麒麟丸联合舍曲林治疗继发性肾气不固型早泄临床观察

目的:观察麒麟丸联合舍曲林治疗继发性肾气不固型早泄的临床疗效。方法:将2012年7月至2013年12月男科门诊120例继发性肾气不固型早泄患者随机均分为A组、B组和C组,年龄分别为(35.5±5.4)岁、(36.2±5.7)岁和(35.2±5.3)岁(P0.05)。A组给予麒麟丸每次6 g,每天分早晚两次口服;B组给予舍曲林每次50 mg,1次/d口服;C组给予麒麟丸每次6 g,每天分早晚两次口服,联合舍曲林每次50 mg,1次/d口服。3组均4周为1个疗程。分别于治疗前、治疗结束后及停药1个月观察射精潜伏期(IELT)、早泄诊断标准评分(PEDT)变化。结果:3组患者IELF治疗前分别为(0.88±0.45)、(0.84±0.47)、(0.85±0.50)min,治疗后分别为(3.23±1.84)、(3.87±2.43)、(5.92±3.11)min,停药1个月后分别为(1.85±1.27)、(1.52±1.06)、(4.26±1.88)min。治疗后IELT均较治疗前改善(P0.01);3组间比较,C组改善程度更为明显,优于其他两组(P0.01)。3组患者PEDT评分治疗前分别为(13.2±3.2)、(12.8±3.1)、(13.1±3.4)分,治疗后分别为(5.1±1.8)、(4.9±1.7)、(3.8±1.2)分,停药1个月后分别为(8.2±2.4)、(8.1±2.4)、(6.5±2.1)分。治疗后PEDT评分均较治疗前改善(P0.01);3组间比较C组改善程度更为明显,优于其他两组(P0.01)。结论:麒麟丸联合舍曲林治疗继发性肾气不固型早泄疗效确切,值得临床推广应用。     

Comparison of the safety and efficacy of the on-demand use of sertraline,dapoxetine, and daily use of sertraline in the treatment of patients with lifelong premature ejaculation: A prospective randomised study

This study compared the safety and efficacy of the on-demand (OD) use of sertraline (50 mg), sertraline (100 mg) and dapoxetine (30 mg), and the daily use of sertraline (50 mg) in the treatment of patients with premature ejaculation (PE). This prospective randomised study involved 120 lifelong PE patients (intravaginal ejaculatory latency time [IELT]: <1 min; Arabic Index of Premature Ejaculation [AIPE] score: < 30) without secondary causes of PE, identified between March 2018 and May 2020. Patients were divided into 4 groups (30 patients per group) and treated for 8 weeks. Assessments were conducted using the AIPE form as a diagnostic tool. Sertraline (50 mg, daily; 196.7 ± 115.5 s) and sertraline (100 mg, OD; 173.3 ± 97.0 s) had similar IELT and AIPE scores. The latter groups had better results in comparison with sertraline (50 mg, OD; 100.5 ± 54.4 s) and dapoxetine (93.7 ± 53.5 s; p < 0.01). Sertraline (100 mg, OD) had a similar efficacy to that of sertraline (50 mg, daily) and was more effective than sertraline (50 mg, OD) and dapoxetine (30 mg, OD). Sertraline (100 mg, OD) can be considered in the treatment of lifelong PE treatment, having tolerable side effects.     

The pharmacokinetics of sertraline in overdose and the effect of activated charcoal

Aims

To investigate the pharmacokinetics (PK) of sertraline in overdose and the effect of single dose activated charcoal (SDAC).

Methods

Patients presenting to a toxicology unit with sertraline overdoses had demographic and clinical information recorded, and serial serum collected for measurement of sertraline concentrations. Monolix® version 4.2 was used to develop a population PK model of sertraline overdose and the effect of SDAC. Uncertainty in dose time was accounted for by shifting dose time using lag time with between subject variability (BSV). BSV on relative fraction absorbed was used to model uncertainty in dose.

Results

There were 77 timed sertraline concentrations measured in 28 patients with sertraline overdoses with a median dose of 1550 mg (250–5000 mg). SDAC was given to seven patients between 1.5 and 4 h post-overdose. A one compartment model with lag time of 1 h and first order input and elimination adequately described the data. Including BSV on both lag time and relative fraction absorbed improved the model. The population PK parameter estimates for absorption rate constant, volume of distribution and clearance were 0.895 h⁻¹, 5340 l and 130 l h⁻¹, respectively. The calculated half-life of sertraline following overdose was 28 h (IQR 19.4−30.6h). When given up to 4 h post-overdose, SDAC significantly increased the clearance of sertraline by a factor of 1.9, decreased the area under the curve and decreased the maximum plasma concentration (C_max).

Conclusions

Sertraline had linear kinetics in overdose with parameter values similar to those in therapeutic use. SDAC is effective in increasing clearance when given 1.5 to 4 h post-overdose.     

舍曲林对阿立哌唑治疗阴性症状为主精神分裂症的增效作用

目的探讨阿立哌唑联合舍曲林治疗阴性症状为主的精神分裂症的疗效与安全性。方法将120例阴性症状为主的精神分裂症患者随机分入试验组和对照组,每组60例,试验组采用阿立哌唑和舍曲林片口服治疗,而对照组只采用阿立哌唑口服治疗。观察治疗12周,用阳性与阴性综合征量表（PANSS）和副反应量表评定临床疗效和安全性。结果在治疗后第8、12周末,试验组临床疗效优于对照组（Z分别=-2.11、-2.03,P均＜0.05）。在治疗后第2、4、8、12周末,试验组PANSS（阳性症状除外）评分均低于对照组（t分别=-4.39、-2.25、-4.71;-6.44、-4.36、-6.87;-5.12、-2.61、-4.89;-4.03、-2.63、-4.61,P均＜0.05）。除了阳性症状外,不同干预手段、不同时间及两者交互效应对于PANSS评分中的阴性症状、精神病理及总分结果均有明显影响（P均＜0.05）。 TESS评分组间比较,差异均无统计学意义（t分别=-0.43、1.58、1.21、1.59、1.70,P均＞0.05）。结论舍曲林联合阿立哌唑治疗阴性症状为主精神分裂症有明显的增效作用,不良反应未见明显增加。     

舍曲林与氯米帕明治疗强迫症对照观察

目的：探讨舍曲林与氯米帕明治疗强迫症的临床疗效和安全性。方法将62例强迫症患者随机分为两组,分别给予舍曲林、氯米帕明治疗,观察8周。采用耶鲁‐布朗强迫量表、副反应量表评定临床疗效及不良反应。结果治疗2周末起两组耶鲁‐布朗强迫量表评分均较治疗前显著降低（P＜0．01）,同期两组比较差异无显著性（P＞0．05）。两组总有效率比较差异无显著性（P＞0．05）,舍曲林组不良反应发生率显著低于氯米帕明组（P＜0．01）。结论舍曲林治疗强迫症疗效显著,与氯米帕明相当,但舍曲林安全性高。