Phosphodiesterase type 5 inhibitors combined with traditional Chinese medicine for diabetes mellitus-induced erectile dysfunction: A systematic review and meta-analysis
Abstract
Background: Diabetes mellitus-induced erectile dysfunction (DMED) involves complex pathophysiology, leading to suboptimal outcomes with phosphodiesterase type 5 inhibitors (PDE5I) alone. Combining PDE5I with traditional Chinese medicine (TCM) may enhance therapeutic efficacy, but evidence synthesis is lacking. Therefore, this systematic review and meta-analysis aims to compare the efficacy and safety of PDE5I combined with TCM versus PDE5I monotherapy in DMED management. Methods: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines (PROSPERO: CRD42021240608). Six databases (PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Wanfang, and VIP Science Technology Periodical Database) were searched up to May 10, 2024. Randomized controlled trials (RCTs) evaluating PDE5I + TCM versus PDE5I alone in DMED patients with International Index of Erectile Function-5 (IIEF-5) ≤ 21 were included. Data extraction, risk of bias assessment (Cochrane tool), and meta-analysis (RevMan 5.3) were performed using fixed/random-effects models. Outcomes included clinical efficacy, IIEF-5 scores, TCM syndrome scores, and adverse events. Results: Twelve RCTs (1070 participants) were included. PDE5I + TCM significantly improved clinical efficacy (relative risk = 2.86, 95% confidence interval [CI] [2.13, 3.84], P .05). Conclusion: This study demonstrates that PDE5I combined…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,070 participants or records.
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