Analysis Of An Animal Model Of Erectile Dysfunction Based On The Characteristics Of Clinical Conditions in Chinese And Western Medicine

Abstract: Objective Based on the characteristics of erectile dysfunction in Chinese and western medicine, we analyzed the existing animal models and evaluated the clinical match of the models as well as their strengths and weaknesses, with a view to improving the existing animal models and providing a more intuitive reference for clinical research. 

Methods The existing animal models of erectile dysfunction were searched, categorized, and combined with the clinical characteristics of erectile dysfunction in Chinese and Western medicine, the models were evaluated for their clinical compatibility and their strengths and weaknesses. 

Results The existing models of erectile dysfunction are divided into vascular models, neurological models, psychological models, detrusor models and endocrine models according to the etiology of the disease, a total of 10 kinds, of which, the higher degree of Chinese medicine clinical match is the drug injection combined with a high-fat diet to replicate the type 2 diabetes mellitus erectile dysfunction animal model, the high uric acid erectile dysfunction rat model, the degree of Chinese medicine match is 63%, and can be comprehensively simulated clinical The higher degree of match in Western medicine is the bilateral cavernous nerve compression model and spinal cord injury model, with the degree of match in Western medicine being 49%; each model has its own advantages and disadvantages, generally due to the lack of a modeling method that combines TCM and Western medicine with disease evidence. Conclusion The existing animal models are prepared with a single causative factor, mostly in accordance with the etiology and mechanism of Western medicine, with less connection to the mechanism of Chinese medicine, and lack of reflection of Chinese medicine symptoms, and the degree of Chinese and Western medicine match is generally not high, Chinese and Western medicine treatment of disease from a multi-faceted diagnosis and treatment should be a combination of the characteristics of Chinese and Western medicine, using multifactorial modeling methods, to reflect the pathology of the pathological process of erectile dysfunction, to improve the existing model, and to establish a more in line with the characteristics of the Chinese and Western medicine clinical conditions of the erectile dysfunction animal models, to provide references for the prevention and control of the clinic. 

Keywords: Erectile dysfunction, Impotence, Pathological combination, Animal model, Fit, Advantages and disadvantages

Treatment of Erectile Dysfunction Herbal Supplements

Erectile dysfunction (ED) refers to a disease in which men are unable to achieve or maintain an erection during sex or other appropriate situations, resulting in sexual dysfunction. It is a chronic disease that seriously affects the physical and mental health of patients [1-2]. It is mainly manifested by the inability of the penis to achieve or maintain an effective erection. It has always been considered one of the important indicators of male sexual quality, and is also an important factor affecting marital relationships and mental health. While reducing the quality of life [3], it has also become a precursor disease for certain cardiovascular diseases [4]. At present, more than 100 million people worldwide are troubled by ED, and it is expected to exceed 300 million by 2025 [5-6]. At present, both traditional Chinese medicine and Western medicine have made some progress in the treatment of ED. Traditional Chinese medicine treatment of ED focuses on adjusting the balance of yin and yang in the human body, regulating the meridians and blood through taking Chinese medicine, acupuncture, massage and other methods, and improving the overall state of the body. Chinese medicine prescriptions such as Jinkui Shenqi Pills and Wuzi Yanzong Pills are often used to treat ED. Clinical practice has shown that these Chinese medicines have good therapeutic effects and few side effects. At the same time, acupuncture, as a meridian conditioning method, can also help improve erectile function. In the field of Western medicine, the treatment of ED mainly relies on drug therapy and surgical therapy. Western medicine drug therapy mainly includes the use of phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), etc. These drugs inhibit the activity of the PDE5 enzyme and increase the release of nitric oxide, thereby relaxing the smooth muscle of the corpus cavernosum, increasing blood flow, and achieving the effect of erection. Although these drugs are effective in most patients, there are also some adverse reactions, such as headache, facial flushing, and visual abnormalities. In addition, for some special types of ED, such as pathological ED, surgical treatment may be required, such as the implantation of a penile prosthesis. However, there are some problems with both traditional Chinese medicine and Western medicine treatment methods. Although traditional Chinese medicine can regulate the overall physical constitution, due to the individual differences in the efficacy of traditional Chinese medicine, the efficacy of erectile dysfunction is unstable. In addition, the treatment methods of traditional Chinese medicine take a certain amount of time to work and cannot be immediate. In the field of Western medicine, although drug therapies such as PDE5 inhibitors are relatively effective, they are not suitable for all patients, and there may be contraindications for some patients with organic lesions or who use specific drugs. In addition, drug treatment only relieves symptoms and cannot fundamentally solve the problem. The pathogenesis and treatment of ED are currently urgent issues to be explored, but due to legal and ethical restrictions, research on ED is still mainly based on animal models [7]. Therefore, this article classifies the existing ED animal models, sets animal model scoring standards based on the clinical diagnostic standards of traditional Chinese and Western medicine, and comprehensively evaluates and analyzes the clinical consistency of each model, in order to further improve the ED animal model and provide a basis for clinical prevention and treatment.

