多塞平治疗早泄的临床研究

我科自 1997年 8月～ 2 0 0 1年 6月对 148例早泄患者采用抗抑郁症药物多塞平治疗 ,取得一定效果 ,现报告如下。对象与方法一、对象 :148例早泄患者 ,无阴茎勃起功能异常 ,平均年龄 32 (2 5～ 5 4)岁 ,符合美国泌尿外科学会 (ＡＵＡ)早泄的诊断标准 ,所有患者的射精潜伏期 (指从阴茎插入阴道至射精的时间 )都小于 2分钟 ,平均 1 5 5± 0 34分钟 ,患者早泄病史平均 3 5 6± 1 43年。其中原发性早泄 (指首次性交即出现早泄 ) 98例 ,占 6 6 2 % ,继发性早泄 (指原无早泄 ,以后由于各种可知或不可知因素导致了早泄 ) 5 0例 ,占 33 8%。二、方…     

氯丙咪嗪联合复方玄驹胶囊治疗早泄疗效观察

目的:观察氯丙咪嗪联合复方玄驹胶囊治疗早泄的疗效.方法:405例早泄患者,分为治疗组(205例)和对照组(200例).两组患者均服用氯丙咪嗪,治疗组同时服用复方玄驹胶囊.治疗4周后观察性生活满意度.结果:治疗后治疗组性生活满意度的治愈率和改善率分别为21.9%和56%,均显著优于对照组.结论:氯丙咪嗪联合复方玄驹胶囊治疗早泄有明显疗效.     

舍曲林联合伐地那非治疗早泄的疗效分析

目的探讨舍曲林联合应用伐地那非治疗早泄的疗效。方法将85例早泄患者随机分为综合组(服用舍曲林和伐地那非)和对照组(服用舍曲林),以治疗前、治疗2w以及治疗4w后的阴道内射精潜伏期时间(ILET)、患者性生活满意度评分(IIEF)来评价疗效。结果与治疗前相比,两组患者在治疗2w、治疗4w时的ILET和IIEF均提高,但治疗2w和4w相比无显著性差异(P>0.05);两组患者相比较,在治疗2w和4w后,综合组患者的ILET和IIEF均比对照组高,差异有统计学意义(P<0.05)。结论治疗早泄患者,舍曲林联合伐地那非能提高疗效。     

达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的临床观察

目的探讨达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的临床观疗效。方法门诊治疗的慢性前列腺炎伴早泄患者,随机分为研究组(n=53)和对照组(n=52)。观察组:达泊西汀联合坦洛新;对照组:单用坦洛新。两组均以8周为1治疗周期。观察两组患者治疗前后前列腺炎症状指数(NIH-CPSI)评分、早泄诊断工具(PEDT)评分、阴道内射精潜伏期(IVELT)变化及安全性评价。结果治疗后患者前列腺炎症状指数(NIH-CPSI)评分显著改善,差异有统计学意义(P<0.05),患者早泄诊断工具(PEDT)评分显著改善,差异有统计学意义(P<0.05),患者治疗后阴道内射精潜伏期(IVELT)明显延长,差异有统计学意义(P<0.05),治疗过程中未见明显恶心、乏力等药物不良反应发生。结论达泊西汀联合坦洛新治疗慢性前列腺炎伴早泄患者的疗效较单纯应用坦洛新治疗效果更佳,能更明显降低前列腺炎症状指数(NIH-CPSI)、早泄诊断工具(PEDT)评分,延长阴道内射精潜伏期(IVELT)时间,提高慢性前列腺炎伴早泄患者的治愈率。     

中药口服联合穴位埋线治疗男性早泄的临床效果分析

目的 探讨中药口服联合穴位埋线治疗男性早泄的临床效果.方法 126例男性早泄患者,按随机数字表法分为中药组、埋线组和联合组,每组42例.中药组患者单纯口服疏肝补肾汤治疗,埋线组患者采用可吸收性外科缝线穴位埋线治疗,联合组患者采用疏肝补肾汤口服联合穴位埋线治疗.比较三组患者临床疗效.结果 中药组患者治愈28例、治愈率为6...     

