ABSTRACT
BACKGROUND: Psychogenic erectile dysfunction (pED) is a common sexual dysfunction often accompanied by psychosomatic factors. Its treatment includes oral medications, psychotherapy, and behavioral therapy. Acupuncture's effect on erectile function in pED patients remains to be investigated. This randomized study evaluated the effects of acupuncture and sham acupuncture in pED patients. Altogether, 66 men with pED were randomized to the acupuncture (n = 33) or sham acupuncture group (n = 33). Both groups have a 6-week treatment with 18 sessions. Primary outcome was the International Index of Erectile Function-5 (IIEF-5) at 6 weeks. Secondary outcomes were IIEF-5 (weeks 2, 4, and 10), erection hardness score (EHS), sexual encounter profile-2 (SEP-2), SEP-3, self-rating anxiety scale (SAS), and self-rating depression scale (SDS). RESULTS: Among the 66 participants, 64 completed the outcome measurements at week 10. Both acupuncture and sham acupuncture groups had improved IIEF-5 and EHS and decreased SAS and SDS post-treatment (p < 0.05). The acupuncture group had significantly better improvement in IIEF-5, EHS, and SEP-3 and significantly reduced SAS and SDS than the sham acupuncture group (p < 0.05). The improvement in SEP-2 post-treatment was not significantly different between the two groups (p > 0.05). There were no serious adverse events. CONCLUSIONS: The 6-week acupuncture treatment significantly improved the erectile capacity and psychosomatic status of pED patients. TRIAL REGISTRATION: ChiCTR2200064345 (Chinese Clinical Trial Registry) ( https://www.chictr.org.cn/showproj.html?proj=174873 ).
RéSUMé: CONTEXTE: La dysfonction érectile psychogène (DEp) est une dysfonction sexuelle courante, souvent accompagnée de facteurs psychosomatiques. Son traitement comprend des médicaments par voie orale, une psychothérapie, et une thérapie comportementale. L'effet de l'acupuncture sur la fonction érectile chez les patients atteints de DEp reste à étudier. Cette étude randomisée a évalué les effets de l'acupuncture et de l'acupuncture simulée chez les patients atteints de DEp. Au total, 66 hommes atteints de DEp ont été répartis par randomisation dans le groupe d'acupuncture (n = 33) ou d'acupuncture simulée (n = 33). Les deux groupes ont eu un traitement de 6 semaines avec 18 séances. Le critère de jugement principal était l'indice international de la fonction érectile-5 (IIEF-5) à six semaines. Les critères de jugement secondaires étaient l'IIEF-5 (semaines 2, 4 et 10), le score dedureté de l'érection (EHS), le profil de rencontre sexuelle-2 (SEP-2), le SEP-3, l'échelle d'auto-évaluation de l'anxiété (SAS) et l'échelle d'auto-évaluation de la dépression (SDS). RéSULTATS: Parmi les 66 participants, 64 ont complété les mesures souhaitées à la semaine 10. Les groupes d'acupuncture et d'acupuncture simulée présentaient une amélioration de l'IIEF-5 et de l'EHS et une diminution du SAS et du SDS après le traitement (p < 0,05). Le groupe d'acupuncture a eu une amélioration significativement meilleure de l'IIEF-5, de l'EHS et du SEP-3 et une réduction significative de la SAS et de la SDS par rapport au groupe d'acupuncture simulée (p < 0,05). L'amélioration post-traitement du SEP-2 n'était pas significativement différente entre les deux groupes (p > 0,05). Il n'y a pas eu d'effets indésirables graves. CONCLUSIONS: Le traitement par acupuncture de six semaines a significativement amélioré la capacité érectile et l'état psychosomatique des patients atteints de dysfonction érectile psychogène (DEp). NUMéRO D'ENREGISTREMENT DE L'ESSAI: ChiCTR2200064345 (Registre chinois des essais cliniques) ( https://www.chictr.org.cn/showproj.html?proj=174873 ) Date d'inscription : 3 octobre 2022. MOTS-CLéS: Acupuncture; psychogène; Dysfonction érectile; Acupuncture simulée; Dysfonction sexuelle.
ABSTRACT
Background: In China, acupuncture has been widely used in treating cerebrovascular diseases since time immemorial. Scalp acupuncture using the long-stay method is a traditional acupuncture treatment. However, previous studies have concluded that the clinical efficacy of scalp acupuncture for the treatment of stroke remains uncertain. In addition, no randomized controlled trials have been conducted on scalp acupuncture using the long-stay method. This study aimed to evaluate the efficacy and safety of the long-stay method of scalp acupuncture for limb movement dysfunction in patients after acute ischemic stroke (AIS). Methods: Seventy-two patients with acute strokes were randomly divided into treatment and control groups. The control group received conventional acupuncture with a half-hour needle stay each time, whereas the treatment group underwent scalp needling using a long retention method, with each retention of needles lasting 24 hours. Both groups received acupuncture treatment for 2 weeks and were followed up for 6 months. Cerebrovascular reserve (CVR), breath-holding index (BHI), pulsatility index (PI), Fugl-Meyer, and Barthel index (BI) were assessed at baseline, week 1, week 2, and during follow-up. Results: Compared with the baseline, both groups showed a significant improvement in CVR, Fugl-Meyer, BI, PI, and BHI (P < 0.05). Compared with the control group, the treatment group showed more significant improvements in Fugl-Meyer scores, BI, CVR, PI, and BHI (P < 0.05). Correlation analysis showed that Fugl-Meyer and BI scores increased significantly with CVR recovery over the course of treatment. Conclusion: Scalp acupuncture with the long-stay method can improve neurological deficits and the ability to perform daily activities among AIS patients, which may be related to the improvement of CVR function in patients.
ABSTRACT
Purpose: Overactive bladder (OAB) syndrome is one of the most common diseases in urology and affects quality of life. Although the current treatment for OAB is based on oral medications, there are limitations and many patients have difficulty accepting drug-induced adverse effects. This review aimed to analyze the efficacy of acupuncture and its related mechanisms and provide a preliminary therapeutic regimen. Methods: Two authors independently searched PubMed, Embase, and Cochrane Library up to April 2022. They searched related English literature and extracted the data under a standard form based on the search strategy. Clinical trials which included OAB women with the treatment of acupuncture were included. Common acupuncture alone without other pharmacotherapy, external treatments was in the treatment group. The control interventions may include any active treatments, sham placebo, or no establishment of a control group. Outcomes included 3-day or 24-hour voiding diary, overactive bladder symptom score, etc. The Cochrane risk of bias tool was also used to assess the methodological quality of the randomized controlled trials (RCTs). Results: We analyzed five RCTs and one comparative study on acupuncture for OAB to review and discuss the acupoint location, treatment course, and retention time based on clinical evidence and treatment ideas in traditional Chinese medicine. Additionally, we used the available evidence to reveal and discuss the acupuncture mechanisms for OAB. Acupuncture may regulate bladder function by inhibiting C-fibers, modulating nerve growth factors and reducing spontaneous contractions of the detrusor muscle. Conclusion: Combined with the available evidence, the combination of local acupoints and distal acupoints should be necessary to consider, especially the lumbosacral acupoints, the small abdomen acupoints and the lower limb acupoints. Among them, acupuncture at SP4, CV4 and KI3 are strongly recommended. The treatment course of acupuncture should be no less than 4 weeks and maintain the frequency of acupuncture no less than once a week. The duration of each session should be no less than 20 minutes. In addition, investigations remain necessary to verify acupuncture's efficacy and precise mechanism for OAB treatment in further exploration.
