糖尿病患者少弱精症及勃起功能障碍的临床观察

目的 :探讨糖尿病患者少弱精症及勃起功能障碍的临床治疗及其效果.方法 :选取2012年1月~2016年12月我院收治的2型糖尿病80例男性患者为研究对象,所有患者均维持正常糖尿病饮食、药物治疗,治疗组加用枸橼酸西地那非片、右归活血汤.统计两组患者治疗前、后的相关指标,评价勃起功能障碍治疗效果.结果 :经治疗,两组患者糖化血红蛋白指标、前向运动精子百分率、正常精子形态率变化,均有所改善,且治疗组前向运动精子百分率、正常精子形态率变化改善情况要显著优于对照组,差异具有统计学意义(P<0.05);治疗组勃起功能障碍治疗总有效率92.86%,显著高于对照组的78.95%,差异具有统计学意义(P<0.05).结论 :临床上血糖控制的同时,加用中药温阳补肾,对于糖尿病患者少弱精症及勃起功能障碍的治疗效果显著,值得推广.     

还少胶囊加枸橼酸西地那非治疗中老年勃起功能障碍疗效观察

目的：探讨还少胶囊加枸橼酸西地那非治疗中老年男性勃起功能障碍的价值。方法：随机开放70例受试者在2周筛选期后进入8周的治疗期，A组还少胶囊加枸橼酸西地那非，还少胶囊10gBid，枸橼酸西地那非8周内至少服用8次。B组单用枸橼酸西地那非。在筛选期及研究结束时填写国际勃起功能问卷（IIEF）。研究者根据IIEF、受试者记事表和总评题对受试者进行疗效评价。结果：还少胶囊加枸橼酸西地那非联合使用后能明显提高性交满足感、性高潮、性欲。两组间差异有统计学意义。但并不提高患者的勃起情况和性生活总体满足感。服药后无严重不良事件发生。结论：对于中老年的ED患者，还少胶囊加枸橼酸西地那非治疗是有价值的。     

枸橼酸西地那非在男性勃起功能障碍和慢性心衰中的有效性和安全性

慢性心衰(CH F)是日益普遍的心血管病症。据报道,许多CH F患者在性活动的频次上出现中等到显著的减退,甚至75%的患者出现勃起功能障碍(ED)。目前几乎还没有可对照的临床资料显示枸橼酸西地那非对同时出现CH F和ED的男性患者的有效性和安全性,因此,本文评估了稳定型CFH患者的这些参数。这是一项双盲、有安慰剂对照并且药物剂量能灵活调整的研究。患有ED和稳定型CFH的男性患者随机地接受西地那非或安慰剂治疗12周。研究的主要结果是国际勃起功能指数评估系统的第3和第4个问题。次要的结果包括:国际勃起功能指数评估的5个功能问题、2…     

丹瓜方联合枸橼酸西地那非片治疗痰瘀型2型糖尿病勃起功能障碍的临床观察

<正>勃起功能障碍是临床男性常见疾病,近年来其发病率呈逐年上升趋势发展,给患者带来较大的心理压力,影响夫妻感情生活。勃起功能障碍可作为糖尿病的一种常见并发症出现,与无糖尿病的男性相比,糖尿病男性勃起功能障碍的发病率增加了3倍。目前,以枸橼酸西地那非片为代表的5型磷酸二酯酶(PDE-5)抑制剂是勃起功能障碍的一线治疗药物,但其对糖尿病勃起功能障碍的临床疗效尚有待提高,且存在一定程度的不良反应。研究~[1]表明,中西医结合治疗勃起功能障碍具有明显优     

西地那非治疗经尿道前列腺电切术后勃起功能障碍临床观察

目的研究西地那非对前列腺电切术(TURP)后勃起功能障碍(ED)的治疗效果。方法将26例TURP术后ED患者随机分为实验组和对照组,每组13人,分别口服西地那非和安慰剂,治疗前和治疗后4个月分别行国际勃起功能指数(IIEF)评估。结果 26例患者中,2例失访。治疗4个月后,实验组12例患者中10例(83.3%)勃起功能得到改善,IIEF评分中勃起功能、性交满意度、性高潮、总体满意度评分都显著高于治疗前(P<0.01);对照组只有2例(16.7%)勃起功能改善,IIEF评分治疗前后无显著差异。两组比较,上述各项指标均有显著性差异(P<0.05)。结论口服西地那非能显著改善TURP术后患者勃起功能障碍。     

