低能量体外冲击波治疗磷酸二酯酶-5抑制剂无反应性勃起功能障碍疗效研究  

Efficacy of focused low-energy extracorporeal shock wave in the treatment of PDE5i unresponsive erectile dysfunction

作　　者：刘利杰 陈鑫[1] 黄华伟 石涛 朱晓博 赵玉浩 张祥生 Liu Lijie;Chen Xin;Huang Huawei;Shi Tao;Zhu Xiaobo;Zhao Yuhao;Zhang Xiangsheng(Department of Andrology and Energy Medicine,Henan University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,450003,China)

机构地区：[1]河南大学人民医院河南省人民医院男科与能量医学科,河南郑州450003

出　　处：《中国男科学杂志》2021年第2期19-23,共5页Chinese Journal of Andrology

基　　金：河南省自然科学基金项目(编号:182300410336)。

摘　　要：目的探讨点状低能量体外冲击波治疗(Li-ESWT)磷酸二酯酶-5抑制剂(phosphodieseterase 5 inhibitors,PDE5i)无反应性勃起功能障碍(ED)患者的疗效和安全性。方法前瞻性选取2018年5月至2019年10月在门诊就诊的符合入组条件的37例PDE5i无反应性的ED患者作为研究对象。使用Li-ESWT和PDE5i进行治疗,分别于患者治疗前、治疗后4周、治疗后8周进行随访,随访指标包括勃起功能专项评分(IIEF-EF)、勃起硬度分级(EHS)、性生活日志(SEP)、总体评估问卷(GAQ)。结果共37例患者入组研究,其中31例患者完成随访,平均年龄(57.45±5.14)岁,在治疗前、治疗后第4周和治疗后第8周,IIEF-EF平均分分别为(8.77±1.86)分、(13.68±3.19)分和(18.06±4.03)分,而EHS平均评分分别为(1.68±0.48)、(2.52±0.57)和(2.71±0.64)。治疗后2次随访IIEF-EF和EHS评分较治疗前基线值以及2次随访之间的差异均具有统计学意义(P<0.05)。患者治疗前针对SEP2,SEP3回答"能",均为0,治疗后第4周和第8周SEP2分别为54.84%、67.74%,SEP3分别为32.26%、38.71%,GAQ问卷回答"有"分别为GAQ1 58.06%、77.42%,GAQ2 48.39%、67.74%。结论 Li-ESWT可以改善PDE5i无反应性ED患者对PDE5i的反应性,并显著改善勃起功能。Objective To explore the efficacy and safety of focused low-energy extracorporeal shock wave(Li-ESWT)in the treatment of PDE5i unresponsive erectile dysfunction(ED). Methods A total of 37 patients with ED who were non-responsive to phosphodieseterase 5 inhibitors(PDE5i) in the outpatient clinic from May 2018 to October 2019 were selected as the research objects. Li-ESWT and PDE5i were used for treatment, and the patients were followed up before treatment, 4 weeks after treatment, and 8 weeks after treatment. Follow-up indicators included erectile function specific score(IIEF-EF), erectile hardness classification(EHS), Sexual Encounter Profile question(SEP), Global Assessment Questionnaire question(GAQ). Results A total of 37 patients were enrolled in the study, of which 31 patients completed the follow-up.The average age of the 31 patients was(57.45 ±5.14) years. Before treatment, 4 weeks after treatment, and 8 weeks after treatment, the average scores of IIEF-EF are(8.77±1.86),(13.68±3.19) and(18.06±4.03) respectively, while the average scores of EHS were(1.68±0.48),(2.52±0.57) and(2.71±0.64). The difference between the IIEF-EF and EHS scores in the 2 follow-up visits after treatment and the baseline value before treatment and the difference between the 2 follow-up visits were statistically significant(P<0.05). Before treatment, the patients answered "Yes" for SEP2 and SEP3, both of which were 0. In the 4 th and 8 th weeks after treatment, SEP2 was 54.84% and 67.74%, SEP3 was 32.26% and 38.71%, and the GAQ questionnaire answered "Yes" respectively. GAQ1 58.06%, 77.42%, GAQ2 48.39%, 67.74%. Conclusion Li-ESWT can improve the responsiveness of PDE5i non-responsive ED patients to PDE5i, and significantly improve erectile function.

关 键 词：勃起功能障碍 低能量体外冲击波 磷酸二酯酶-5抑制剂 

分 类 号：R698.1[医药卫生—泌尿科学] R454.1[医药卫生—外科学]