舍曲林联合多沙唑嗪或他达拉非治疗早泄的疗效比较

Comparison of sertraline plus doxazosin and tadalafil in the treatment of premature ejaculation

目的 比较舍曲林联合多沙唑嗪或他达拉非治疗早泄的疗效及不良反应. 方法 2011年2月至2011年8月收治的无器质性病变的早泄患者105例.年龄19～52岁,平均35岁.抽签法随机分成A、B、C组,每组35例,3组均口服舍曲林50 mg,1次/d（性生活前4～6h服用）;B组加服多沙唑嗪4 mg,1次/d（性生活前8～9h服用）;C组性生活前1h加服他达拉非20 mg.服药12周.A组治疗前平均阴道内射精潜伏期、患者性生活满意度评分、配偶性生活满意度评分分别为（0.6±0.1） min、（8.3±1.3）分、（5.3±1.4）分;B组分别为（0.6±0.1） min、（7.6±1.5）分、（5.6±1.5）分;C组分别为（0.6±0.1） min、（8.1±1.1）分、（5.0±1.2）分.比较3组治疗前后的平均阴道内射精潜伏期、患者性生活满意度评分及配偶性生活满意度评分的差异,治疗结束后比较3组的不良反应发生率的差异.结果 治疗12周后,A组的平均阴道内射精潜伏期、患者性生活满意度评分、配偶性生活满意度评分分别为（3.9±0.1） min、（10.6±0.1）分、（9.7±0.1）分;B组分别为（4.5±0.1）min、（12.8±1.3）分、（11.9±1.6）分;C组则分别为（5.6±0.3） min、（14.6± 1.4）分、（13.1±1.5）分,B、C组与A组比较差异均有统计学意义（P＜0.05）.C组的患者性生活满意度评分、配偶性生活满意度评分高于B组,但差异无统计学意义（P＞0.05）.A组9例（25.7％）、B组8例（22.9％）、C组8例（22.9％）出现恶心、胃部不适;A组5例（14.3％）、B组8例（22.9％）、C组9例（25.7％）出现头痛、头晕;C组6例（17.1％）出现潮红,A、B组各1例（2.9％）性欲下降.B、C组的不良反应发生率显著高于A组,差异有统计学意义（P＜0.05）.结论 舍曲林联合他达拉菲或多沙唑嗪治疗早泄的疗效好于单用舍曲林,但不良反应发生率也稍有增加;舍曲林与他达拉非或多沙唑嗪联用治疗早泄的疗效无明显区别.

Objective To compare the efficacy and safety of sertraline plus doxazosin and tadalafil in the treatment of premature ejaculation （PE）.Methods From Feb.to Aug.2011,One hundred and five patients from 19 to 52 years old with PE but without any obvious organic cause were enrolled in this study.They were randomly divided into Groups A,B and C in equal number.All the three Groups received 50 mg sertraline daily 4 to 6 hours before planned sexual activity for 12 weeks,Group B were added with 4 mg Doxazosin every day 8 to 9 hour before planned sexual activity,and Group C were given 20 mg Tadalafil as needed one hour before planned sexual activity.The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A before treatment were 0.6±±0.1 min,8.3±1.3,5.3±1.4; Group B were 0.6±0.1 min,7.6± 1.5,5.6± 1.5 ; Group C were 0.6±0.1 min,8.1 ± 1.1,5.0± 1.2,respectively.We observed before and after the treatment for 12 weeks and the effects were evaluated.Results The mean intravaginal ejaculatory latency time,the mean intercourse satisfaction domain values and the sexual activity satisfaction domain values of the patient couples of group A were 3.9±0.l min,10.6±0.1,9.7±0.1,respectively; Group B were 4.5 ± 0.1 min,12.8±1.3,11.9±1.6; Group C were 5.6±0.3 min,14.6±1.4,13.1±1.5,respectively.The mean intravaginal ejaculatory latency time improved in all of the 3 groups,but more significantly in Group B and C （P〈0.05）.The mean intercourse satisfaction domain values of the IIEF were significantly greater in Group B and C than in Group A （P〈0.05） after the treatment; and the sexual activity satisfaction domain values of the patient couples were greater in Group C than in Group B after the treatment,but it is not significant.As for the side effects,5 cases in group A felt headaches and dizzy （14.3%）,8 cases in group B felt headaches and dizzy （22.9%）,and in group C,9 cases felt headaches and dizzy （25.7%）,6 cases experienced flushing episodes on the body （17.1%）.there was a higher rate of headaches （P〈0.05） and flushing episodes （P〈0.05） in Group B and C than in Group A.Conelusions Sertraline combined with Tadalafil or Doxazosin can achieve significantly better results than sertraline alone in patients with premature ejaculation.However,the combined treatment is associated with a slightly increased in the drug related side effects,and there is no significant difference in the efficacy of Sertraline Plus Tadalafil or Doxazosin in the treatment of premature ejaculation.