The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
The First Clinical College, Nanjing University of Chinese Medicine, Jiangsu, China.
Andrology. 2020 Mar;8(2):268-276. doi: 10.1111/andr.12696. Epub 2019 Aug 28.
Erectile dysfunction (ED) is a tough problem in medicine. This article aims to provide the latest evidence for the efficacy and safety of traditional Chinese medicine (TCM) combined with tadalafil in treatment of erectile dysfunction.
All randomized controlled trials that Chinese herbal medicine combined with tadalafil for erectile dysfunction were included in databases of China National Knowledge Infrastructure (CNKI), Wanfang, Weip Database, China Biology Medicine disc (CBM), MEDLINE, EMBASE, and Cochrane Library. The quality of the included articles was evaluated using Cochrane Reviewer's Handbook 5.3, and meta-analysis was performed using Stata 13.1.
A total of 11 studies including 451 cases in the treatment group and 452 cases in the control group were obtained. Compared with tadalafil alone, meta-analysis suggests there were statistically significant differences in International Index of Erectile Function-5 (IIEF-5), effective rate, Sexual Encounter Profile questions 2 and 3 (SEP-Q2, SEP-Q3) between traditional Chinese medicine combined with tadalafil, and no statistically significant differences in side effects between the two groups. All included studies were tested for publication bias, and the results indicated that there was no significant bias. Two of the articles mentioned the scheme that traditional Chinese medicine combined with low-dose tadalafil for erectile dysfunction by down stairs.
Traditional Chinese medicine combined with tadalafil has significant efficacy in the treatment of ED with no increase in side effects. The specific implementing regulations and effect of de-escalation therapy still need more long-term, multicenter, randomized, and double-blind clinical trials.
勃起功能障碍（ED）是医学领域的一个难题。本文旨在为中药联合他达拉非治疗勃起功能障碍的疗效和安全性提供最新证据。
检索中国知网（CNKI）、万方、维普数据库、中国生物医学文献数据库（CBM）、MEDLINE、EMBASE 和 Cochrane Library 中关于中药联合他达拉非治疗勃起功能障碍的随机对照试验。采用 Cochrane 手册 5.3 对纳入文献质量进行评价，采用 Stata 13.1 进行 Meta 分析。
共纳入 11 项研究，治疗组 451 例，对照组 452 例。Meta 分析结果显示，与他达拉非单药治疗相比，中药联合他达拉非在国际勃起功能指数-5（IIEF-5）、有效率、性经历问卷 2 和 3（SEP-Q2、SEP-Q3）方面差异有统计学意义，两组不良反应发生率差异无统计学意义。所有纳入研究均进行了发表偏倚检验，结果提示无明显偏倚。有 2 篇文献报道了中药联合小剂量他达拉非治疗勃起功能障碍的方案。
中药联合他达拉非治疗 ED 疗效确切，且不增加不良反应。具体的降级治疗方案和效果仍需要更多长期、多中心、随机、双盲的临床试验来验证。
