少腹逐瘀汤联合小剂量他达那非治疗腹膜透析患者勃起功能障碍临床研究

Clinical Study on Shaofu Zhuyu Decoction Combined with Small-Dose Tadalafil for Erectile Dysfunction in Peritoneal Dialysis Patients

目的:观察少腹逐瘀汤联合小剂量他达拉非治疗腹膜透析患者勃起功能障碍(ED)的临床疗效。方法:选取68例男性腹膜透析伴ED患者,按随机数字表法分为观察组和对照组各34例。对照组给予小剂量他达拉非治疗,观察组在对照组基础上给予少腹逐瘀汤治疗。2组均治疗30 d。评价2组临床疗效,比较2组治疗前后国际勃起功能问卷调查表-5(IIEF-5)评分、勃起硬度分级(EHS)评分、中医证候积分、阴茎血流动力学参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、背深静脉流速(VV)]及氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)]等,同时记录不良反应。结果:观察组总有效率为88.24%,高于对照组73.53%(P<0.05)。治疗后,2组IIEF-5、EHS评分较治疗前升高,且观察组高于对照组(P<0.05);2组中医证候积分较治疗前降低,且观察组低于对照组(P<0.05)。治疗后,2组PSV和RI水平较治疗前升高,且观察组高于对照组(P<0.05);2组EDV、VV较治疗前降低,且观察组低于对照组(P<0.05)。治疗后,2组SOD和NO水平较治疗前升高,且观察组高于对照组(P<0.05);2组MDA水平较治疗前降低,且观察组低于对照组(P<0.05)。观察组不良反应发生率为5.88%,低于对照组14.71%(P<0.05)。结论:少腹逐瘀汤联合小剂量他达拉非治疗腹膜透析伴ED疗效确切,可有效改善阴茎血流动力学和氧化应激状态。

Objective:To observe the clinical effect of the therapy of Shaofu Zhuyu Decoction combined with small-dose Tadalafil on erectile dysfunction(ED)in peritoneal dialysis patients.Methods:A total of 68 male peritoneal dialysis patients with ED were selected and divided into the observation group and the control group according to random number table method,with 34 cases in each group.The control group was given small-dose of Tadalafil,and the observation group was additionally given Shaofu Zhuyu Decoction based on the treatment of the control group.Both groups were treated for 30 days.The clinical effects in the two groups were evaluated.The scores of International Index of Erectile Function-5(IIEF-5),the scores of Erection Hardness Grading Scale(EHS),traditional Chinese medicine(TCM)syndrome scores,penile hemodynamic parameters,including peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)and deep dorsal vein velocity(VV),and oxidative stress indexes,including malonaldehyde(MDA),superoxide dismutase(SOD)and nitric oxide(NO),were compared between the two groups before and after treatment.The adverse reactions were also recorded.Results:The total effective rate was 88.24%in the observation group,higher than that of 73.53%in the control group(P<0.05).After treatment,the IIEF-5 and EHS scores in the two groups were increased when compared with those before treatment,and those in the observation group were higher than those in the control group(P<0.05);the TCM syndrome scores in the two groups were decreased when compared with those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the PSV and RI levels in the two groups were increased when compared with those before treatment,and the above levels in the observation group were higher than those in the control group(P<0.05);the EDV and VV levels in the two groups were decreased when compared with those before treatment,and the above levels in the observation group were lower than those in the control group(P<0.05).After treatment,the SOD and NO levels in the two groups were increased when compared with those before treatment,and the above two levels in the observation group were higher than those in the control group(P<0.05);the MDA levels in the two groups were decreased when compared with those before treatment,and the level in the observation group was lower than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was 5.88%,lower than that of 14.71%in the control group(P<0.05).Conclusion:The therapy of Shaofu Zhuyu Decoction combined with small-dose Tadalafil has a definite therapeutic effect on the treatment of peritoneal dialysis complicated with ED,which can effectively improve penile hemodynamics and oxidative stress state.