盐酸达泊西汀治疗原发性早泄的临床疗效和停药原因分析

Efficacy and discontinuation reasons of dapoxetine in the treatment of lifelong premature ejaculation

目的观察盐酸达泊西汀治疗原发性早泄的临床疗效和停药原因。方法收集2017年1月至2017年6月以原发性早泄就诊的门诊患者126例,将上述患者采用盐酸达泊西汀进行治疗,性生活前1~3h口服一粒(30mg),随访治疗后1、3、6个月患者早泄评估量表(PEP)得分的变化,并记录患者是否停药及停药原因。结果坚持治疗到1、3、6个月的患者治疗前后PEP得分分别为4.87±2.72 vs 9.43±2.59、4.80±2.81 vs 10.16±2.37、4.69±2.36 vs10.72±2.21,治疗后与治疗前相比差异均有统计学意义,P<0.05。126例原发性早泄患者中,5例(4%)一开始就拒绝服用达泊西汀进行治疗,拒绝的原因中花费高、担心产生药物依赖分别为60%、40%。121例(96%)患者接受达泊西汀进行治疗。64例(53%)坚持服药6个月;57例(47%)在6个月内停药,其停药原因分别为无效(3.5%)、疗效低于预期(31.6%)、费用高(33.3%)、副作用(7.0%)、失访(7.0%)、选择其他的治疗方式(8.8%)、痊愈(8.8%)。此外,年龄≥40岁、收入<10万元、本科以下学历的原发性早泄患者停药率分别高于年龄<40岁、收入≥10万元、本科及以上学历的患者(P<0.05)。结论盐酸达泊西汀(30mg)能有效治疗原发性早泄,然而其停药率较高。

Objective To evaluate the efficacy of dapoxetine hydrochloride and its discontinuation reasons in the treatment of lifelong premature ejaculation. Methods Total of 126 patients with lifelong premature ejaculation from outpatient department were recruited in the study from Jan. 2017 to Jun. 2017. The patients were administrated with a dapoxetine with 30 mg 1-3 hours before sexual life. Follow-up was conducted after 1,3,6 month. Premature ejaculation profile（PEP）, discontinuation or not, and reasons of discontinuation were recorded. Results PEP score of the patients who received continuing treatment at 1,3,6 months were increased significantly compared with the scores before treatment（4.87±2.72, 4.80±2.81, 4.69±2.36 vs 9.43±2.59, 10.16±2.37, 10.72±2.21, P〈0.05）. Of all the patients, 5（4%） patients rejected dapoxetine from the beginning, and their reasons were high cost and afraid of addiction to dapoxetine, the rates of which were 60% and 40% respective. 121（96%） patients accepted the treatment, and 64（53%） of them insisted on the treatment within 6 months, 57（47%） patients discontinue the treatment, and their reasons were inefficient（3.5%）, effect below expectation（31.6%）, high cost（33.3%）, side effect（7.0%）, losing follow-up（7.0%）, other treatment（8.8%） and cure（8.8%）. Patients whose age ≥40, or income 100 thousand yuan, or education beneath the bachelor degree were more inclined to discontinue the treatment compared with men of age 40, or income ≥100 thousand yuan, or education of bachelor degree or above（P 0.05）. Conclusion Dapoxetine is effective and well-tolerated for the treatment of lifelong premature ejaculation. However, its discontinuation rate was high.