hardness scale (EHS), erectile dysfunction inventory of treatment satisfaction (EDITS) and TCM symptoms were observed in the patients of the two groups. Before and after treatment, the levels of serum sex hormones (testosterone [T], luteinizing hormone [LH], estradiol [E], prolactin [PRL]) and the expressions of relevant proteins (matrix metalloproteinase-3 [MMP-3], matrix metalloproteinase-9 [MMP-9] and vascular endothelial growth factor [VEGF]) were determined in the patients of the two groups separately. The penile vascular function (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistance index [RI]) was compared before and after treatment. Besides, the clinical therapeutic effect was evaluated.

Results: After treatment, the scores of IIEF5, EHS and EDITS were all increased as compared with the values before treatment (<0.05), and the scores of TCM symptoms were reduced as compared with the values before treatment in the patients of the two groups (<0.05). After treatment, the scores of IIEF5, EHS and EDITS in the observation group were higher than those in the control group (<0.05), and the score of TCM symptoms was lower than the control group (<0.05). After treatment, the levels of T and LH in serum of the two groups and the expressions of serum MMP-3 and MMP-9 in the observation group were all increased as compared with those before treatment (<0.05), the levels of E and PRL in the observation group and VEGF expressions in the two groups were all reduced as compared with those before treatment (<0.05). The levels of serum T and LH and the expressions of MMP-3 and MMP-9 in the observation groups were all higher than those in the control group (<0.05), and the levels of E and PRL and VEGF expression were lower than the control group (<0.05). After treatment, PSV was increased and EDV was reduced as compared with those before treatment in the patients of the two groups (<0.05), RI in the observation group was reduced as compared with that before treatment (<0.05). After treatment, PSV in the observation group was higher and EDV and RI were lower than the control group (<0.05). The total effective rate was 87.9% (51/58) in the observation group, higher than 76.8% (43/56) in the control group (<0.05).

Conclusion: The combined therapy of moxibustion and decoction effectively increases erectile function, erectile hardness and treatment satisfaction in the patients with functional erectile dysfunction of kidney deficiency and liver stagnation, as well as improves penile vascular function. The effect mechanism of this therapy may be related to the regulation of serum sex hormones and relevant proteins.