按规律联合按需服用西地那非治疗合并早泄的勃起功能障碍的临床观察  

A clinical study of regular combined with on-demand use of sildenafil in the treatment of premature ejaculation complicated with erectile dysfunction

作　　者：徐亚威 张园园[2] 杨永姣 陈业刚[3] 刘晓强 XU Ya-wei;ZHANG Yuan-yuan;YANG Yong-jiao;CHEN Ye-gang;LIU Xiao-qiang(Department of Urology,General Hospital of Tianjin Medical University,Tianjin 300052;Department of Thyroid Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450008;Department of Urology,The Second Hospital of Tianjin Medical University,Tianjin Institute of Urology,Tianjin 300211,China)

机构地区：[1]天津医科大学总医院泌尿外科,天津300052 [2]郑州大学附属第一医院甲状腺外科,河南郑州450008 [3]天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津300211

出　　处：《现代泌尿外科杂志》2018年第12期948-951,962,共5页Journal of Modern Urology

摘　　要：目的评价按规律联合按需服用西地那非治疗合并早泄(PE)的勃起功能障碍(ED)患者的临床疗效和安全性。方法采用按规律联合按需服用西地那非疗法(若无性生活每天睡前口服西地那非50mg,建议1周性生活1次,性生活前1h口服西地那非100mg)治疗合并PE的ED患者,疗程为12周。以国际勃起功能指数5(IIEF-5)评分评价勃起功能,以阴道内射精潜伏期(IELT)和配偶性生活满意率(SRSSL)评价PE的疗效;嘱患者准确记录各种不良反应,严重不能耐受者予停药。结果 381例患者完成本研究,勃起功能改善者343例(90.0%),治疗后IIEF-5评分平均增加(7.2±2.8)分,与治疗前相比有显著差异(P=0.03);早泄改善者285例(74.8%),治疗后IELT平均增加(119.7±45.2)s,SRSSL平均增加(24.6±15.6)%,与治疗前相比均有显著差异(P<0.05)。不良反应共102例(26.8%),主要为轻微头痛(15.2%)、颜面部潮红(11.0%)和消化不良(6.6%),所有不良反应均较轻,无患者因不良反应而停药。结论按规律联合按需服用西地那非能安全有效地改善合并PE的ED患者的勃起功能,如勃起功能获得改善,多能使患者的PE亦得到明显改善。Objective To evaluate the clinical efficacy and safety of regular combined with on-demand use of sildenafil in the treatment of premature ejaculation(PE)complicated with erectile dysfunction(ED).Methods Patients of PE complicated with ED received regular combined with on-demand sildenafil therapy.If they did not have sex,they took 50 mg of sildenafil before going to bed every day.They were recommended to have sex once a week and took 100 mg sildenafil 1 hour before sex.The treatment lasted for 12 weeks.The erectile function before and after treatment was evaluated with International Index of Erectile Function 5(IIEF-5);the therapeutic effect was evaluated with intravaginal ejaculation latency time(IELT)and satisfaction rate of spouse s sexual life(SRSSL).Patients were instructed to accurately record all adverse reactions,and those who were severely intolerant should stop taking the medicine.Results Among the 381 patients who completed the study,343(90%)had improved erectile function.The average increase of IIEF-5 score was 7.2±2.8 after treatment,showing a significant difference(P=0.03).A total of 285 patients had PE improved,and the overall effective rate was 74.8%.The average increase of IELT and SRSSL were(119.7±45.2)s and(24.6±15.5)%respectively,with significant differences(P<0.05).A total of 102 patients(26.8%)had adverse reactions after treatment,including minor headache(15.2%),facial flushing(11.0%)and dyspepsia(6.6%).All adverse reactions were mild,and no patient stopped taking the medicine due to adverse reactions.Conclusion Regular combined with on-demand sildenafil therapy can improve erectile function safely and effectively in patients with PE and ED.If the erectile function is improved,most premature ejaculation can be significantly improved too.

关 键 词：勃起功能障碍 早泄 西地那非 

分 类 号：R698.1[医药卫生—泌尿科学]