早泄类型和年龄因素与盐酸达泊西汀临床疗效的相关性研究

目的:探讨早泄的类型和年龄因素与盐酸达泊西汀临床疗效的关系。方法:选取2018年10月至2020年1月在秦皇岛市第一医院生殖医学科男科门诊治疗的96例早泄患者作为研究对象。根据早泄的类型将患者分为原发组(原发性早泄)42例、继发组(继发性早泄)54例;再根据年龄将患者分为青年组(<35岁)46例、中年组(≥35岁)50例。各组患者均于性交前1~3 h给予盐酸达泊西汀30 mg,口服;所有患者均连续治疗2个月,停药1个月后随访。观察各组患者治疗前后阴道内射精潜伏期(IELT)、早泄诊断标准量表(PEDT)评分、早泄分析表(PEP)评分、临床疗效和复发情况。结果:(1)原发组、继发组患者治疗后和随访末期IELT、PEDT评分较治疗前有显著改善,且继发组患者治疗后和随访末期的IELT显著长于原发组,PEDT评分显著低于原发组,差异均有统计学意义(P<0.05)。两组患者治疗后和随访末期的各项PEP评分与治疗前比较,均有显著改善,差异有统计学意义(P<0.05)。治疗后和随访末期,继发组患者的射精控制能力和性生活满意度评分显著高于原发组,早泄相关苦恼、早泄对伴侣关系的影响评分显著低于原发组,差异均有统计学意义(P<0.05)。(2)青年组、中年组患者治疗后和随访末期IELT、PEDT评分较治疗前有显著改善,青年组患者的IELT显著长于中年组,而PEDT评分显著低于中年组,差异均有统计学意义(P<0.05)。两组患者治疗后和随访末期的各项PEP评分与治疗前比较,均有显著改善,差异均有统计学意义(P<0.05)。治疗后,青年组患者的射精控制能力评分显著高于中年组,早泄相关苦恼及早泄对伴侣关系的影响评分显著低于中年组;随访末期,青年组患者的早泄相关苦恼及早泄对伴侣关系的影响评分显著低于中年组,差异均有统计学意义(P<0.05)。(3)原发组、继发组患者的总有效率分别为71.43%(30/42)、88.89%(48/54),复发率分别为30.95%(13/42)、9.26%(5/54),21.42%(9/42)、7.41%(4/54)组间的差异均有统计学意义(P<0.05)。青年组、中年组患者的总有效率分别为89.13%(41/46)、72.00%(36/50),组间的差异有统计学意义(P<0.05);复发率分别为17.39%(8/46)、20.00%(10/50),组间的差异无统计学意义(P>0.05)。结论:盐酸达泊西汀治疗继发性早泄的临床效果优于原发性早泄,治疗青年早泄患者的临床效果优于中年早泄患者。

Study on the Correlation Between Types and Age Factors of Premature Ejaculation and Clinical Efficacy of Dapoxetine Hydrochloride

OBJECTIVE:To probe into the correlation between types and age factors of premature ejaculation and clinical efficacy of dapoxetine hydrochloride.METHODS:Totally 96 patients with premature ejaculation admitted into reproductive medicine department of First Hospital of Qinhuangdao from Oct.2018 to Jan.2020 were extracted to be divided into 42 cases in the primary group(primary premature ejaculation)and 54 cases in the secondary group(secondary premature ejaculation)according to different types of premature ejaculation.According to age,the patients were divided into 46 cases in the young group(<35 years)and 50 cases in the middle-aged group(≥35 years).All patents were given dapoxetine hydrochloride 30 mg orally from 1 h to 3 h before sex behavior,and all patients received continuous treatment for 2 months and followed up one month after drug withdrawal.The intravaginal ejaculation latency period(IELT),premature ejaculation diagnostic criteria scale(PEDT)score,premature ejaculation analysis scale(PEP)score,clinical efficacy and recurrence of patients in each group before and after treatment were observed.RESULTS:(1)IELT and PEDT scores in the primary group and the secondary group were significantly improved after treatment and at the end of follow-up compared with those before treatment,and IELT scores in the secondary group were significantly longer than those in the primary group after treatment and at the end of follow-up,while PEDT scores were significantly lower than those in the primary group,with statistically significant difference(P<0.05).PEP scores of two groups after treatment and at the end of follow-up were significantly improved compared with those before treatment,the difference was statistically significant(P<0.05).After treatment and at the end of follow-up,patients in the secondary group had significantly higher ejaculatory control and sexual satisfaction scores than those in the primary group,while the scores of premature ejaculation-related distress and impacts of premature ejaculation on partner relationship were significantly lower than those in the primary group,with statistically significant difference(P<0.05).(2)IELT and PEDT scores of the young group and the middle-aged group were significantly improved after treatment and at the end of follow-up compared with those before treatment,and IELT of the young group were significantly longer than those of the middle-aged group,while PEDT scores were significantly lower than those of the middle-aged group,with statistically significant difference(P<0.05).PEP scores of two groups after treatment and at the end of follow-up were significantly improved compared with those before treatment,with statistically significant difference(P<0.05).After treatment,the scores of ejaculation control ability in the young group were significantly higher than those in the middle-aged group,while the scores of premature ejaculation-related distress and impacts of premature ejaculation on partner relationship were significantly lower than those in the middle-aged group.At the end of follow-up,the scores of premature ejaculation-related distress and impacts of premature ejaculation on partner relationship in the young group were significantly lower than those in the middle-aged group,with statistically significant difference(P<0.05).(3)The total effective rates in the primary group and the secondary group were respectively 71.43%(30/42)and 88.89%(48/54),and the recurrence rates were respectively 30.95%(13/42)and 9.26%(5/54),the differences were statistically significant(P<0.05).The total effective rates of the young group and the middle-aged group were respectively 89.13%(41/46)and 72.00%(36/50),the difference was statistically significant(P<0.05);and the recurrence rates were respectively 17.39%(8/46)and 20.00%(10/50),with no statistically significant difference(P>0.05).CONCLUSIONS:The clinical efficacy of dapoxetine hydrochloride in the treatment of secondary premature ejaculation is better than that of primary premature ejaculation,and the clinical effects of dapoxetine hydrochloride in the treatment of young patients with premature ejaculation is better than that of middle-aged patients.