高海拔地区2型糖尿病合并勃起功能障碍患者的临床治疗探索

Clinical treatment of erectile dysfunction in type 2 diabeticpatients in the high-altitude area

目的:探讨胰激肽原酶肠溶片联合西地那非治疗高海拔地区2型糖尿病合并勃起功能障碍(ED)患者的安全性及疗效。方法:选择青海西宁地区糖尿病合并ED患者93例,随机分成两组,试验组(48例)服用胰激肽原酶肠溶片(120 u,3次/d)联合小剂量西地那非规律服用(25 mg,每晚1次),对照组(45例)小剂量西地那非规律服用(25 mg,每晚1次),两组治疗4、8周后评价两组阴茎彩色多普勒超声(CDDU)检查、国际勃起功能指数(IIEF-5)、性交满意度。结果:患者年龄及糖尿病病程两组间均无显著差异(P>0.05)。治疗4周:试验组和对照组治疗前后IIEF-5评分[(8.81±2.06)分vs(11.54±7.72)分和(8.29±1.91)分vs(9.37±1.65)分]、SIS[(3.35±2.43)分vs(6.83±2.61)分和(3.41±2.38)分vs(4.92±2.49)分]、CDDU均有显著差异(P<0.05),两组间IIEF-5评分[(11.54±7.72)分vs(9.37±1.65)分]和SIS[(6.83±2.61)分vs(4.92±2.49)分]有显著差异(P<0.05),而CDDU参数无差异(P>0.05)。治疗8周:试验组和对照组治疗前后IIEF-5评分[(8.81±2.06)分vs(19.29±1.85)分和(8.29±1.91)分vs(15.43±1.74)分]均有显著差异(P<0.05),两组间IIEF-5评分[(19.29±1.85)分vs(15.43±1.74)分]、SIS[(11.73±2.57)分vs(6.55±2.71)分]、CDDU参数均有显著差异(P<0.05)。结论:胰激肽原酶肠溶片联合西地那非治疗高海拔地区2型糖尿病合并ED患者具有一定临床疗效,且较单一西地那非治疗更为有效。

Objective： To investigate the safety and efficacy of pancreatic kininogenase combined with sildenafil in the treatment of erectile dysfunction（ ED） in type 2 diabetes mellitus（ DM） patients in the high-altitude area. Methods： This study included93 ED patients with type 2 DM,all residents of the Xining area 1500 meters above sea level. We randomly divided them into an experimental group（ n = 48） and a control group（ n = 45）,the former treated with pancreatic kininogenase（ 120 u,tid） and sildenafil（ 25 mg,qd at bedtime）,while the latter with sildenafil only（ 25 mg,qd at bedtime）. After 4 and 8 weeks of medication,we obtained the penile hemodynamic parameters,IIEF-5 scores,and sexual intercourse satisfaction（ SIS） scores and compared them between the two groups of patients. Results： There were no statistically significant differences in age or DM course between the two groups of patients（ P 〈0. 05）. Compared with the baseline,both the experimental and control groups showed remarkably improvement inthe IIEF-5 score（ 8. 81 ± 2. 06 vs 11. 54 ± 7. 72 and 8. 29 ± 1. 91 vs 9. 37 ± 1. 65,P 〈0. 05）,SIS score（ 3. 35 ± 2. 43 vs6. 83 ± 2. 61 and 3. 41± 2. 38 vs 4. 92 ± 2. 49,P 〈0. 05）,and penile hemodynamic parameters obtained by color duplex Doppler ultrasonography（ P 〈0. 05）,with significant differences between the two groups in the IIEF-5 score（ 11. 54 ± 7. 72 vs 9. 37 ± 1. 65,P 〈0. 05） and SIS score（ 6. 83 ± 2. 61 vs 4. 92 ± 2. 49,P 〈0. 05） but not in the penile hemodynamic parameters（ P 〈0. 05）. Even more remarkable improvement was observed at 8 weeks in the experimental and control groups in the IIEF-5 score（ 19. 29 ± 1. 85 and 15. 43 ± 1. 74）（ P 〈0. 05）,SIS score（ 11. 73 ± 2. 57 and 6. 55 ± 2. 71）（ P 〈0. 05）,and penile hemodynamic parameters（ P 〈0. 05）,all with significant differences between the two groups（ P 〈0. 05）. Conclusion： Pancreatic kininogenase combined with sildenafil has a better clinical effect than sildenafil alone on ED in type 2 DM patientsin the high-altitude area.