西地那非联合心理干预治疗勃起功能障碍的临床效果分析

Analysis of clinical effect of Sildenafil combined with psychologic intervention in the treatment of erectile dysfunction

目的评估西地那非联合心理干预治疗男性勃起功能障碍（erectiledysfunction，ED）的有效性。方法选取2012年3月～2013年3月就诊于海军总医院的ED患者151例．随机分为西地那非治疗组（75例）和联合治疗组（76例）；西地那非治疗组按需服用50mg西地那非，每日最多1次，联合治疗组西地那非用法、用量同西地那非治疗组，同时进行个性化心理治疗及抗焦虑抑郁药物治疗。治疗前、治疗12周末均对两组进行勃起功能国际问卷-5（IIEF-5）、抑郁自评量表（SDS）、焦虑自评量表（SAS）测试。结果①西地那非组治疗有效率为73．33％，联合治疗组有效率为92．15％，差异有统计学差异（P〈0．05）。②两组治疗12周后，IIEF-5各项目评分及总分均较同组治疗前明显提高，差异均有统计学意义（P〈0．05）；治疗后，联合治疗组各项目评分及总分均高于西地那非组（P〈0．05）。③西地那非组和联合治疗组治疗12周后，器质性ED、心理性ED和混合性ED患者SDS、SAS评分均较治疗前降低，差异均有统计学意义（P〈0．05）。治疗后，联合治疗组患者SDS、SAS评分低于西地那非治疗组．差异均有统计学意义（P〈0．05）。结论ED是受生理和心理共同作用的疾病，西地那非联合个性化心理治疗可以更有效治疗ED患者。

Objective To evaluate the efficacy of Sildenafil with psychologic intervention on men with erectile dys- function. Methods A total of 151 ED patients were selected in Naval General Hospital from March 2012 to March 2013. 151 patients with ED were randomly divided into Sildenafil group with 75 cases and combined treatment group with 76 cases. Sildenafil group was treated with Sildenafil 50 mg daily before sexual intercourse, no more than 1 time/ day. Combined treatment group was treated with Sildenafil as the same of Sildenafil group, and was performed with in- dividual psychotherapy or antidepressant drug treatment. A total of 151subjects were evaluated by IIEF-5, SDS, SAS before and after treatment. Results ①The effective rate of Sildenafil group was 73.33%, the effective rate of combined treatment group was 92.15%, the difference was statistically significant （P 〈 0.05）. ②Each individual item scores and total scores of IIEF-5 in the two groups 12 weeks after the treatment were all higher than those before the treatment, the differences were statistically significant （P 〈 0.05）. But each individual item scores and total scores of IIEF-5 of the combined treatment group 12 weeks after the treatment were higher than those of Sildenafil group （P 〈 0.05）. ③The SDS and SAS scores in patients with organic ED, psychological ED, mixed ED in the two groups 12 weeks after the treatment were lower than those before the treatment, the differences were statistically significant （P 〈 0.05）. The SDS and SAS scores in the combined treatment group 12 weeks after the treatment were higher than those in Sildenafil treatment group, the differences were statistically significant （P 〈 0.05）. Conclusion Erectile dysfunction is a major sexual dysfunction involving both physiological and psychological factors, Sildenafil and individual psychotherapy or antidepressant drug treatment is more effective in the treatment of patients with ED.