他达那非与表面麻醉剂外用联合心理行为干预对勃起功能障碍伴早泄的临床疗效

Clinical effects of tadalafil combined psychological and behavioral interventions on erectile dysfunction with premature ejaculation

目的探讨他达那非联合心理行为干预对勃起功能障碍伴早泄的临床疗效。方法选取98例勃起功能障碍伴早泄患者为研究对象,随机分为单独他达那非药物治疗组(单独组)和他达那非联合心理行为干预治疗组(联合组),每组49例。采用阴道内射精潜伏期、中国早泄患者性功能评价量表(CIPE)、焦虑自评表(SAS)、国际勃起功能指数(IIEF)和性交满意程度问卷,分别观察2组患者的临床疗效。结果与治疗前比较,单独组患者在治疗后8周阴道内射精潜伏期明显延长(P<0.05);而联合组则在治疗后4周即表现为显著延长的阴道内射精潜伏期(P<0.05),并且联合组在治疗后4、8和12周时间点上的阴道内射精潜伏期均明显长于单独组(P<0.05);治疗12周后,2组患者CIPE量表指标性欲程度、阴茎勃起硬度、勃起持续时间、射精潜伏期、控制射精难易程度、性生活满意程度、配偶性生活满意程度、高潮频率、性生活自信度、焦虑程度的得分及SAS量表评分值、IIEF指数和性生活满意程度均有所改善,而且联合组患者上述各项指标的改善程度均明显优于单独组,差异具有统计学意义(P<0.05)。此外,单独组患者的不良反应发生率为10.20%(5/49),与联合组(6.12%,3/49)比较差异无统计学意义(χ2=0.544,P=0.416)。结论他达那非联合心理行为干预的治疗策略比单独他达那非药物治疗所取得的临床疗效更佳。

Objective To investigate the clinical effects of tadalafil combined with psychological and behavioral intervention on erectile dysfunction with premature ejaculation. Methods A total of 98 cases of erectile dysfunction with premature ejaculation were selected and randomly divided into the tadalafil treatment group （tadalafil group） and tadalafil combined with psychological and behavioral intervention group （combination group） with 49 cases in each group. Intravaginal ejaculation latency, Chinese patients with premature ejaculation sexual function assessment scale （CIPE）, self-rating anxiety scale （SAS）, international index of erectile function （IIEF）, and sexual satisfaction questionnaire were used to evaluate the clinical effects of two groups. Results Compared to before treatment, the intravaginal ejaculation latency of the tadalafil group increased significantly after 8 weeks of treatment （P 〈 0.05）, while the intravaginal ejaculation latency of the combination group increased significantly after 4 weeks of treatment （P 〈 0.05）. The intravaginal ejaculation latency of the combination group was significandy longer than that of the tadalafil group after 4, 8, and 12 weeks of treatment （P〈0.05）. After 12 weeks of treatment, scores of CIPE degree scale indicators libido, penile erection hardness, duration of erection, ejaculation latency, control of ejaculation, sexual satisfaction, sexual satisfaction of the spouse, orgasm frequency, sexual self-confidence, and anxiety, and SAS scale scores, IIEF index, and sex satisfaction were all improved. The improvement of above indexes of the combination group was significantly more obvious than that of the tadalalil group and the differences were statistically significant （P 〈 0. 05）. In addition, the incidence of adverse reactions of the tadalafd group was 10.20% （5/49） and compared to the combination group （6.12%, 3/49）, the difference was not statistically significant （χ2 =0. 544, P=0. 416）. Conclusion Compared to the treatment by tadalafil alone, the clinical effects of the treatment by tadalafil combined with psychological and behavioral intervention are better.