1 Etiology and pathogenesis of ED

1.1 Etiology and pathogenesis of modern medicine

Modern medicine believes that penile erection is a complete hemodynamic process[8]. Psychological, neurological, endocrine, vascular factors, etc. that lead to abnormalities in the central nervous system and sexual impulses, or cause any structural defects in the penis such as the corpus cavernosum and smooth muscle, or cause any dysfunction in the penile veins and corpus cavernosum blood flow during the erection process can lead to ED[8-10].

1.2 Etiology and pathogenesis of traditional Chinese medicine

Traditional Chinese medicine includes erectile dysfunction in the category of "impotence". The earliest name of impotence is "inability to get up due to old age"[9]. Traditional Chinese medicine believes that factors such as emotions, diet, six evils, injuries from falls, endowment, long-term illness, and old age and physical weakness make the blood in the tendons unable to be nourished, leading to ED[4]. Traditional Chinese medicine divides this disease into seven syndromes: liver depression and qi stagnation syndrome, blood stasis syndrome, tendon dampness and heat syndrome, spleen and kidney deficiency syndrome, kidney deficiency and blood stasis syndrome, life gate fire decline syndrome, and brain and heart disorder syndrome[2,9-10].

2 Diagnostic criteria of ED in traditional Chinese and Western medicine

2.1 Diagnostic criteria of Western medicine

The clinical diagnosis of ED is summarized in accordance with the European Association of Urology's Guidelines for the Diagnosis and Treatment of Erectile Dysfunction (2021 edition)[11], the Guidelines for the Diagnosis and Treatment of Erectile Dysfunction (2022 edition)[12] and the Guidelines for the Multidisciplinary Diagnosis and Treatment of Erectile Dysfunction Combining Traditional Chinese and Western Medicine (2022 edition)[13], which include medical history, physical examination, laboratory auxiliary examinations and corresponding assessment scales. According to the needs of animal model research and in combination with the relevant indicators of the animal model, different degrees of value were assigned to medical history, assessment scale, physical examination, and auxiliary examinations [14]: Physical examination and laboratory auxiliary examinations are intuitive indicators for diagnosing ED, so they were assigned 40% each. Meeting any physical examination and laboratory auxiliary examination scored 5% and 4% respectively. Medical history is a necessary condition for diagnosing the disease, so it was assigned 10%, and meeting any medical history scored 2%. The assessment scale is a commonly used quantitative diagnostic tool for evaluating erectile function, so it was assigned 10%, and meeting any assessment scored 5%, with a total score of 100% [15]. See Table 1 for details.

Treatment of Erectile Dysfunction Herbal Supplements

CLICK FOR MORE DETAILS

2.2 TCM diagnostic criteria

Referring to the "Guidelines for Clinical Diagnosis and Treatment of TCM Surgery" (2020 edition) compiled by the Chinese Association of Traditional Chinese Medicine [9,17] and the "Standards for Diagnosis and Efficacy of TCM Internal Medicine Diseases" issued by the TCM Industry Standards of the People's Republic of China [17], the following is summarized: ED diagnosis basis: ① Young and middle-aged men, the penis cannot be erected during sexual intercourse, or the penis is erect but not hard, and cannot have normal sexual intercourse; ② Adolescents often have a history of masturbation, or have excessive sexual intercourse, often accompanied by soreness of the waist and knees, fatigue, fear of cold and cold limbs, or difficulty urinating, dripping, etc.; ③ Exclude impotence caused by sexual organ dysplasia or drugs [18]. The diagnosis and differentiation of TCM syndromes are summarized and summarized. I. The main symptoms include: ① Penile flaccidity and inability to erect; ② Erection is not hard, sexual desire is indifferent; ③ Penile erection is hard but not long, and the number of morning erections decreases; if one of the main symptoms is met, a value of 15% is assigned. The secondary symptoms included: ① burning, short, red urine, white drops from the urethra, and sticky stools; ② distended lower abdomen; ③ irritability, restlessness; ④ insomnia, dreaminess, and spermatorrhea; ⑤ anxiety and depression; ⑥ fatigue, long, clear urine; ⑦ weakness in the limbs, soreness in the waist and knees; ⑧ loose stools, frequent urination at night; ⑨ pale complexion, chills, cold limbs, and cold lower abdomen and perineum; ⑩ spermatorrhea and clear, cold semen. The score for each secondary symptom was 5.5% [19], and the total score was 100%. The tongue and pulse were not convenient for animal model evaluation, so they are not described in detail. See Table 2 for details.