针对勃起功能障碍的非药物干预措施的比较有效性和安全性:系统性审查和网络元分析
Xinlei He1, Tingxin Li2, Wenrui Huang3
1Urology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Sichuan Province, Chengdu 610031, China.
Sexual medicine reviews
|February 6, 2026
概括
与运动相结合的电刺激 (ES) 比其他非药物干预措施显著改善勃起功能障碍 (ED). 虽然单独ES也显示了益处,但需要进一步的研究来确认长期疗效.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 康复医学 康复医学 康复医学
- 生物医学工程 生物医学工程
背景情况:
- 许多勃起功能障碍 (ED) 患者对固酶5型抑制剂 (PDE5is) 的治疗反应不佳.
- 非药物干预 (NPI) 正在成为ED的有希望的替代或辅助治疗方法.
- 评估各种NPI的比较疗效对于临床决策至关重要.
研究的目的:
- 系统地审查并进行网络元分析,比较不同NPI对ED的疗效和安全性.
- 根据目前的证据,确定改善勃起功能最有效的NPI.
主要方法:
- 根据PRISMA指南进行了系统审查和网络元分析 (NMA).
- 随机对照试验 (RCT) 评估了电刺激 (ES),运动,低强度体外冲击波疗法 (Li-ESWT),针治疗 (ABT) 和高压氧气治疗 (HOT) 治疗ED.
- 主要结局包括国际勃起功能指数-5 (IIEF-5),勃起硬度得分 (EHS) 和缩速度峰值 (PSV);通过不良事件 (AE) 评估安全性.
- 偏差风险和证据确定性分别使用RoB 2.0和CINeMA进行了评估.
主要成果:
- 分析了31个涉及1874名参与者的RCT.
- 与假药/安慰剂 (MD = 6.81) 相比,电刺激 (ES) 加运动在IIEF-5分数中表现出最显著的改善,具有高确定性证据.
- 单独ES也产生了显著的改善 (MD = 2.86),而Li-ESWT显示了适度的好处 (MD = 0.65).
- 对于EHS的改善,ES最有效,对于PSV的增加,Li-ESWT加运动最有效,没有报告严重不良事件.
结论:
- NPIs,特别是基于ES的疗法,显示出改善ED的巨大潜力.
- 在ED治疗中,ES和运动的组合似乎是最有效和最一致的.
- 由于目前的证据局限性,进一步的大规模,高质量的试验是有必要的,以确认在不同人群中有效性和安全性.
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