盐酸舍曲林联合坦索罗辛治疗早泄并发焦虑50例

目的 评价盐酸舍曲林片联合坦索罗辛缓释胶囊治疗早泄并发焦虑的临床疗效. 方法 将100例早泄并发焦虑患者随机分为两组,各50例,治疗组口服盐酸舍曲林片,每晚50 mg;坦索罗辛缓释胶囊,每晚0.2 mg. 对照组口服盐酸舍曲林片,用法用量同治疗组. 均4周为1个疗程. 记录并分析患者治疗前后平均阴道内射精潜伏时间、双方性交满意度及焦虑症状评分. 结果 治疗组、对照组患者平均阴道内射精潜伏时间、双方性交满意度及焦虑症状评分较治疗前差异有统计学意义(P<0.05或P<0.01). 治疗组治疗后平均阴道内射精潜伏时间延长,双方性交满意度提高,均较对照组差异有统计学意义(P<0.05或P<0.01). 结论 盐酸舍曲林片联合坦索罗辛缓释胶囊可明显延长早泄并焦虑患者平均阴道内射精潜伏时间,提高性交满意度,缓解焦虑,且优于单纯应用盐酸舍曲林片.     

盐酸坦洛新缓释片结合行为疗法治疗早泄

目的:探讨高选择性α-肾上腺素能受体阻断剂盐酸坦洛新缓释片结合行为疗法在早泄治疗中的疗效。方法:对符合诊断标准的90例早泄患者随机分为单纯行为疗法组、单纯药物组和盐酸坦洛新缓释片+行为疗法组,每组30例,给予相应治疗,观察疗效及药物副作用。结果:治疗后结合组与单纯行为疗法组阴道内射精潜伏期均较治疗前比较差异有统计学意义(P<0.01),单纯药物组则无统计学意义(P>0.05)。治疗后各组阴道内射精潜伏期比较,结合组>单纯行为疗法组>单纯药物组,且各组间均有统计学意义(P<0.01)。从夫妻双方对性生活满意率来看,结合组高于单纯行为疗法组及单纯药物组,但各组间无统计学意义(P>0.05)。各组均未出现严重不良反应。结论:盐酸坦洛新缓释片结合行为疗法可明显增加阴道内射精潜伏期,且疗效优于单纯的药物治疗和行为疗法,该疗法对提高夫妻生活满意率也有一定帮助。     

盐酸舍曲林联合心理辅导治疗早泄及对患者性生活满意度改善效果的回顾性研究

摘 要 目的： 观察盐酸舍曲林治疗早泄及对患者性生活满意度改善的效果。方法: 采用回顾性研究方法,280例早泄患者根据治疗方法不同分为观察组和对照组。对照组140例采用采用常规心理治疗;观察组在对照组基础上加用盐酸舍曲林胶囊50 g·d^-1,po。比较治疗1个月后两组患者的射精潜伏期、中国早泄患者性功能评价表（CIPE）评分、汉密尔顿抑郁量表（HAMD）评分、国际勃起功能评分表（IIEF-5）评分,以及两组患者和配偶的性生活满意度、药品不良反应发生情况等。结果: 治疗后,两组患者射精潜伏期、CIPE评分、HAMD评分、IIEF-5评分等各项指标均较治疗前明显改善（P<0.05）,且观察组患者明显优于对照组（P<0.05）。观察组患者及配偶的总满意率明显高于对照组（P<0.05）。观察组患者药品不良反应发生率明显高于对照组（P<0.05）,但均较轻微可耐受。结论:在传统的心理辅导行为基础上给予盐酸舍曲林治疗早泄,能显著改善患者射精潜伏期、CIPE评分、HAMD评分、IIEF 5评分等各项指标,提高患者及配偶的满意度,不良反应症状较轻微,值得临床推广。     

