[Clinical efficacy and preliminary mechanistic exploration of Wendan decoction for erectile dysfunction with liver-qi stagnation syndrome].

Authors

Yang Sun, Xu Wang, Yi Jing, Yidong Deng, Ao Wang, Zhaowei Chen, Xinghao Zhang, Ziheng Zhang, Huaying Qian, Jinbo Tian, Xintong Tian, Chengxu Cao, Zhixing Sun, Xinyi Sun, Ziyang Han, Yun Chen

Published in

Zhonghua nan ke xue = National journal of andrology. Volume 32. Issue 2. Pages 143-152.

Abstract

Objective　The aim of this study is to evaluate the clinical efficacy of Wendan Decoction in the treatment of erectile dysfunction （ED） with liver-qi stagnation pattern, and to explore its potential mechanisms and targets. Methods　In this retrospective study, 68 patients with ED of liver-qi stagnation pattern who attended the Andrology Department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2024 to December 2024 were enrolled. The patients were assigned to the Wendan Decoction group （n=28） or the Chaihu Shugan San group（n=40）, with a treatment duration of 8 weeks.The International Index of Erectile Function-5（IIEF-5）, Erection Hardness Score（EHS） and Traditional Chinese Medicine syndrome score（TCMSS） were used to assess efficacy, and safety was monitored. Active components of Wendan Decoction and their putative targets were obtained from public databases, and psychogenic-ED-related targets were collected. Common targets were identified and subjected to enrichment analysis. After obtaining the targets of Chaihushugan Powder for psychogenic ED, Wendan-specific targets were screened and analyzed. Molecular docking was performed to verify the binding of key components to key/common and Wendan-specific targets. Brain-region enrichment of Wendan-specific targets was further conducted to predict the possibly modulated neural circuits. Results　After treatment, IIEF-5, EHS and TCMSS were significantly improved in both groups compared with baseline(P<0.01). The improvements in TCMSS（12.71±2.12 vs 14.15±3.88）and EHS（3.43±0.50 vs 3.02±0.76）were more significant in the observation group than those in the control group（both P<0.01）. No obvious adverse reactions were reported in either group. Network pharmacology suggested that core components of Wendan Decoction may act on key targets such as AKT1, TNF, TP53, IL6, IL1B, CASP3, ESR1, PTGS2, BCL2 and STAT3, thereby modulating PI3K-Akt, cGMP-PKG and other signaling pathways to exert anti-inflammatory, anti-apoptotic and antioxidative effects. Molecular docking showed stable binding between core components and these targets, with binding energies all <－5 kcal/mol. Brain-region enrichment analysis indicated that the specific targets of Wendan Decoction were mainly distributed in key regions including the thalamus, basal ganglia, prefrontal and orbitofrontal cortices, hypothalamus, and cerebellum. Accordingly, Wendan Decoction may facilitate recovery from liver-qi stagnation-type ED by modulating the prefrontal-amygdala emotional circuit, the orbitofrontal-striatal reward circuit, and the frontoparietal attention network. Conclusion　Wendan Decoction can effectively improve erectile function and accompanying symptoms in patients with ED of liver-qi stagnation pattern, with good safety. Its therapeutic effects may involve synergistic regulation of multiple components, multiple targets, multiple signaling pathways and multiple brain regions.

PMID:
43012180
Bibliographic data and abstract were imported from PubMed on 11 Nov 2026.

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