口腔矫正器联合他达拉非治疗重度阻塞性睡眠呼吸暂停低通气综合征合并ED的疗效分析

Oral-appliance combined with tadalafil for erectile dysfunction induced by severe obstructive sleep apneahypopnea syndrome

目的:评价口腔矫正器联合他达拉非治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并勃起功能障碍(ED)患者的效果。方法:纳入重度OSAHS合并ED患者90例,随机分为3组:口腔矫正器治疗组(A组)、他达拉非治疗组(B组)及联合治疗组(C组),各30例,A组应用口腔矫正器连续治疗3个月,B组每日口服他达拉非1次,每次10 mg,C组联合应用口腔矫正器和口服他达拉非治疗。治疗3个月后,比较3组患者治疗前后"性活动日志"(SEP)阳性回答率、勃起功能国际问卷-5(IIEF-5)评分的变化及患者配偶性生活总体满意度。结果:A组、C组分别有1例、2例患者不能耐受口腔矫正器而放弃治疗,其余87例患者完成治疗,其中A组29例,B组30例,C组28例。治疗3个月后,C组患者IIEF-5评分增值(4.18±1.19)分显著高于A组(2.66±1.63)分及B组(2.77±1.74)分(P分别为0.009、0.026);C组患者插入阴道的成功率(85.7%)显著高于A组(58.6%)、B组(53.3%)(P分别为0.023、0.008);C组患者完成性生活的成功率(64.3%)显著高于A组(37.9%)、B组(33.3%)(P分别为0.047、0.018);A组、C组患者配偶对性生活总体满意程度显著高于B组(P分别为0.027、0.007)。结论:口腔矫正器联合他达拉非能有效治疗重度阻塞性睡眠呼吸暂停低通气综合征合并勃起功能障碍患者,其治疗效果优于单纯用口腔矫正器治疗或单纯他达拉非治疗。

Objective：To evaluate the efteet of the oral-appliance combined with tadalafil in the treatment of erectile dysfunc- tien （ED） induced by severe obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods： We equally randomized 90 patients with severe OSAHS-indueed ED to groups A, B, and C to be treated with the oral-appliance, tadalafil （SO mg daily qd）, and oral- appliance plus tadalafil, respectively, all for 3 months. Then we compared the therapeutic effects among the three groups of patients u- sing the IIEF-5 questionnaire, Sexual Encounter Profile （SEP） diaries, and the intercourse satisfaction rate of the patients＇partners. Results： Totally 87 of the patients accomplished the treatment, 29 in group A, 30 in B, and 28 in C. After treatment, group C, ascompared with A and B, showed significant increases in the IIEF-5 score （4.18 ± 1.19 vs 2.66 ± 1.63 and 2.77 ± 1.74, P =0. 009 and P = 0. 026）, the success rate of penile intromission （SEP2） （85.7% vs 58.6% and 53.3%, P = 0. 023 and P = 0. 008）, and the success rate of intercourse （ SEP3 ） （64.3% % vs 37.9% and 33.3% , P = 0. 047 and P = 0. 018）. The overall satisfaction of the female partners was remarkably higher in groups A and C than in B （ P = 0. 027 and P = 0. 007 ）. Conclusion ： Oral-appliance com- bined with tadalafil can improve erectile function in patients with severe OSAHS-induced ED, with a better efficacy than either of them used alone.