护理干预对年龄相关性白内障患者心理状态并发症及护理满意度的影响

<正>为了对年龄相关性白内障患者进行积极有效的护理干预,从而对患者预后进行有效改善,本研究探讨了护理干预对年龄相关性白内障患者心理状态、并发症及护理满意度的影响。1资料与方法1.1临床资料:选取2017年8月至2018年8月我院年龄相关性白内障患者158例,分为2组:常规护理干预组79例,综合护理干预组79例。综合护理干预组患者中男性40例,女性39例,年龄65～76岁,平均(72±10)岁;病程1～2年,平均(1.5±0.5)年。在疾病类型方面,皮质性白内障35例,核型白内障31例,后囊下白内障13例;在疾病部位方面,单眼49     

针药结合治疗早泄54例疗效观察

目的 :观察针灸配合中药治疗早泄的临床疗效。方法 :对 10 8例功能性早泄患者采用随机对照治疗分组。治疗组 5 4例 ,用针灸配合中药治疗 ;对照组 5 4例 ,用单纯中药治疗。结果 :治疗组总有效率 92 6 % ,对照组总有效率 74 1% ,P <0 0 5 ,有显著性差异。结论 :针灸配合中药治疗早泄疗效可靠     

盐酸达泊西汀治疗早泄的临床研究进展

早泄(PE)是最常见的男性性功能障碍。达泊西汀是一个新型、作用快速的选择性5-羟色胺(5-HT)再摄取抑制剂(SSRIs)。尽管达泊西汀与其他SSRIs有相似的药理作用,但其口服吸收快,半衰期短,排泄快的药动学特征,使其成为适于需时服用治疗PE的药物。临床试验表明,达泊西汀能有效地延长PE患者的阴道内射精的潜伏时间(IELT),改善性功能,且没有严重的不良反应。与传统的SSRIs相比具有更好的安全性和耐受性。本品有可能成为今后改善PE的第一个新药。     

Safety and efficacy of dapoxetine in the treatment of premature ejaculation: a double-blind, placebo-controlled, fixed-dose, randomized study.

The aim of the study was to evaluate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) drug dapoxetine in delaying ejaculation in patients with premature ejaculation (PE). A total of 212 potent men with PE were randomly assigned to receive 30 mg orally dapoxetine (group 1, N=106) twice daily or similar regimen of placebo (group 2, N=106) during a 12-week period for each agent. Pretreatment evaluation included history and physical examination, geometric mean intravaginal ejaculatory latency time (IELT, primary outcome measure), and International Index of Erectile Function (IIEF). The efficacy of two treatments was assessed every 2 weeks during treatment, at the end of study, and in 3-month follow-up after cessation of treatment. We measured geometric mean IELT. Thus, the IELT values were logarithmically transformed before statistical analysis, and the results are reported as fold increases from baseline with associated 95% confidence intervals (CI). The independent sample two-tailed t-test was used to compare the IELTs. At the end of 12-week treatment, the dapoxetine group had a 2.9- (95% CI, 1.84-4.16) fold increase of the geometric mean IELT, while after placebo the geometric mean IELT did not increase significantly (1.4-fold increase; 95% CI, 0.84-1.63) (p=0.001). The mean weekly intercourse episodes increased from pretreatment values of 1.16 and 1.14 to 2.2 and 1.4, for dapoxetine and placebo, respectively (p=0.04). Baseline mean intercourse satisfaction domain values of IIEF, 12 and 11, reached to 16 and 10 at the 12-week treatment in groups 1 and 2, respectively (p=0.04). At the end of 3-month follow-up period, the geometric mean IELT in dapoxetine and placebo group demonstrated 1.4- (95% CI, 0.66-1.46) and 1.3- (95% CI, 0.77-1.63) fold increase, respectively (p=0.1). Three-month intercourse satisfaction domain value of IIEF was 11 in group 1 and 10 in group 2 (p=0.1). Mean number of adverse events was 19 for dapoxetine and 7 for placebo (p=0.02). Dapoxetine has moderately better results in terms of IELT and intercourse satisfaction vs placebo without long-term benefit for the patient after it is withdrawn. Further studies are necessary to draw final conclusions on the efficacy of this drug in PE.     

