甘肃中医药大学第一临床医学院;解放军第九四〇医院泌尿外科;
勃起功能障碍(ED)是多因素引起的一种常见性功能障碍疾病,磷酸二酯酶-5抑制剂(PDE5i)虽是治疗ED常用的药物,但对于中重度及患有糖尿病等基础性疾病的患者往往疗效不佳。低能量体外冲击波治疗(Li-ESWT)是一种新型非侵入性物理治疗,具有组织损伤小、安全性高、治疗周期短等优点。经过十多年间研究发展,Li-ESWT治疗ED的有效性和安全性得到初步论证,对PDE5i疗效不佳的ED患者,改用Li-ESWT后症状改善显著。国内外对Li-ESWT的研究日益增多,其在ED治疗领域中的应用成为目前关注的热点。本文阐述了Li-ESWT在ED治疗中的作用机制及应用情况,为ED患者的临床诊治提供新思路。
87 | 0 | 36 |
下载次数 | 被引频次 | 阅读次数 |
[1] Salonia A,Bettocchi C,Boeri L,et al.European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update:Male Sexual Dysfunction.Eur Urol,2021,80(3):333-357.
[2] Geyik S.Comparison of the efficacy of low-intensity shock wave therapy and its combination with platelet-rich plasma in patients with erectile dysfunction.Andrologia,2021,53(10):e14197.
[3] Ortac M,zmez A,Cilesiz NC,et al.The impact of extracorporeal shock wave therapy for the treatment of young patients with vasculogenic mild erectile dysfunction:A prospective randomized single-blind,sham controlled study.Andrology,2021,9(5):1571-1578.
[4] Gallo L,Pecoraro S,Sarnacchiaro P.Adjuvant daily therapy with L-arginine 2,500 mg and tadalafil 5 mg increases efficacy and duration of benefits of low-intensity extracorporeal shock wave therapy for erectile dysfunction:A prospective,randomized,single-blinded study with 1-year follow-up.Investig Clin Urol,2022,63(1):83-91.
[5] 刘帅,蒲九州,李绪,等.低能量体外冲击波治疗勃起功能障碍基础研究进展.中华男科学杂志,2021,27(4):356-360.
[6] Chung E,Bailey W,Wang J.A prospective,randomized,double-blind,clinical trial using a second-generation Duolith SD1 low-intensity shockwave machine in males with vascular erectile dysfunction.World J Men's Health,2023,41(1):94-100.
[7] Kitrey ND,Vardi Y,Appel B,et al.Low-intensity shock wave treatment for erectile dysfunction:How long does the effect last.J Urol,2018,200(1):167-170.
[8] Kalyvianakis D,Mykoniatis I,Pyrgidis N,et al.The effect of low-intensity shock wave therapy on moderate erectile dysfunction:A double-blind,randomized,sham-controlled clinical trial.J Urol,2022,208(2):388-395.
[9] Yao H,Wang X,Liu H,et al.Systematic review and meta-analysis of 16 randomized controlled trials of clinical outcomes of low-intensity extracorporeal shock wave therapy in treating erectile dysfunction.Am J Men's Health,2022,16(2):15579883221087532.
[10] Tao R,Chen J,Wang D,et al.The efficacy of Li-ESWT combined with VED in diabetic ED patients unresponsive to PDE5is:A single-center,randomized clinical trial.Front Endocrinol (Lausanne),2022,13:937958.
[11] Ergün M,Akyüz O.Is Li-ESWT effective in diabetic patients with severe erectile dysfunctionAsian.J Androl,2022,24(5):521-524.
[12] Tzou KY,Hu SW,Bamodu OA,et al.Efficacy of penile low-intensity shockwave therapy and determinants of treatment response in Taiwanese patients with erectile dysfunction.Biomedicines,2021,9(11):1670.
[13] Kalyvianakis D,Mykoniatis I,Pyrgidis N,et al.The effect of combination treatment with low-intensity shockwave therapy and daily tadalafil on severe erectile dysfunction:A double-blind,randomized,sham-controlled clinical trial.J Sex Med,2024,21(6):533-538.
