盐酸达泊西汀治疗男性早泄及提高女性伴侣性满意度的临床观察
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摘要
目的比较盐酸达泊西汀及盐酸舍曲林治疗早泄患者及提高女性伴侣性满意度的疗效。方法选取我院2014年11月至2016年5月门诊早泄患者206例随机分组,分为A组(103例,按需服用盐酸达泊西汀30mg),B组(103例,每日一次盐酸舍曲林50mg),4周后随访,记录治疗前后的阴道内射精潜伏时间(IELT),国际勃起功能评分表(IIEF-5)以及性伴侣的性满意度(非常满意、基本满意、平平、不满意、非常不满意),用药后临床总印象变化(CGIC)评分,并记录不良反应。结果治疗后A组及B组IELT均显著提高[A组由(1.02±0.45)min提升到(5.17±2.13)min;B组由(0.96±0.37)min提升到(4.56±1.57)min]。治疗后IIEF-5评分两组较前均有下降[A组由(23.7±1.9)分降低到(19.6±2.3)分;B组由(23.2±2.2)分降低到(16.9±3.4)分],差异有统计学意义(P<0.05),治疗后IIEF-5评分B组较A组下降明显,差异有统计学意义(P<0.05)。应用CGIC评分,用药后效果A组与B组有效的比率分别为73%与68%;性伴侣的性满意度A组从25%提升到52%,B组从23%提升到53%。B组出现的食欲不振、恶心等不良反应明显多于A组,差异有统计学意义(P<0.05)。结论按需服用盐酸达泊西汀治疗早泄患者能够提升IELT以及女性伴侣的性满意度,不良反应低,值得临床推广。
Objective To evaluate the efficacy and adverse effects between dapoxetine and sertraline in the treatment of male premature ejaculation and female sexual dissatisfaction. Methods Total of 206 patients with premature ejaculation in outpatient department were recruited during 2014.11-2016.5, they were randomly assigned to the treatment group(30 mg dapoxetine on demand, n = 103) or the control group(50 mg sertraline qd for 4 weeks, n = 103) in the proportion of 1:1. Follow-up was conducted after 4 weeks. The intravaginal ejaculatory latency time(IELT), International Index of Erectile Function(IIEF-5), female sexual function index( FSFI), clinical global impression of change(CGIC) score, and adverse reactions of the patients were recorded and compared between the two groups. Results IELT was significantly increased in both the dapoxetine group(from 1.02±0.45 to 5.17±1.23 min, P <0.05) and the sertraline group( from 0.96±0.37 to 4.56±1.57 min, P <0.05) after medication.IIEF-5 score were significantly declined in both groups(from23.7±1.9 to 18.6±2.3 in dapoxetine group, from23.2±2.2 to 16.9±3.4 in sertraline group). After treatment, the IIEF-5 score of group B was significantly lower than that of group A, P <0.05. Based on the CGIC scores, the rate of effectiveness was 73% in the dapoxetine group and 68% in the sertraline group. The degree of sexual satisfaction was elevated from 25% to 52% in the dapoxetine group and from 23% to 54% in the sertraline group. The incidence rates of nausea,inappetence were significantly higher(P <0.05) in the sertraline group. Conclusion On-demand oral medication of dapoxetine is effective and well-tolerated for the treatment of male premature ejaculation and female sexual dissatisfaction.
Objective To evaluate the efficacy and adverse effects between dapoxetine and sertraline in the treatment of male premature ejaculation and female sexual dissatisfaction. Methods Total of 206 patients with premature ejaculation in outpatient department were recruited during 2014.11-2016.5, they were randomly assigned to the treatment group(30 mg dapoxetine on demand, n = 103) or the control group(50 mg sertraline qd for 4 weeks, n = 103) in the proportion of 1:1. Follow-up was conducted after 4 weeks. The intravaginal ejaculatory latency time(IELT), International Index of Erectile Function(IIEF-5), female sexual function index( FSFI), clinical global impression of change(CGIC) score, and adverse reactions of the patients were recorded and compared between the two groups. Results IELT was significantly increased in both the dapoxetine group(from 1.02±0.45 to 5.17±1.23 min, P <0.05) and the sertraline group( from 0.96±0.37 to 4.56±1.57 min, P <0.05) after medication.IIEF-5 score were significantly declined in both groups(from23.7±1.9 to 18.6±2.3 in dapoxetine group, from23.2±2.2 to 16.9±3.4 in sertraline group). After treatment, the IIEF-5 score of group B was significantly lower than that of group A, P <0.05. Based on the CGIC scores, the rate of effectiveness was 73% in the dapoxetine group and 68% in the sertraline group. The degree of sexual satisfaction was elevated from 25% to 52% in the dapoxetine group and from 23% to 54% in the sertraline group. The incidence rates of nausea,inappetence were significantly higher(P <0.05) in the sertraline group. Conclusion On-demand oral medication of dapoxetine is effective and well-tolerated for the treatment of male premature ejaculation and female sexual dissatisfaction.
