西地那非对慢性非细菌性前列腺炎合并勃起功能障碍的作用

The effect of sildenafil in the treatment of chronic non-bacteria prostatitis a nd concomitant erectile dysfunction

目的观察西地那非在治疗慢性非细菌性前列腺炎(CNP)合并勃起功能障碍(ED)时的作用。方法CNP合并ED患者52例,随机分为西地那非组(A组)和对照组(B组)。A组34例,NIH-CPSI评分27.4±9.5,IIEF-5评分10.7±2.8,用α1-受体阻断剂及消炎痛栓治疗4周后加用西地那非治疗6周。B组18例,NIH-CPSI评分27.3±9.6,IIEF-5评分10.9±2.7,持续使用α1-受体阻断剂及消炎痛栓治疗10周。治疗4、10周末行NIH-CPSI和IIEF-5评分并观察疗效。结果4周末,A、B组NIH-CPSI评分分别为13.2±4.7、12.5±4.5,较治疗前均显著下降(P<0.01),2组间比较差异无统计学意义(P>0.05);A、B组IIEF-5评分分别为14.1±4.3、14.8±4.6,较治疗前均显著上升(P<0.01),2组间比较差异无统计学意义(P>0.05)。NIH-CPSI评分改变值与自身IIEF-5评分改变值无明显相关性。10周末,A组NIH-CPSI评分9.4±3.6,IIEF-5评分19.1±4.0,与4周末比较差异均有统计学意义(P<0.01);B组NIH-CPSI评分12.9±5.1,IIEF-5评分14.8±5.0,与4周末比较差异均无统计学意义(P>0.05);2组间NIH-CPSI与IIEF-5评分比较差异均有统计学意义(P<0.01)。A组IIEF-5评分改变值与NIH-CPSI评分改变值呈负相关(r=-0.95,P=0.00)。结论对CNP合并ED患者,西地那非在有效治疗ED的同时,还能降低NIH-CPSI评分,促使CNP恢复。

Objective To evaluate the effect of sildenafil in the treatment of chronic non-bacteria prostatitis （CNP） with erectile dysfunction （ED）. Methods Fifty-two cases diagnosed to have CNP with ED were randomized into sildenafil group （group A, n=34） and control group （group B, n=18）. In group A, NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） score was 27.4±9.5 and international index of Erectile Function-5 （IIEF-5） score was 10.7±2.8; antagonist of α1-adrenoceptors and indomethacin suppository were used for 4 weeks, then sildenafil was added for 6 weeks. In group B, NIH-CPSI score was 27.3±9.6 and IIEF-5 score was 10.9±2.7; antagonist of α1-adrenoceptors and indomethacin suppository were used for 10 weeks. All the cases were evaluated with IIEF-5 and NIH-CPSI at 4 weeks and 10 weeks, respectively, after treatment. Results At the end of the 4th week, NIH-CPSI score was 13.2±4.7 in group A and 12.5±4.5 in group B, which were significantly decreased compared with pre-treatment in both groups （P〈0.01 for both）; but there was no statistically significant difference between the 2 groups （P〉0.05）. IIEF-5 score was 14.1±4.3 in group A and 14.8±4.6 in group B, which were significantly increased compared with pre-treatment in both groups （P〈0.01 for both）; but there was no statistically significant difference between the 2 groups （P〉0.05）. The change of scores of NIH-CPSI was not correlated with that of IIEF-5. At the end of 10th week, NIH-CPSI score was 9.4±3.6 and IIEF-5 score was 19.1±4.0 in group A, which were significantly different from those at the end of 4th week （P〈0.01 for both）. NIH-CPSI score was 12.9±5.1 and IIEF-5 score was 14.8±5.0 in group B, which were not significantly different from those at the end of 4th week （P〉0.05 for both）. There were significant differences of NIH-CPSI and IIEF-5 scores between the 2 groups （P〈0.01 for both）. The change of NIH-CPSI score was negatively correlated with that of IIEF-5 in group A （r=-0.95, P〈0.01）. Conclusions For patients with CNP with ED, sildenafil can effectively improve erectile function as well as decrease the NIH-CPSI score, thus in favor of covering from CNP.