他达拉非单独与联合阿法骨化醇治疗ED合并低血清25-羟维生素D的临床对比分析

Clinical comparative analysis of tadalafil alone and in combination with alfacalcidol in the treatment of ED with low serum 25-hydroxy vitamin D

目的对比分析他达拉非单独与联合阿法骨化醇治疗勃起功能障碍(ED)合并低血清25-羟维生素D[25-(OH)D]的临床疗效及不良反应。方法收集安徽医科大学第一附属医院泌尿外科2011年8月到2021年3月在门诊就诊的ED合并低血清25-(OH)D患者的资料,全部249例患者根据就诊顺序随机分为A、B两组,A组112例,B组137例。A组口服阿法骨化醇软胶囊1粒,每日1次,连续服用45天;性生活前1小时内口服他达拉非20mg。B组性生活前1小时内口服他达拉非20mg。比较两组患者治疗前后的国际勃起功能指数(IIEF-5)、血清25-(OH)D水平、睾酮(T)水平及不良反应。结果两组患者治疗后的IIEF-5均显著高于治疗前(P<0.05);A组血清25-(OH)D水平和T水平显著高于治疗前(P<0.05);B组血清25-(OH)D水平和T水平与治疗前比较差异无统计学意义(P>0.05);A组治疗后的总有效率、血清25-(OH)D水平及T水平均显著高于B组(P<0.05)。治疗期间两组患者的不良反应有头痛、消化不良、背痛、肌肉酸痛,所有患者均症状较轻,且可耐受,无需特殊处理。结论他达拉非联合阿法骨化醇治疗ED合并低血清25-(OH)D患者疗效优于单用他达拉非,不良反应轻微,且可耐受,值得临床应用。

Objective To compare the clinical efficacy and adverse reactions of tadalafil alone and in combination with alfacalccidol in the treatment of erectile dysfunction(ED)with low serum 25-hydroxyvitamin D[25-(OH)D].Methods Clinical data of patients with ED combined with low serum 25-(OH)D in the department of urology,the first affiliated hospital of Anhui Medical University from August 2011 to March 2021 were collected.All 249 patients were randomly divided into two groups such as group A(112 cases)and group B(137 cases).The patients in group A were given with alfacalcidol soft capsule 1,once a day,for 45 days.Except that,they were administrated with oral tadalafil 20 mg within 1 hour before sexual life.The patients in group B were only given with tadalafil 20 mg orally 1 hour before sexual life.International erectile function index(IIEF-5),serum 25-(OH)D level,testosterone(T)level and adverse reactions were compared between two groups before and after treatment.Results IIEF-5 in 2 groups after treatment was significantly higher in two groups than that before treatment(P<0.05).The serum levels of serum 25-(OH)D and T in group A after treatment were significantly higher than those before treatment(P<0.05).There was no significant differences in serum 25-(OH)D level and T level in group B between before and after treatment(P>0.05).The total effective rate,serum 25-(OH)D level and T level in group A were significantly higher than those in group B(P<0.05).During the treatment,the adverse reactions of patients in the two groups included headache,dyspepsia,back pain and muscle soreness.All patients had mild and tolerable symptoms,but no special treatment required.Conclusion Tadalafil combined with alfacalccidol is superior to tadalafil alone in the treatment of ED patients with low serum 25-(OH)D,and the adverse reactions are mild and tolerable,which is worthy of clinical application.