山莨菪碱对糖尿病并发阳萎的治疗探讨

A study of diabetic impotence treated with anisodamine

报告用山莨菪碱治疗５例糖尿病并发阳萎的疗效。全部患者均经夜间阴茎勃起试验提示为器质性阳萎。经有关激素测定，３例显示有不同程度的性腺功能减低，并经阴茎肱动脉指数、阴茎血管超声多普勒测定、膀胱测压、尿流率及神经肌电图测定显示：ｌ例为阴茎动脉病变，３例为动脉病变加静脉漏伴神经病变，ｌ例为动脉病变加静脉漏。经用山莨菪碱１０￣３０ｍｇ静脉滴注，每天１次。治疗１个月后，患者均诉说有不同程度的晨间勃起反应，罂粟碱试验患者阴茎勃起有不同程度改善，勃起角度由１２±１６°上升至４３±３０°（Ｐ＜０．０５），平均血管扩张度由４２±６％上升至５５±７％（Ｐ＜０．０５）。阴茎血管血流峰值速度和尺神经传导速度也有增加。提示山莨菪碱对神经和动脉血管性阳萎有疗效。

Five patients with diabetic impotence were treated with anisodamine and showed good re-sponse。The impotence was suggested to be organic,based on the negative nocturnal penile tumescencetest for three succesive nights.Measurement of LH,FSH,testosterone,E2,and PRL in 3 patients showedvarious degrees of hypogonadal function The results of Doppler ultrasonogrnphy and electromyography,together with bladder pressure and urine flow rate measurement suggested that penile arteriopathy,neuropathy and venous fisture are present differently among these patients。After treatment with daily intravenous infusion of l0～30mg of anisodamine for one month,in addi-tion to diet control and hypoglycemic drug therapy,these patients began to experience penis erection invarious degrees in the morning.The angle of penile erection increased from l2± l6 degree to 43±30 de-gree (P<0.5) and the dilating degree of penile arteries increased from 42± 6% to 55 ± 7% (P<0.05)。The peak speed of blood flow of penile arteries and the conducting speed of Ulner nerve also increasedOur results showed that anisodamine couid improve the diabetic impotence caused by arteriopathy andneuropathy。