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作 者:王俊龙[1] 江专新[1] 杨念钦[2] 钟山[3] 吴旻[1] 周巍[1] 李朋[1] 田汝辉[1] 马猛[1] 刘宇飞[1] 沈周俊[3] 王国民[2] 黄翼然[1] 王益鑫[1] 李铮[1]
机构地区:[1]上海交通大学医学院附属仁济医院泌尿外科,上海200001 [2]复旦大学附属中山医院泌尿外科,上海200032 [3]上海交通大学医学院附属瑞金医院泌尿外科,上海200025
出 处:《中华男科学杂志》2014年第1期14-18,共5页National Journal of Andrology
基 金:上海市科委重点课题(09DJ1400400)~~
摘 要:目的:探讨他达拉非按需与按时治疗ED的安全性和有效性。方法:采用多中心随机对照研究,按需组于性生活前口服他达拉非10 mg/20 mg,按时组每周两次口服他达拉非10 mg/20 mg,治疗期为8周,于治疗前(V0)、治疗4周(V1)、治疗8周(V2)和治疗8周停药1个月(V3)时分别行IIEF-5、EDITS和SF-PAIRS评分,评估两种方案的安全性和有效性。结果:共有110例患者完成本研究,其中按时组56例,按需组54例。按时组与按需组V1、V2和V3的IIEF-5评分相比V0均明显改善,且V2[(21.6±2.9)分vs(18.5±1.7)分]和V3[(20.9±2.1)分vs(17.9±2.3)分]时按时组的得分明显高于按需组(P<0.05)。按时组V2[(31.7±6.9)分]和V3[(30.6±4.7)分]的EDITS评分与按需组V2[(28.6±5.8)分]和V3[(27.9±6.5)分]相比明显提高(P<0.05)。两组患者SF-PAIRS性自信指数、性自然指数和性时间顾虑指数评分与基线期相比均有明显改善(P<0.05),且在治疗8周停药1个月(V3)时按时组三者的评分明显优于按需组。两组安全性无明显差异。结论:他达拉非按时用药方案治疗ED安全有效,在治疗8周及停药1个月时按时组疗效优于按需组。按时治疗作为他达拉非一种新的用药方案,有望成为ED治疗的新策略。Objective: To evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction. Methods : We conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales ( SF-PAIRS), and compared the safety and efficacy of medication between the two groups of patients. Results : Totally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 ± 2.9 vs 18.5 ± 1.7) and 1 month after withdrawal (20.9± 2.1 vs 17.9± 2.3 ) (P 〈 0.05 ). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 ± 6.9 vs 28.6 ± 5.8) and 1 month after withdrawal ( 30.6 ± 4.7 vs 27.9 ± 6.5 ) ( P 〈 0.05 ). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P 〈 0.05), even more significantly in the on-time than in the on-demand group at l month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups. Conclusion : On-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than ondemand dosing at 8 weeks of medication and 1 month after withdrawal.
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