Clinically meaningful improvement on the quality of erection questionnaire in men with erectile dysfunction

Effects of Chaihu-Shugan-San capsule for psychogenic erectile dysfunction: Study protocol of a randomized placebo-controlled trial

BACKGROUND

Erectile dysfunction (ED) affects many adult men worldwide. Many studies on the brain of psychogenic ED have shown significant cerebral functional changes and reduced volume of gray matter and white matter microstructural alterations in widespread brain regions. Chaihu-Shugan-San (CHSGS) capsule has been used to treat ED from the 20th century in China. However, clinical research of CHSGS capsule in the treatment of ED was lack. We design this study to evaluate the efficacy and safety of CHSGS capsule in the treatment of patients suffering from psychogenic ED. Furthermore, we also aim to provide a new evidence as well as an innovation of the clinical treatment in psychogenic ED.

METHODS

This study is designed as a multi-center, 3-arms, randomized trial. From the perspective of psychogenic ED, we will divide patients into 3 groups, which are placebo group, tadalafil group and CHSGS group. One hundred thirty-five patients will be randomly allocated to receive placebo, CHSGS capsule or tadalafil oral pharmacotherapy. After the period of 4-week treatment, the outcome of primary assessment changes in the brain MRI, IIEF-5, EHS, and QEQ total scores from baseline. Secondary assessments include the SEAR, HAMA-14, HAMD-17 scores, response rate of the patients and their partners.

DISCUSSION

We designed this study based on previous research about psychogenic erectile dysfunction (ED). This study will provide objective evidences to evaluate the effects of CHSGS capsule as an adjuvant treatment for psychogenic ED.

TRIAL REGISTRATION NUMBER

chictr.org.cn, ChiCTR-IOR-1800018301.

Cerebral Activity Changes in Different Traditional Chinese Medicine Patterns of Psychogenic Erectile Dysfunction Patients

Background. Pattern differentiation is the foundation of traditional Chinese medicine (TCM) treatment for erectile dysfunction (ED). This study aims to investigate the differences in cerebral activity in ED patients with different TCM patterns. Methods. 27 psychogenic ED patients and 27 healthy subjects (HS) were enrolled in this study. Each participant underwent an fMRI scan in resting state. The fractional amplitude of low-frequency fluctuation (fALFF) was used to detect the brain activity changes in ED patients with different patterns. Results. Compared to HS, ED patients showed an increased cerebral activity in bilateral cerebellum, insula, globus pallidus, parahippocampal gyrus, orbitofrontal cortex (OFC), and middle cingulate cortex (MCC). Compared to the patients with liver-qi stagnation and spleen deficiency pattern (LSSDP), the patients with kidney-yang deficiency pattern (KDP) showed an increased activity in bilateral brainstem, cerebellum, hippocampus, and the right insula, thalamus, MCC, and a decreased activity in bilateral putamen, medial frontal gyrus, temporal pole, and the right caudate nucleus, OFC, anterior cingulate cortex, and posterior cingulate cortex (P < 0.005). Conclusions. The ED patients with different TCM patterns showed different brain activities. The differences in cerebral activity between LSSDP and KDP were mainly in the emotion-related regions, including prefrontal cortex and cingulated cortex.