性治疗联合小剂量规律服用他达拉非在男性临时射精障碍中的作用

Effect of sexual therapy combined with regular low-dose tadalafil in the treatment of male temporary ejaculation failure during assisted reproduction technology

目的 探讨性治疗联合小剂量规律服用他达拉非在辅助生殖过程男性临时射精障碍中的临床疗效.方法 选取2019年1月至2020年5月本院生殖男科就诊拟行辅助生育,主诉手淫临时取精困难的患者73例,门诊给予焦虑与抑郁量表评分(GAD-7+PHQ-9)、国际勃起功能指数评分(IIEF-5)调查患者的心理状态和勃起情况.告知后续治疗方案,按照患者及家属自主选择的治疗方法将其分为两组,A组为性治疗联合小剂量规律服用他达拉非(43例),B组为小剂量规律服用他达拉非(30例).统计分析两组治疗1个月后的手淫取精结果.结果 73例患者的IIEF-5评分为22~24分,均无勃起功能障碍,GAD-7+PHQ-9量表提示,仅有4例无焦虑,5例无抑郁表现,其余患者表现出不同程度的焦虑抑郁症状.取精当日,A组成功取精35例(81.40%),B组成功取精19例(63.33%),A组的取精成功率高于B组,差异有统计学意义(P<0.05).结论 辅助生殖过程中男性临时取精困难的患者多伴有焦虑、抑郁的心理状态,相对于单一应用小剂量规律服用他达拉非,采用性治疗联合小剂量规律服用他达拉非的方法更能有效提高获精率.

Objective To investigate the clinical effect of sex therapy combined with regular low-dose tadalafil in men with temporary ejaculation failure during assisted reproduction technology.Methods From January 2019 to May 2020,73 patients who prepare for assisted reproduction technology and complained of temporary ejaculation failure were selected.They were given anxiety and depression scale score(GAD-7+PHQ-9)and international erectile function index score(IIEF-5)to investigate their psychological state and erectile function.According to the treatment methods independently selected by patients and their families,patients were divided into two groups:Group A was sex therapy combined with low dose regular tadalafil group(43 cases),and group B was low dose regular tadalafil group(30 cases).Results The IIEF-5 score of 73 patients was 22-24 scores,and none of them had erectile dysfunction.As indicated by the GAD-7+PHQ-9 scale,only 4 patients had no anxiety,5 had no depression,and the rest of the patients showed different degrees of anxiety and depression symptoms.On the day of sperm collection,35 cases(81.40%)in group A and 19 cases(63.33%)in group B were successfully collected.The success rate of semen extraction in group A was higher than that in group B,the difference was statistically significant(P<0.05).Conclusions Male patients with temporary ejaculation failure during assisted reproduction technology are often accompanied by anxiety and depression.Compared with the single use of low-dose regular tadalafil,the method of sexual therapy combined with low-dose regular tadalafil can more effectively improve the sperm acquisition rate.