Chinese herbal medicine combined with cognitive–behavioural therapy for avoidant paruresis: a controlled trial

Background Avoidant paruresis is a common clinical condition in urology and psychosomatic medicine. However, it has limited treatment options that are safe and effective with few side effects.Aims Our study aimed to investigate the effectiveness and safety of the Chinese herbal Yangxin Tongquan decoction combined with cognitive–behavioural therapy (CBT) for avoidant paruresis.Methods Sixty-eight patients with avoidant paruresis were divided into a treatment group (33 patients) and a control group (35 patients). The control group was assigned 10 weeks of CBT and systematic desensitisation. In addition to CBT and systematic desensitisation, the treatment group was given the Chinese herbal Yangxin Tongquan decoction during the 10-week study. The Shy Bladder Syndrome Scale (SBS) and the Self-rating Anxiety Scale (SAS) were administered before and after treatment to measure any change.Results The overall efficacy in the treatment group (n=30) was 80.0% vs 62.5% in the control group (n=33). Comparing pretreatment and post-treatment measures, both groups showed improvement in SBS scores and SAS scores (treatment group: t(SBS)=8.397, p(SBS)<0.001, t(SAS)=8.216, p(SAS)<0.001; control group: t(SBS)=6.802, p(SBS)<0.001, t(SAS)=5.171, p(SAS)<0.001). Moreover, both groups’ SBS and SAS scores changed significantly over time (SBS scores: Ftime=118.299, p<0.001; SAS scores: Ftime=92.114, p<0.001). However, the treatment group performed better than the control group (SBS scores: Ftime*group=5.709, p=0.020; SAS scores: Ftime*group=7.235, p=0.009).Conclusions The Chinese herbal Yangxin Tongquan decoction combined with cognitive–behavioural psychotherapy positively affects the treatment of avoidant paruresis without significant adverse effects.