生物反馈法联合甲睾酮、氟西汀治疗心理性性功能障碍的效果及勃起功能、性激素水平变化

Effects of biofeedback combined with methyltestosterone and fluoxetine in the treatment of psychosexual dysfunction and changes in erectile function and sex hormone levels

目的观察生物反馈法联合甲睾酮、氟西汀治疗心理性性功能障碍的效果及对勃起功能、性激素水平变化的影响。方法选取2019年10月—2021年1月自贡市第四医院泌尿外科诊治心理性性功能障碍患者96例作为研究对象,按照随机数字表法分为对照组、观察组,各48例。对照组采用甲睾酮、氟西汀治疗,观察组采用生物反馈法联合甲睾酮、氟西汀治疗。比较2组治疗8周后疗效,治疗前后国际勃起功能指数表-5(IIEF-5)评分、自测勃起硬度分级(EHGS)、射精功能评分表(CI-PE)评分,血管内皮功能[内皮素(ET-1)、一氧化氮(NO)、血管舒张功能(FMD)]、性激素水平[睾酮(T)、雌二醇(E_(2))、黄体生成素(LH)、促卵泡生成素(FSH)]、改良性生活质量量表(mSLQQ-QOL)评分及不良反应发生率。结果观察组总有效率高于对照组(87.50%vs.68.75%,χ^(2)/P=4.937/0.026);治疗8周后,观察组IIEF-5、EHGS、CI-PE评分高于对照组(t/P=2.719/0.008、2.386/0.019、2.666/0.009),FMD、NO、T、LH水平高于对照组(t/P=3.029/0.003、2.481/0.015、2.060/0.042、2.885/0.005),ET-1、E_(2)、FSH低于对照组(t/P=2.509/0.014、3.246/0.002、2.558/0.012),mSLQQ-QOL评分高于对照组(t/P=2.668/0.009);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论生物反馈法联合甲睾酮、氟西汀治疗心理性性功能障碍效果显著,可有效改善勃起功能、射精功能及血管内皮功能,调节性激素水平,提升性生活质量,且安全性较高。

Objective To observe the effect of biofeedback combined with methyltestosterone and fluoxetine in the treatment of psychosexual dysfunction and the effect on erectile function and changes in sex hormone levels.Methods From October 2019 to January 2021,96 patients with psychosexual dysfunction diagnosed and treated in the Urology Department of the Fourth Hospital of Zigong City from October 2019 to January 2021 were selected as the research objects,and divided into the control group and the observation group according to the random number table method,with 48 cases in each group.The control group was treated with methyltestosterone and fluoxetine,while the observation group was treated with biofeedback combined with methyltestosterone and fluoxetine.After 8 weeks of treatment,the curative effects of the two groups were compared.Before and after treatment,the International Index of Erectile Function-5(IIEF-5),the self-measured erectile hardness scale(EHGS),the ejaculation function score(CIPE)score,and the vascular endothelial function[endothelin(ET-1),nitric oxide(NO),vasodilation(FMD)],sex hormone levels[testosterone(T),estradiol(E_(2)),luteinizing hormone(LH),follicle-stimulating hormone(FSH)],Modified Quality of Life Scale(mSLQQ-QOL)score and incidence of adverse reactions were compared.Results The total effective rate in the observation group was higher than that in the control group(87.50%vs.68.75%,χ^(2)/P=4.937/0.026).After 8 weeks of treatment,compared with control group,the IIEF-5,EHGS and CIPE scores of the observation group were higher(t/P=2.719/0.008,2.386/0.019,2.666/0.009),the levels of FMD,serum NO,T and LH were higher(t/P=3.029/0.003,2.481/0.015,2.060/0.042,2.885/0.005),ET-1,E_(2),FSH were lower(t/P=2.509/0.014,3.246/0.002,2.558/0.012),mSLQQ-QOL score was higher than the control group(t/P=2.668/0.009).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Biofeedback method combined with methyltestosterone and fluoxetine in the treatment of patients with psychosexual dysfunction has a significant effect,can effectively improve erectile function,ejaculation function and vascular endothelial function,regulate sex hormone levels,improve the quality of sexual life,and has high safety.