[14] 陈鑫,黄华伟,朱晓博,等.点状低能量体外冲击波治疗勃起功能障碍疗效的初步观察(附32例报告).中华男科学杂志,2018,24(6):529-532.
[15] 刘利杰,陈鑫,黄华伟,等.低能量体外冲击波治疗磷酸二酯酶-5抑制剂无反应性勃起功能障碍疗效研究.中国男科学杂志,2021,35(2):19-23.
[16] Wang J,Luo L,Zhao S,et al.Low-intensity extracorporeal shockwave therapy shifts PDE5i nonresponders to responders.Int Braz J Urol,2020,46(6):934-942.
[17] Vena W,Vaccalluzzo L,LA Vignera S,et al.Low-intensity shockwave treatment improves penile rigidity in eugonadal subjects with erectile dysfunction:A pilot study.Minerva Endocrinol (Torino),2023,48(1):4-11.
[18] Vinay J,Moreno D,Rajmil O,et al.Penile low-intensity shock wave treatment for PDE5I refractory erectile dysfunction:A randomized double-blind sham-controlled clinical trial.World J Urol,2021,39(6):2217-2222.
[19] Geyik S.A single-centre result of two courses of low-intensity shockwave therapy in erectile dysfunction.Andrologia,2022,54(2):e14324.
[20] Shendy WS,Elsoghier OM,El Semary MM,et al.Effect of low-intensity extracorporeal shock wave therapy on diabetic erectile dysfunction:Randomized control trial.Andrologia,2021,53(4):e13997.
[21] Verze P,Capece M,Creta M,et al.Efficacy and safety of low-intensity shockwave therapy plus tadalafil 5 mg once daily in men with type 2 diabetes mellitus and erectile dysfunction:A matched-pair comparison study.Asian J Androl,2020,22(4):379-382.
[22] Rho BY,Kim SH,Ryu JK,et al.Efficacy of low-intensity extracorporeal shock wave treatment in erectile dysfunction following radical prostatectomy:A systematic review and meta-analysis.J Clin Med,2022,11(10):2775.
[23] Jang SW,Lee EH,Chun SY,et al.Comparison of the efficacy of the early Li-SWT plus daily tadalafil with daily tadalafil only as penile rehabilitation for postprostatectomy erectile dysfunction.Int J Impot Res,2023,35(5):447-453.
[24] Di MM,Russo GI,Della CPA,et al.Extracorporeal shock wave therapy in Peyronie's disease:Clinical efficacy and safety from a single-arm observational study.World J Mens Health,2019,37(3):339-346.
[25] Mason MM,Pai RK,Masterson JM,et al.Low-intensity extracorporeal shockwave therapy for diabetic men with erectile dysfunction:A systematic scoping review.Andrology,2023,11(2):270-281.
[26] Chen PY,Cheng JH,Wu ZS,et al.New frontiers of extracorporeal shock wave medicine in urology from bench to clinical studies.Biomedicines,2022,10(3):675.
[27] Pang K,Pan D,Xu H,et al.Advances in physical diagnosis and treatment of male erectile dysfunction.Front Physiol,2023,13:1096741.
[28] 刘洋,刘树坤,孙吉磊,等.低强度脉冲超声波和低能量冲击波治疗神经性阴茎勃起功能障碍的对比研究.中华男科学杂志,2021,27(8):694-700.
[29] Chung DY,Song KM,Choi MJ,et al.Neutralizing antibody to proNGF rescues erectile function by regulating the expression of neurotrophic and angiogenic factors in a mouse model of cavernous nerve injury.Andrology,2021,9(1):329-341.
[30] Klomjit N,Lerman A,Lerman LO.It comes as a shock:Kidney repair using shockwave therapy.Hypertension,2020,76(6):1696-1703.
[31] Chen RF,Chang CH,Wang CT,et al.Modulation of vascular endothelial growth factor and mitogen-activated protein kinase-related pathway involved in extracorporeal shockwave therapy accelerate diabetic wound healing.Wound Repair Regen,2019,27(1):69-79.
[32] Zhou W,Jiang J,Jiang R.A low androgenic state inhibits erectile function by suppressing endothelial glycosides in the penile cavernous tissue of rats.Sex Med,2024,12(3):qfae039.
