包括再生疗法在内的组合疗法的比较疗效与勃起功能障碍单一疗法:系统性审查和元分析
Alberto Quistini1, Giuseppe Fallara2, Marco Tozzi2
1Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, University of Milan, Milan, Italy.
Andrology
|August 13, 2025
概括
与低强度外部冲击波疗法结合固酶-5抑制剂,与单一治疗相比,显著改善勃起功能,特别是在血管性勃起功能障碍或糖尿病患者中. 这种组合疗法显示出增强勃起功能障碍治疗结果的希望.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 再生医学是一种再生医学.
- 男人的健康 男人的健康
背景情况:
- 目前欧洲泌尿病学协会的指导方针缺乏将再生疗法与勃起功能障碍 (ED) 的标准治疗相结合的建议.
- 现有的研究还没有广泛地比较联合再生和标准疗法的疗效与ED的单一疗法.
研究的目的:
- 系统地审查和比较联合再生疗法与单一疗法的疗效,以治疗勃起功能障碍.
- 用验证的评估工具评估组合疗法对勃起功能的影响.
主要方法:
- 根据PRISMA 2020指南进行了系统审查和元分析.
- 包括的研究是随机对照试验和前性/后性研究,比较组合疗法 (例如,低强度外部冲击波疗法与PDE5抑制剂) 与单一疗法.
- 使用国际勃起功能指数-5 (IIEF-5) 和勃起硬度量表 (EHS) 评估勃起功能.
主要成果:
- 包括553名患者的8项研究;所有使用的固酶-5抑制剂 (PDE5i) 和低强度外部冲击波疗法 (Li-ESWT).
- 总体而言,组合治疗和单一治疗组之间没有观察到IIEF-5评分的显著差异.
- 亚组分析显示,联合治疗与单独使用Li-ESWT显著改善 (SMD:0.61;p=0.013),特别是在血管性ED病例 (SMD:0.65;p<0.001) 和糖尿病性ED病例 (SMD:1.05;p<0.001).
结论:
- 与Li-ESWT单独治疗相比,PDE5抑制剂和Li-ESWT的联合治疗显著改善了勃起功能.
- 这种组合疗法对患有血管性ED和糖尿病的患者特别有效.
- 由于包含的研究质量低,因此注意到存在偏差的高风险,需要进一步进行高质量的研究.
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