引文
1蒲春晓,董强,韩平.早泄的药物治疗进展.华西医学2014;29(9):1795-1799
2刘继红,饶可.早泄的研究现状.中国男科学杂志2009;23(2):1-3,8
3 Gur S,Kadowitz PJ,Sikka SC.Current therapies for premature ejaculation.Drug Discov Today 2016;21(7):1147-1154
4 Waldinger MD.Pharmacotherapy for premature ejaculation.Expert Opin Pharmacother 2015;16(17):2615-2624
5郭军,张春影,张国喜,等.PE筛査与医患沟通-PE诊治中国专家共识.中国男科学杂志2016;(6):57-60
6 Du J,Ruan X,Gu M,et al.Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index:an internet-based survey.Eur J Contracept Reprod Health Care 2016;21(3):259-263
7 Serefoglu EC,Saitz TR.New insights on premature ejaculation:A review of definition,classification,prevalence and treatment.Asian J Androl 2012;14(6):822-829
8周乐友,冯华国,王仁顺.早泄的治疗现状.中国男科学杂志2010;24(2):70-72
9高晶晶,张贤生,刘吉双,等.从性伴侣的心理角度分析早泄患者抑郁发病的风险.中国男科学杂志2013;27(7):27-31
10侯继开,曲海明,李一竹,等.早泄的诊疗进展.现代生物医学进展2014;14(7):1392-1397
11朱勇,乐进,刘正建,等.盐酸舍曲林联合“三采嬉戏”疗法治疗原发性早泄的疗效观察.中华男科学杂志2015;21(12):1116-1120
12 McMahon C,Lee SW,Kim SW,et al.The AsiaPacific Flexible Dose Study of Dapoxetine and Patient Satisfaction in Premature Ejaculation Therapy:The PASSION Study.Sex Med 2016;4(1):e18-e27
13杨林,雒磊,陈兴发,等.达泊西汀治疗早泄的临床观察.现代泌尿外科杂志2014;19(8):505-507.
14罗秋莎,王海臣,彭涛.性满意度影响因素的相关研究.中国性科学2013;22(7):106-111
2刘继红,饶可.早泄的研究现状.中国男科学杂志2009;23(2):1-3,8
3 Gur S,Kadowitz PJ,Sikka SC.Current therapies for premature ejaculation.Drug Discov Today 2016;21(7):1147-1154
4 Waldinger MD.Pharmacotherapy for premature ejaculation.Expert Opin Pharmacother 2015;16(17):2615-2624
5郭军,张春影,张国喜,等.PE筛査与医患沟通-PE诊治中国专家共识.中国男科学杂志2016;(6):57-60
6 Du J,Ruan X,Gu M,et al.Prevalence of and risk factors for sexual dysfunction in young Chinese women according to the Female Sexual Function Index:an internet-based survey.Eur J Contracept Reprod Health Care 2016;21(3):259-263
7 Serefoglu EC,Saitz TR.New insights on premature ejaculation:A review of definition,classification,prevalence and treatment.Asian J Androl 2012;14(6):822-829
8周乐友,冯华国,王仁顺.早泄的治疗现状.中国男科学杂志2010;24(2):70-72
9高晶晶,张贤生,刘吉双,等.从性伴侣的心理角度分析早泄患者抑郁发病的风险.中国男科学杂志2013;27(7):27-31
10侯继开,曲海明,李一竹,等.早泄的诊疗进展.现代生物医学进展2014;14(7):1392-1397
11朱勇,乐进,刘正建,等.盐酸舍曲林联合“三采嬉戏”疗法治疗原发性早泄的疗效观察.中华男科学杂志2015;21(12):1116-1120
12 McMahon C,Lee SW,Kim SW,et al.The AsiaPacific Flexible Dose Study of Dapoxetine and Patient Satisfaction in Premature Ejaculation Therapy:The PASSION Study.Sex Med 2016;4(1):e18-e27
13杨林,雒磊,陈兴发,等.达泊西汀治疗早泄的临床观察.现代泌尿外科杂志2014;19(8):505-507.
14罗秋莎,王海臣,彭涛.性满意度影响因素的相关研究.中国性科学2013;22(7):106-111