Dapoxetine for premature ejaculation

Importance of the field: Premature ejaculation (PE) is a common male sexual disorder which is associated with substantial personal and interpersonal negative psychological factors. Drug treatment of PE with an off-label antidepressant selective serotonin reuptake inhibitor (SSRI) drug is common. The lack of an approved drug and total reliance on off-label treatment represents a substantial unmet treatment need.

Areas covered in this review: Medline and the proceedings of major international and regional scientific meetings during the period 1994 – 2010 were searched for publications or abstracts using the word ‘dapoxetine’ in the title, abstract or keywords. This search was then manually cross-referenced for all papers. This review encompasses studies of dapoxetine pharmacokinetics, animal studies, human phase I, II and III efficacy and safety studies and drug-interaction studies. Dapoxetine is a potent SSRI, which is administered on demand 1 – 3 h before planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30 and 60 mg has been evaluated in five randomized, double-blind, placebo-controlled studies in 6,081 men aged ≥ 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) items, clinical global impression of change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (p < 0.001 for all). The most common adverse events included nausea, dizziness and headache, and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use.

What the reader will gain: Readers will gain insight into the epidemiology, pathophysiology and contemporary drug treatment of premature ejaculation.

Take home message: Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.     

高选择性肾上腺素能α1受体阻断剂结合行为疗法治疗早泄的疗效观察

目的:探讨高选择性肾上腺素能α1受体阻断剂盐酸坦洛新缓释片结合行为疗法在早泄(premature ejaculation,PE)治疗中的临床应用及疗效评价。方法:对符合诊断标准的80例PE患者以随机抽样法分为A组(盐酸坦洛新缓释片+行为疗法)和B组(安慰剂+行为疗法)2组,每组40例,分别给予相应治疗,观察疗效及药品不良反应。结果:经8周治疗后,A组总有效率为77.5%(31/40),B组治疗前后无明显变化。A组阴道内射精潜伏期(intravaginal ejaculatory latency time,IELT)较B组明显延长,与治疗前相比也明显延长(P<0.01),且A组男女双方性生活满意度评分较治疗前和B组相比明显提高(P<0.05),差异具有统计学意义。2组患者均未出现严重不良反应。结论:盐酸坦洛新缓释片结合行为疗法,可明显延长IELT,提高男女双方性生活满意度,疗效确切,明显优于单纯疗法,且不良反应小,患者容易接受,是治疗PE行之有效的方法之一。     

伊木萨克片联合帕罗西汀治疗早泄的临床效果研究

目的对比研究单独使用伊木萨克片或帕罗西汀的治疗方案以及两种药物联合使用的治疗方案治疗早泄（PE）的临床效果。方法 136例患者,分为伊木萨克片组39例,帕罗西汀组47例,联合组50例,分别以口服伊木萨克片3片/d,帕罗西汀20 mg/d,联合使用两种药物治疗早泄,疗程均为30 d,对比三种治疗方案的患者在治疗前后的阴道内射精潜伏时间（IELT）和性伴侣满意程度评分结果,同时统计各治疗方案的副作用。结果各方案治疗后的IELT明显提高,其中以联合组最为明显,而治疗后性伴侣满意度评分差异无统计学意义（P〉0.05）。三种治疗方案以联合组治愈率为最高,达到82.0%。差异有统计学意义（P〈0.05）,结论联合使用伊木萨克片、帕罗西汀治疗PE有较高的治愈率,能明显提高患者的IELT和其性伴侣的满意程度,可予以临床推广。     

Pharmacotherapy for premature ejaculation

Introduction: Four premature ejaculation (PE) subtypes are distinguished on the basis of the duration of the intravaginal ejaculation latency time (IELT), its course in life, and frequency of complaints. Since the 1930s oral drug treatment and local anesthetics have been used to treat PE. Apart from dapoxetine, all currently available drugs to treat PE (SSRIs, clomipramine, and local anesthetics) are off-label. Not only men with lifelong and acquired PE, but also men with normal IELT values may want to postpone their ejaculation time.

Areas covered: The guideline of the International Society for Sexual Medicine for the treatment of PE has provided evidence-based recommendations for the pharmacotherapy of lifelong and acquired PE. Selective serotonin reuptake inhibitors (SSRIs) delay ejaculation by interfering with the serotonin (5-HT) neurotransmission system in the central nervous system. Attention is given not only to the well-known but also to the recently published, very rare side effects of SSRIs.

