Objective  To evaluate the clinical efficacy of sacral-4 acupuncture combined with tadalafil in the treatment of male erectile dysfunction (ED).

Methods  A retrospective analysis was conducted on the data of ED patients who sought treatment in Affiliated Huzhou Hospital of Zhejiang Chinese Medical University from June 2022 to October 2023, and the patients were divided into a control group (treated with tadalafil) and a treatment group (treated with tadalafil combined with sacral-4 acupuncture). The International Index of Erectile Function-5 (IIEF-5) and erectile hardness score (EHS) were assessed before treatment, at the end of treatment, and at 1, 3, and 6 months of follow-up.

Results  A total of 100 patients was included, with 50 in the control group and 50 in the treatment group. The group, time, and interaction effects of IIEF-5 scores were significant (P<0.05). At 1-month and 3-month follow-ups, the difference in IIEF-5 scores between the treatment group and the control group was the greatest, at 3.625 points (P<0.05), and decreased to 0.725 points at 6 months (P﹥0.05). The group and time effects of EHS scores were significant (P<0.05). EHS scores at 1, 3, and 6 months of follow-up were significantly higher in the treatment group than in the control group (P<0.05), but there was a trend towards a diminishing efficacy advantage: the difference between the groups was greatest at 1 month of follow-up (+0.425 points, P﹤0.05), maintained at 3 months (P<0.05), and then fell back to a difference of +0.425 points (P﹤0.05) by 6 months.

Conclusion  Sacral-4 acupuncture combined with tadalafil significantly improves erectile function and hardness in the short to medium term and demonstrates superior efficacy over tadalafil alone, suggesting promising clinical value in the treatment of ED.

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