Lai Bao Yong, Cao Hui Juan, Yang Guo Yan, Jia Li Yan, Grant Suzanne, Fei Yu Tong, Wong Emma, Li Xin Lin, Yang Xiao Ying, Liu Jian Ping
Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
NICM Health Research Institute, Western Sydney University, Penrith, Australia.
World J Mens Health. 2019 Sep;37(3):322-338. doi: 10.5534/wjmh.180090. Epub 2019 Mar 15.
To assess the effectiveness and safety of acupuncture for erectile dysfunction (ED).
We searched six major English and Chinese databases included randomized controlled trials (RCTs) testing acupuncture alone or in combination for ED. Dichotomous data were presented as risk ratio (RR) and continuous data were presented as mean difference (MD) both with 95% confidence interval (CI). The Revman (v.5.3) was used for data analyses. Quality of evidence across studies was assessed by the online GRADEpro tool.
We identified 22 RCTs, fourteen of them involving psychogenic ED. Most of the included RCTs had high or unclear risk of bias. There was no difference between electro-acupuncture and sham acupuncture with electrical stimulation on the rate of satisfaction and self-assessment (RR, 1.50; 95% CI, 0.71-3.16; 1 trial). Acupuncture combined with tadalafil appeared to have better effect on increasing cure rate (RR, 1.31; 95% CI, 1.00-1.71; 2 trials), and International Index of Erectile Function-5 scores (MD, 5.38; 95% CI, 4.46-6.29; 2 trials). When acupuncture plus herbal medicine compared with herbal medicine alone, the combination therapy showed significant better improvement in erectile function (RR, 1.68; 95% CI, 1.31-2.15; 7 trials). Only two trials reported facial red and dizziness cases, and needle sticking and pruritus cases in acupuncture group.
Low quality evidence shows beneficial effect of acupuncture as adjunctive treatment for people mainly with psychogenic ED. Safety of acupuncture was insufficiently reported. The findings should be confirmed in large, rigorously designed and well-reported trials.
评估针刺治疗勃起功能障碍（ED）的有效性和安全性。
我们检索了六个主要的英文和中文数据库，纳入了单独或联合使用针刺治疗ED的随机对照试验（RCT）。二分类数据以风险比（RR）表示，连续数据以均数差（MD）表示，两者均伴有95%置信区间（CI）。采用Revman（v.5.3）进行数据分析。通过在线GRADEpro工具评估各研究的证据质量。
我们共纳入22项RCT，其中14项涉及心因性ED。大多数纳入的RCT存在高偏倚风险或偏倚风险不明确。电针与电刺激假针刺在满意度和自我评估率方面无差异（RR，1.50；95%CI，0.71 - 3.16；1项试验）。针刺联合他达拉非在提高治愈率方面似乎有更好的效果（RR，1.31；95%CI，1.00 - 1.71；2项试验），以及国际勃起功能指数-5评分（MD，5.38；95%CI，4.46 - 6.29；2项试验）。当针刺加中药与单纯中药相比时，联合治疗在勃起功能改善方面显示出显著更好的效果（RR，1.68；95%CI，1.31 - 2.15；7项试验）。仅两项试验报告了针刺组出现面部潮红和头晕病例，以及针刺部位疼痛和瘙痒病例。
低质量证据表明针刺作为主要针对心因性ED患者的辅助治疗具有有益作用。针刺安全性的报告不足。这些发现应在大型、设计严谨且报告完善的试验中得到证实。
