达泊西汀治疗早泄的有效性系统评价  

Dapoxetine in treatment of premature ejaculation:A systematic review

作　　者：王亚波[1,2] 毛宇[1] 魏强[1] 吴泰相[3] 董强[1] 

机构地区：[1]四川大学华西医院泌尿外科,成都610041 [2]成都市龙泉驿区第一人民医院泌尿外科 [3]四川大学华西医院中国循证医学中心

出　　处：《北京大学学报（医学版）》2010年第4期425-432,共8页Journal of Peking University:Health Sciences

基　　金：卫生部部属(管)医院临床学科重点项目([2007]353-46);首都医学发展基金(2007-1006)资助~~

摘　　要：目的:系统评价达泊西汀治疗早泄的有效性。方法:计算机及手工检索1979～2009年Medline、EMbase、Cochrane图书馆、中国生物医学文献、中文科技期刊全文数据库、CNKI数字图书馆,《中国男科学杂志》等5种相关杂志纳入达泊西汀治疗早泄相关的临床随机对照试验,评价和提取资料,RevMan软件Meta分析,进行系统评价。结果:共纳入5篇随机对照试验(randomized controlled trial,RCT),受试患者4433例。方法学质量评价3个试验为A级,2个为B级,将患者性生活时阴道内射精潜伏时间(intravaginal ejaculatory latency time,IELT)、总体感觉改善情况(patient-reported global impression of change,PGI)、性生活满意度(satisfaction with sexual intercourse,SWSI)、射精感觉控制(perceived control over ejaculation,PCOE)和早泄相关困惑感(personal distress related to ejaculation,PDRE)改善情况作为指标,经达泊西汀治疗9～24周,Meta分析结果表明,治疗前后IELT、SWSI及PCOE改善状况的加权均数差及其95%可信区间(CI)分别为1.38(1.21,1.55)、0.55(0.48,0.62)和0.63(0.49,0.78),P均<0.001;治疗组与安慰剂组相比,患者PGI问卷评分、SWSI、PCOE及PDRE改善状况OR值及其95%CI分别为3.56(2.60,4.88)、3.85(2.08,7.10)、2.87(2.30,3.58)和2.02(1.69,2.42),P均<0.001,差异具有统计学意义。被纳入的研究均报告无严重不良反应发生,绝大部分患者能耐受试验。结论:现有研究表明,达泊西汀能改善早泄患者症状,明显延长患者性生活阴道内射精潜伏时间,有效改善患者射精感觉控制评分,减轻患者困惑感,提高性生活满意度以及总体感觉评分。Objective：To assesss the effectiveness of dapoxetine in the treatment of premature ejaculation.Methods：Both English and Chinese studies involving men with prematrue ejaculation who were treated with dapoxetine from the Cochrane Library,MEDLINE,EMBASE and CNKI,CBM,VIP between 1979 and 2009.were included in the randomized controlled trials（RCTs） and the data processed by RevMan.Results：Five RCTs involving 4433 patients were included in the Meta analysis,of which 3 were of grade A and 2 were of grade B according to the quality evaluation of methodology.Intravaginal ejaculatory latency time（IELT）,patient-reported global impression of change（PGI）,satisfaction with sexual intercourse（SWSI）,perceived control over ejaculation（PCOE）,personal distress related to ejaculation（PDRE） were used for assessment.Meta analysis based on included studies of patients having been treated with dapoxetine for 9-24 weeks showed that：（1） the difference of the patients＇ IELT between treatment group and control group was statistically significan [P〈0.001,WMD（95%CI） was 1.38（1.21,1.55）];（2） the difference of the PGI of development in premature ejaculation between treatment group and control group was statistically significant [P〈0.001,OR（95%CI） was 3.56（2.60,4.88）];（3） the difference of the patients＇ SWSI between treatment group and control group was statistically significant [P〈0.001,OR（95%CI） was 3.85（2.08,7.10）];the difference of the patients＇ score of SWSI between treatment group and control group was statistically significant [P〈0.001,WMD（95%CI） was 0.55（0.48,0.62）];（4） the difference of the patients＇ change of PCOE between treatment group and control group was statistically significant [P〈0.001,OR（95%CI） was 2.87（2.30,3.58）];the difference of the patients＇ score of PCOE between treatment group and control group was statistically significant [P〈0.001,WMD（95%CI） was 0.63（0.49,0.78）];（5） after being treated with dapoxet

关 键 词：早泄 达泊西汀 META分析 血清素摄取抑制药 

分 类 号：R256.55[医药卫生—中医内科学]