负压吸引联合认知行为疗法治疗无性生活勃起功能障碍的临床疗效

Clinical Efficacy of Vacuum Aspiration Combined with Cognitive Behavioral Therapy in Treating Patients with Erectile Dysfunction-No Sexual Life

目的探讨负压吸引联合认知行为疗法治疗无性生活勃起功能障碍(ED-NS)的临床疗效。方法选择2021年3月至2023年10月山东第二医科大学附属医院收治的90例成年男性ED-NS患者作为研究对象,依据随机数字表法分为负压吸引组、认知行为组、联合治疗组,每组30例。负压吸引组采用负压吸引疗法治疗,认知行为组采用认知行为疗法治疗,联合治疗组采用负压吸引疗法联合认知行为疗法治疗。比较3组患者治疗前、治疗3个月结束时和治疗结束后3个月的勃起功能自我评价表(SIEF-NS)评分、勃起硬度评分(EHS)、焦虑自评量表评分(SAS)和抑郁自评量表评分(SDS)。结果90例ED-NS患者中有87例完成了随访,负压治疗组失访1例,认知行为组失访2例。重复测量方差分析结果显示,SIEF-NS、EHS、SAS、SDS评分的时点间主效应、组间主效应、组间和时点间的交互作用差异均有统计学意义(P<0.05或P<0.01)。进一步进行简单效应分析,以时间为自变量的时点间效应显示,3组治疗3个月结束时及治疗结束3个月后的SIEF-NS、EHS评分均高于治疗前基线水平(P<0.01),SAS、SDS评分低于治疗前基线水平(P<0.01),联合治疗组治疗结束3个月后SIEF-NS、EHS评分高于治疗3个月结束时(P<0.01)。以组别为自变量的组间效应显示,治疗结束3个月后,联合治疗组的SIEF-NS、EHS评分高于负压吸引组和认知行为组(P<0.05或P<0.01),SAS评分低于负压吸引组(P<0.05),SDS评分低于负压吸引组和认知行为组(P<0.01)。结论负压吸引联合认知行为疗法治疗ED-NS的效果优于负压吸引治疗和认知行为疗法的单独治疗,且能够明显改善患者焦虑、抑郁的心理状态,无明显副作用,操作安全。

Objective To explore the effect of vacuum aspiration combined with cognitive behavioral therapy on the treatment of patients with erectile dysfunction-no sexual life(ED-NS).Methods A total of 90 male adults with ED-NS treated in the Affiliated Hospital of Shandong Second Medical University from Mar.2021 to Oct.2023 were included,and were divided into a vacuum aspiration group,a cognitive behavioral group and a combined treatment group,with 30 cases in each group.The vacuum aspiration group was treated with vacuum aspiration therapy,the cognitive behavioral group was treated with cognitive behavioral therapy,and the combined treatment group was treated withboth therapies.The self-estimation index of erectile function-no sexual life(SIEF-NS),erectile hardness scale(EHS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)of the patients in each group were compared before treatment,at the end of treatment,and three months after the end of treatment.Results 87 cases of the 90 ED-NS patients completed the follow-up,one lost to follow-up in the vacuum aspiration group and two in the cognitive behavioral group.Results of the repeated-measures ANOVA showed that there were statistically significant differences in the time main effect,intergroup main effect,and between-group and temporal interaction of SIEF-NS,EHS,SAS and SDS scores(P<0.05).Further simple effect analysis,the time effect with time as the independent variable showed that,SIEF-NS and EHS scores of the three groups at the end of three months of treatment and 3 months after treatment were higher than the baseline before treatment(P<0.01),the SAS and SDS scores were below the pre-treatment baseline level(P<0.01),the SIEF-NS and EHS scores at three months after the end of treatment in the combined treatment group were higher than at the end of the three months of treatment(P<0.01).Intergroup effects with group as the independent variable showed that,three months after the end of treatment,SIEF-NS and EHS scores of the combined treatment group were higher than vacuum aspiration group and the cognitive behavioral group(P<0.05 or P<0.01),while SAS was lower than vacuum aspiration group(P<0.05)and SDS was lower than the vacuum aspiration gorup and the cognitive behavioral group(P<0.01).Conclusion The combined treatment of vacuum aspiration and cognitive behavioral therapy for ED-NS is more effective than either treatment alone and can significantly improve the psychological state of anxiety and depression in the patients with safe operation and without noticeable side effects.