“夫妻同治、身心同治”理念下“递进式”行为疗法联合药物治疗早泄的临床研究  

Efficacy of progressive behavioral treatment combined with Dapoxetine in the treatment of primary premature ejaculation

作　　者：杨锐林 李展翔 叶旭莹 黄卫兰 YANG Ruilin;LI Zhanxiang;YE Xuying;HUANG Weilan(Department of Andrology,Reproductive Health Care Center,Central Hospital of Panyu District,Guangzhou 511400,Guangdong,China)

机构地区：[1]广州市番禺区中心医院生殖健康中心男科,广州511400

出　　处：《中国性科学》2020年第6期13-17,共5页Chinese Journal of Human Sexuality

摘　　要：目的观察"递进式"行为疗法联合达泊西汀治疗早泄患者的临床疗效。方法选取2018年6月至2019年3月广州市番禺区中心医院生殖健康中心男科诊治的46例早泄患者作为研究对象。按随机数字表将这46例患者分成两组,联合组(n=24),按照"夫妻同治、身心同治"理念下进行"递进式"行为疗法联合达泊西汀治疗。药物组(n=22),单纯给予口服达泊西汀治疗。两组疗程均为12周。分别于治疗前、治疗12周、随访4周后对患者的阴道内射精潜伏期(IELT)和早泄诊断标准评分(PEDT)进行比较,利用重复测量方法,对比两组停药后的疗效差异。结果两组患者治疗前IELT和PEDT无明显差异。联合组患者"递进式"行为疗法下脱敏治疗的最佳持续时间显著延长,差异具有统计学意义(P<0.01)。联合组IELT各阶段的延长时间高于药物组,差异具有统计学意义(P<0.01),在随访4周后较治疗前延长2.4min,差异具有统计学意义(P<0.01),药物组为延长0.4min,差异无统计学意义(P>0.05)。两组治疗和随访后的PEDT较治疗前明显降低,差异具有统计学意义(P<0.01),随访4周后,联合组的IELT增加值和PEDT降低值高于药物组,联合组中总体有效率为79%,药物组中总体有效率为36%,差异具有统计学意义(P<0.01)。两组内各受试者内因素与自变量的交互作用的多元分析结果显示"时间"因素以及"时间"与"分组"因素之间的交互作用差异具有统计学意义(P<0.01),重复测量结果显示,两组治疗效果显著不同,差异具有统计学意义(P<0.01)。结论"递进式"行为疗法联合达泊西汀可以改善患者IELT和维持性满意度,疗效明显,并在后续随访中具有更好的优势,是治疗原发性早泄的可靠方法。Objective To evaluate the efficacy of progressive behavioral treatment under the concept of"husband and wife co-treatment,body and psychology co-treatment"combined with Dapoxetine in the treatment of primary premature ejaculation(PPE).Methods 46 patients of PPE in our hospital from June 2018 to March 2019 were selected and randomly divided into the combination group(24 cases)and the drug group(24 cases).The combination group was treated with progressive behavioral treatment combined with Dapoxetine and drug group was treated with Dapoxetine only,all for 12 weeks.The Intra-vaginal Ejaculation Latency Time(IELT)and Premature Ejaculation Diagnosis Tool(PEDT)scores were compared between the two groups before treatment,after 12 weeks of treatment and 4 weeks of follow-up respectively.Difference in curative effect between the two groups after withdrawal were compared with repeated measures.Results There was no significant difference in IELT and PEDT between the two groups before treatment.The optimal duration of desensitization was significantly prolonged in combination group(P<0.01).The prolonged time of each stage of IELT in combination group was longer than that in drug group respectively(P<0.01).At the end of 4 weeks of follow-up,the IELT in combination group prolonged for 2.4 min and that in drug group prolonged for 0.4 min,with no significant differences(P>0.05).The PEDT at the end of treatment and follow-up were significantly lower than that before treatment in the two groups,with statistically significant differences(P<0.01).After 4 weeks of follow-up,the overall effective rate was 79%in combination group and 36%in drug group,with statistically significant differences(P<0.01).Multivariate analysis showed that there were statistically significant differences in the interaction"within time factors"and"time and group factors"between the two groups(P<0.01).Repeated measures showed that the treatment effect was significantly different between the two groups(P<0.01).Conclusions Progressive behavioral therapy combined

关 键 词：递进式 行为疗法 原发性早泄 疗效 重复测量 

分 类 号：R698[医药卫生—泌尿科学]