Summary:
In 90 male patients with diabetes mellitus-induced erectile dysfunction and TCM diagnosis of qi deficiency with blood stasis syndrome, combined therapy of mild moxibustion at specific acupoints (Zusanli ST36, Sanyinjiao SP6, Yinlingquan SP9) every other day plus daily oral tadalafil 5 mg for 4 weeks demonstrated 90% total effectiveness rate versus 46.7% (moxibustion alone) and 60% (tadalafil alone), with significant improvements in IIEF-5 scores, EHS, TCM symptom scores, and penile Doppler parameters (PSV, RI, EDV) compared to moxibustion alone or tadalafil alone for 4 weeks, with no significant adverse effects in any group.
| PICO | Description |
|---|---|
| Population | 90 male patients with diabetes mellitus-induced erectile dysfunction and TCM qi deficiency with blood stasis syndrome. |
| Intervention | Mild moxibustion at acupoints (ST36, SP6, SP9) every other day plus daily tadalafil 5 mg for 4 weeks. |
| Comparison | Moxibustion alone or tadalafil alone, each for 4 weeks. |
| Outcome | 90% effectiveness rate vs 46.7% and 60%. Significant improvements in IIEF-5, EHS, and penile Doppler parameters. No adverse effects. |
Clinical Context
Erectile dysfunction affects 35-75% of men with diabetes. Response rates to PDE5 inhibitors are lower in diabetic men (50-60%) compared to general ED population.
Clinical Pearls
1. Synergistic Efficacy: 90% effectiveness with combination substantially exceeds either monotherapy, suggesting true synergy.
2. Specific Acupoint Selection: Points (Zusanli, Sanyinjiao, Yinlingquan) classically indicated for qi and blood circulation.
3. Objective Hemodynamic Improvements: Improvements in penile Doppler parameters demonstrate measurable vascular changes.
4. Low-Dose Daily Tadalafil Context: Daily 5 mg provides continuous PDE5 inhibition with endothelial rehabilitative effects.
Practical Application
Consider referral for adjunctive moxibustion therapy for diabetic men with partial PDE5 inhibitor response. Continue optimizing diabetes management.
Study Limitations
Single-center study. Blinding impossible for moxibustion. Four-week duration may not reflect long-term outcomes.
Bottom Line
Moxibustion combined with low-dose daily tadalafil achieves 90% effectiveness for diabetic ED, significantly outperforming either treatment alone.
Source: Liu T, et al. “Moxibustion Combined with Low-Dose Tadalafil for Diabetes Mellitus-Induced Erectile Dysfunction: A Prospective, Single-Center, Three-Arm Randomized Controlled Trial.” Read article