Expert opinion: Men with normal IELT values who want to postpone ejaculation do not need “drugs for the treatment of PE” but “ejaculation delaying drugs.” Pharmacological research of these ejaculation-delaying drugs ought to be investigated in men with normal IELT values, such as in men with subjective PE, variable PE, and in male volunteers.     

手术和脱敏及药物三种方法治疗原发性早泄的临床对比研究

目的对比手术、脱敏及药物3种方法治疗原发性早泄的临床疗效。方法选取2009年3月至2011年8月我院收治的原发性早泄患者450例,完全随机分为手术、患者组、脱敏组和药物组,每组150例。手术组行阴茎背神经选择性切断术,脱敏组进行早泄脱敏训练,药物组口服盐酸舍曲林片（商品名：佐洛复）50mg／d。比较3组患者射精潜伏期患者及其配偶性生活满意度评分患者性功能评价表（CIPE-5）评分及治疗后的总有效率。结果治疗后手术组、脱敏组和药物组患者射精潜伏期均较治疗前长[（14．38±2．26）min比（1．28±0.16）min,（10．26±1．88）min比（1．33±0．21）min,（8．93±3．42）min比（1．26±0．19）min,均P〈0．05],患者性生活满意度[（12．1±1．1）分比（5．8±1．3）分,（10．4±1．1）分比（5．7±0．9）分,（9．2±1．4）分比（5．9±1．1）分]、配偶性生活满意度评分[（11．2±1．4）分比（4．2±0．8）分,（10．9±0．9）分比（4．3±0．8）分,（9．7±0．8）分比（4．3±0．9）分]及CIPE-5评分[（21．1±4．0）分比（9．9±2．1）分,（18．1±3．0）分比（9．7±1．4）分,（16．9±1．2）分比（9．9±1．4）分]均较治疗前高,差异均有统计学意义（均P〈0．05）;治疗后3组问比较,手术组患者射精潜伏期较脱敏组和药物组长,患者、配偶性生活满意度评分及CIPE-5评分也较其余2组高,差异均有统计学意义（均P〈0．05）。3组患者总有效率分别为96．7％（145／150）、83．3％（125／150）和78．7％（118／150）,手术组的总有效率明显高于脱敏组和药物组,差异均有统计学意义（均P〈0．05）。结论手术、脱敏和药物均能有效治疗原发性早泄,但采用阴茎背神经选择性切断术的手术疗法疗效更好。     

达泊西汀的合成方法研究进展

达泊西汀是一种选择性5-羟色胺再摄取抑制剂,最初广泛用于治疗抑郁症和相关的情感障碍,后来又被用于男性早泄的治疗。该药具有化学稳定性好、起效迅速、不良反应相对较小等优点,已经越来越受到人们的关注。本文对达泊西汀的合成方法进行归纳总结。     

性感集中训练法联合西地那非治疗早泄的临床观察

目的 观察应用性感集中训练法联合西地那非治疗早泄的疗效.方法 32例早泄患者应用性感集中训练法治疗4周,并于性交前0.5～1 h口服西地那非50 mg,观察患者治疗前后、停药后4周及8周的阴道内射精潜伏期时间、阴道内射精潜伏期评分、患者性生活满意度、配偶性生活满意度.结果 治疗后,阴道内射精潜伏期时间及其评分、患者性生活满意度、配偶性生活满意度与治疗前比较,差异有统计学意义[(3.84±0.42)min比(0.72 ±0.20) min,(1.86±0.28)分比(2.52±0.21)分,(9.8±1.3)分比(4.8±1.5)分,(9.5±1.2)分比(4.6±1.3)分,P＜0.01或P＜0.05],停药后4、8周上述指标与治疗后比较,差异均无统计学意义(P＞0.05).结论 性感集中训练法联合西地那非对早泄有较好的治疗效果,能延长阴道内射精潜伏期、提高患者夫妻双方性生活满意度,且治疗效果稳定、复发率低.