磷酸二酯酶-5型抑制剂与五羟色胺再摄取抑制剂治疗勃起功能障碍合并早泄疗效及安全性Meta分析  

Efficacy and safety of phosphodiesterase type 5 inhibitors and selective serotonin reuptake inhibitors in the treatment of comorbiditiy of erectile dysfunction and premature ejaculation:a meta analysis

作　　者：苗德雨 王祖龙[2] 张宸铭[3] 万雯熙 MIAO Deyu;WANG Zulong;ZHANG Chenming;WAN Wenxi(The First Clinical Medical School of Henan University of Chinese Medicine,Zhengzhou 450099;Department of Andrology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003;The Second Clinical Medical School of Henan University of Chinese Medicine,Zhengzhou 450053,China)

机构地区：[1]河南中医药大学第一临床医学院,河南郑州450099 [2]河南中医药大学第一附属医院男科,河南郑州450003 [3]河南中医药大学第二临床医学院,河南郑州450053

出　　处：《现代泌尿外科杂志》2023年第10期888-893,共6页Journal of Modern Urology

摘　　要：目的评价单独使用磷酸二酯酶-5型(PDE5)抑制剂或联合五羟色胺再摄取抑制剂(SSRIs)对比单独应用SSRIs治疗勃起功能障碍(ED)与早泄(PE)共病的疗效与安全性。方法检索下述网站:知网、PubMed、Web of Science、Embase、万方、维普数据库、中国生物医学文献服务系统、中华医学期刊,自建库起至2022年11月,单独使用PDE5抑制剂或联合SSRIs对比单独应用SSRIs治疗ED与PE共病的随机对照试验,用Revman 5.4.1软件分析阴道内射精潜伏期(IELT)、国际勃起功能指数5项问卷(IIEF-5)评分及不良反应率。结果最终纳入文献9篇,涉及793例患者。Meta分析显示:与单独应用SSRIs治疗ED与PE共病相比,单独使用PDE5抑制剂或联合SSRIs治疗后患者IELT更高[MD=1.99,95%CI(1.51~2.46),P<0.001]、IIEF-5评分更高[MD=4.61,95%CI(3.68~5.55),P<0.001],不良反应无统计学差异[RR=0.99,95%CI(0.74~1.31),P=0.92]。结论治疗ED与PE共病患者时,应优先治疗ED或同时治疗ED和PE,在ED和PE方面都能获得更好的治疗效果,同时不良反应也没有增加。Objective To evaluate the efficacy and safety of phosphodiesterase type 5(PDE5)inhibitors alone or in combination with selective serotonin reuptake inhibitors(SSRIs)compared with SSRIs alone in the treatment of comorbidity of erectile dysfunction(ED)and premature ejaculation(PE).Methods The clinical randomized controlled trials of ED and PE comorbidity treated with PDE5 inhibitors alone or in combination with SSRIs were searched from database inception to Sep.2022,in CNKI,PubMed,Web of Science,Embase,Wanfang Database,cqVIP Database,SinoMed and Yiigle.The intravaginal ejaculatory latency time(IELT),score of International Index of Erectile Function 5(IIEF-5)and adverse reaction rate were analyzed with RevMan 5.4.1 software.Results A total of9 studies involving 793 patients were included.Meta analysis showed that compared with SSRIs alone,PDE5 inhibitors alone or in combination with SSRIs yielded better results in IELT[MD=1.99,95%CI(1.51-2.46),P<0.001]and higher IIEF-5 score[MD=4.61,95%CI(3.68-5.55),P<0.001],but no increase in adverse events[RR=0.99,95%CI(0.74-1.31),P=0.92].Conclusion In the treatment of ED and PE comorbidity,priority should be given to ED or both ED and PE,which can produce better efficacy without increasing the adverse effects.

关 键 词：勃起功能障碍 早泄 META分析 5型磷酸二酯酶抑制剂 五羟色胺再摄取抑制剂 

分 类 号：R698[医药卫生—泌尿科学]