Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis
ObjectiveThe efficacy of compound Xuanju capsule (CXC) in the treatment of erectile dysfunction (ED) remains unclear. This study aimed to quantitatively assess the benefits and risks of CXC in the treatment of ED.MethodsEight major databases were systematically searched for relevant literature publi...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1537789/full |
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| author | Ronghui Li Min Liao Yunfeng Yu Bing Guo Rong Yu Qinghu He Qinghu He Guomin Zhang |
| author_facet | Ronghui Li Min Liao Yunfeng Yu Bing Guo Rong Yu Qinghu He Qinghu He Guomin Zhang |
| author_sort | Ronghui Li |
| collection | DOAJ |
| description | ObjectiveThe efficacy of compound Xuanju capsule (CXC) in the treatment of erectile dysfunction (ED) remains unclear. This study aimed to quantitatively assess the benefits and risks of CXC in the treatment of ED.MethodsEight major databases were systematically searched for relevant literature published till 10 May 2025. Studies were screened based on established criteria; meta-analysis and trial sequential analysis of included literature were conducted.ResultsThe meta-analysis demonstrated that, compared with phosphodiesterase type 5 inhibitors alone, the combination of CXC and phosphodiesterase type 5 inhibitors significantly improved the International Index of Erectile Function (IIEF)-5 score by 3.19 points (mean difference [MD] = 3.19; 95% confidence interval [CI]: 2.42–3.96; P < 0.00001), clinical effectiveness rate by 23% (risk ratio [RR] = 1.23; 95% CI: 1.15–1.32; P < 0.00001), penile cavernous blood flow by 5.21 cm/s (MD = 5.21; 95% CI: 4.43–6.00; P < 0.00001), and serum testosterone levels by 4.09 nmol/L (MD = 4.09; 95% CI: 3.14–5.04; P < 0.00001). There was no significant difference in total adverse events between the groups (RR = 0.94; 95% CI: 0.62–1.42; P = 0.77). Trial sequential analysis confirmed that the meta-analysis results for IIEF-5, clinical effectiveness rate, penile cavernous blood flow, and serum testosterone levels were conclusive. However, the results of adverse events require further validation through additional similar studies. Funnel plot analysis and Egger’s test indicated no potential publication bias for outcomes other than the clinical effectiveness rate.ConclusionCXC improves erectile function and testosterone levels in patients with ED without increasing the incidence of adverse events. These findings support the potential role of CXC as an adjunctive treatment for ED. However, due to the limitations in the quality of the current evidence, further validation through multicenter, randomized, double-blind controlled trials is necessary. |
| format | Article |
| id | doaj-art-b8aab2a6dff948a2b4f6537f6999150f |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-b8aab2a6dff948a2b4f6537f6999150f2025-08-20T03:27:51ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-06-011610.3389/fphar.2025.15377891537789Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysisRonghui Li0Min Liao1Yunfeng Yu2Bing Guo3Rong Yu4Qinghu He5Qinghu He6Guomin Zhang7School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaDepartment of Anesthesiology, People’s Hospital of Ningxiang City, Changsha, Hunan, ChinaSchool of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaSchool of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaSchool of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaSchool of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaSchool of Traditional Chinese Medicine, Hunan University of Medicine, Huaihua, Hunan, ChinaSchool of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, ChinaObjectiveThe efficacy of compound Xuanju capsule (CXC) in the treatment of erectile dysfunction (ED) remains unclear. This study aimed to quantitatively assess the benefits and risks of CXC in the treatment of ED.MethodsEight major databases were systematically searched for relevant literature published till 10 May 2025. Studies were screened based on established criteria; meta-analysis and trial sequential analysis of included literature were conducted.ResultsThe meta-analysis demonstrated that, compared with phosphodiesterase type 5 inhibitors alone, the combination of CXC and phosphodiesterase type 5 inhibitors significantly improved the International Index of Erectile Function (IIEF)-5 score by 3.19 points (mean difference [MD] = 3.19; 95% confidence interval [CI]: 2.42–3.96; P < 0.00001), clinical effectiveness rate by 23% (risk ratio [RR] = 1.23; 95% CI: 1.15–1.32; P < 0.00001), penile cavernous blood flow by 5.21 cm/s (MD = 5.21; 95% CI: 4.43–6.00; P < 0.00001), and serum testosterone levels by 4.09 nmol/L (MD = 4.09; 95% CI: 3.14–5.04; P < 0.00001). There was no significant difference in total adverse events between the groups (RR = 0.94; 95% CI: 0.62–1.42; P = 0.77). Trial sequential analysis confirmed that the meta-analysis results for IIEF-5, clinical effectiveness rate, penile cavernous blood flow, and serum testosterone levels were conclusive. However, the results of adverse events require further validation through additional similar studies. Funnel plot analysis and Egger’s test indicated no potential publication bias for outcomes other than the clinical effectiveness rate.ConclusionCXC improves erectile function and testosterone levels in patients with ED without increasing the incidence of adverse events. These findings support the potential role of CXC as an adjunctive treatment for ED. However, due to the limitations in the quality of the current evidence, further validation through multicenter, randomized, double-blind controlled trials is necessary.https://www.frontiersin.org/articles/10.3389/fphar.2025.1537789/fullcompound Xuanju capsulephosphodiesterase type 5 inhibitorerectile dysfunctionmeta-analysistrial sequential analysis |
| spellingShingle | Ronghui Li Min Liao Yunfeng Yu Bing Guo Rong Yu Qinghu He Qinghu He Guomin Zhang Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis Frontiers in Pharmacology compound Xuanju capsule phosphodiesterase type 5 inhibitor erectile dysfunction meta-analysis trial sequential analysis |
| title | Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis |
| title_full | Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis |
| title_fullStr | Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis |
| title_full_unstemmed | Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis |
| title_short | Compound Xuanju capsules combined with phosphodiesterase-5 inhibitors as a new strategy for erectile dysfunction: a meta-analysis and trial sequential analysis |
| title_sort | compound xuanju capsules combined with phosphodiesterase 5 inhibitors as a new strategy for erectile dysfunction a meta analysis and trial sequential analysis |
| topic | compound Xuanju capsule phosphodiesterase type 5 inhibitor erectile dysfunction meta-analysis trial sequential analysis |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1537789/full |
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