[33] Zhang J,Zhao D,Zang Z,et al.miR-200a-3p-enriched MSC-derived extracellular vesicles reverse erectile function in diabetic rats by targeting Keap1.Biomed Pharmacother,2024,177:116964..
[34] Sokolakis I,Dimitriadis F,Teo P,et al.The basic science behind low-intensity extracorporeal shockwave therapy for erectile dysfunction:A systematic scoping review of pre-clinical studies.J Sex Med,2019,16(2):168-194.
[35] Gurbuz N,Gurkan R,Ender CA,et al.The therapeutic effect of ALT-711 on erectile function in rats treated with high-level AGEs (advanced glycation end products) containing diet.Int J Impot Res,2022,34(2):222-228.
[36] Wang HS,Ruan Y,Banie L,et al.Delayed low-intensity extracorporeal shock wave therapy ameliorates impaired penile hemodynamics in rats subjected to pelvic neurovascular injury.J Sex Med,2019,16(1):17-26.
[37] Mykoniatis I,Pyrgidis N,Sokolakis I,et al.Assessment of combination therapies vs monotherapy for erectile dysfunction:A systematic review and meta-analysis.JAMA Netw Open,2021,4(2):e2036337.
[38] Huang Y,Yin GN,Liu FY,et al.Argonaute 2 restored erectile function and corpus cavernosum mitochondrial function by reducing apoptosis in a mouse model of cavernous nerve injury.Investig Clin Urol,2024,65(4):400-410.
[39] Xi Y,Feng Z,Xia T,et al.Caveolin-1 scaffolding domain-derived peptide enhances erectile function by regulating oxidative stress,mitochondrial dysfunction,and apoptosis of corpus cavernosum smooth muscle cells in rats with cavernous nerve injury.Life Sci,2024,348:122694.
[40] Jie H,Jie W,Yingxue G,et al.Cldn4 overexpression promotes penile cavernous smooth muscle cell fibrotic response via the JNK signaling pathway.J Sex Med,2024,21(6):511-521.
[41] Mao Y,Zha Y,Zang Y,et al.Isorhamnetin improves diabetes-induced erectile dysfunction in rats through activation of the PI3K/AKT/eNOS signaling pathway.Biomed Pharmacother,2024,177:116987.
[42] Luo L,Wang Z,Tong X,et al.LncRNA MALAT1 facilitates BM-MSCs differentiation into endothelial cells and ameliorates erectile dysfunction via the miR-206/CDC42/PAK1/paxillin signalling axis.Reprod Biol Endocrinol,2024,22(1):74.
[43] Chen Z,Jiang J,Jiang R.A low testosterone level impairs erectile function by increasing endocan expression in rat penile corpus cavernosum.J Sex Med,2024,21(8):663-670.
[44] Masterson TA,Molina M,Ledesma B,et al.Platelet-rich plasma for the treatment of erectile dysfunction:A prospective,randomized,double-blind,placebo-controlled clinical trial.J Urol,2023,210(1):154-161.
[45] Al Demour S,Adwan S,Jafar H,et al.Stem cell therapy in diabetic men with erectile dysfunction:A 24-month follow-up of safety and efficacy of two intracavernous autologous bone marrow derived mesenchymal stem cells injections,an open label phase 2 clinical trial.Basic Clin Androl,2024,34(1):13.
[46] Kim KS,Jeong HC,Choi SW,et al.Electromagnetic low-intensity extracorporeal shock wave therapy in patients with erectile dysfunction:A sham-controlled,double-blind,randomized prospective study.World J Men's Health,2020,38(2):236-242.
[47] Wang CM,Wu BR,Xiang P,et al.Management of male erectile dysfunction:From the past to the future.Front Endocrinol (Lausanne),2023,14:1148834.
基本信息:
DOI:10.13263/j.cnki.nja.2025.01.011
中图分类号:R698.1
引用信息:
[1]徐海中,宁艺萍,杨旭凯.低能量体外冲击波在勃起功能障碍中的应用及其机制的研究进展[J].中华男科学杂志,2025,31(01):69-75.DOI:10.13263/j.cnki.nja.2025.01.011.
基金信息:
兰州市人才创新创业项目(2021-RC-106)~~