枸橼酸西地那非片治疗勃起功能障碍176例的临床观察

目的　评价西地那非治疗勃起功能障碍 (ED)的安全性和有效性。方法　 176例诊断为 ED的病人 ,平均年龄 4 0 .5 9± 12 .4 0岁。根据患者需要 ,性生活前约 1小时口服枸橼酸西地那非片 (万艾可 ) 5 0～ 10 0 mg,疗程 1～ 3月。评估患者勃起功能改善的总体疗效及满意程度 ,并比较治疗前后国际勃起功能指数评分 - 5 (IIEF- 5 )。结果　共 16 6例患者完成治疗及随访。总体疗效评估勃起功能改善者共 139例 ,有效率为 83.73%。治疗满意者在勃起功能改善者中达5 1.80 %。 16 6例患者治疗前 IIEF- 5评分平均为 11.13± 3.70分 ,治疗后 17.71± 4 .4 7分 ,两者间差异显著。发生不良反应共 4 2例 (2 5 .30 % ) ,均为轻、中度 ,未经特殊处理自行缓解。结论　枸橼酸西地那非片是治疗各种病因、不同程度勃起功能障碍安全有效的口服药物     

昔多芬对眼部血流的影响

目的:研究一种治疗勃起功能障碍的普及新药昔多芬对眼部血流的影响。方法:前瞻性、双盲、安慰剂对照研究。给予20例患有勃起功能障碍的受试者单一口服剂量100m g的昔多芬,另10例勃起功能障碍患者给予安慰剂。所有受试者接受常规全身及眼科检查。服用昔多芬或安慰剂之前及1h后测量双眼眼压、收缩压及舒张压、眼部血流(眼动脉、中央视网膜动脉、睫状后短动脉)。采用彩色多普勒超声检查法进行眼部血流测量。结果:研究药物服用前两组间各参数无显著差别。在服药后1h,昔多芬组与安慰剂组相比,虽然中央视网膜动脉血流速度无变化,但眼动脉和睫状后…     

西地那非治疗勃起功能障碍182例的临床观察

目的 探讨西地那非对勃起功能障碍的治疗效果.方法 对182例不同原因的勃起功能障碍进行西地那非口服治疗,观察病人勃起功能改善情况.结果 本组病人临床总有效率为86.8%,满意程度达85.7%.药物减量或者停药后,副作用得到了缓解.没有不良事件的发生.结论西地那非对不同原因的勃起功能障碍都有良好的治疗效果,是一种安全、有效、方便的一线药物.     

维持性血液透析患者勃起功能障碍的初步研究

目的 :为了明确勃起障碍在透析患者中的发病率 ,及评价西地那非的疗效、副作用。方法 :以国际勃起功能指数 (IIEF)对 2 2例维持性血液透析男性患者进行评分 ,勃起障碍者每次给予西地那非 2 5mg ,5 0mg ,10 0mg ,治疗12周。对比治疗前后IIEF分值变化。结果 :正在接受血液透析患者勃起障碍发病率为 72 .73% ,西地那非总有效率为 87.5 % ,常见的副作用为头痛、面色潮红等。结论 :西地那非对于正在接受血液透析治疗的肾衰患者安全性和有效性等同于其它人群     

万艾可的安全应用问答

1　万艾可是什么 ?万艾可 ,即以前国内称呼的“伟哥” ,英文名Ｖｉａ ｇｒａ ,化学名枸橼酸西地那非 ,是用来治疗男性勃起功能障碍的口服药。目前国际国内的临床研究结果表明 :万艾可对各种原因引起的勃起功能障碍总体有效率约为 80 %。由于万艾可治疗男性勃起功能障碍简单、安全、方便和有良好的疗效 ,自美国食品与药物管理局 1 998年 3月2 7日批准该药上市以来 ,全球范围内已开出近 2 0 0 0万张处方、1亿 5千多万片万艾可 ,世界范围内已有1 0 0 0多万人接受了该药的治疗。2　万艾可的作用机制是什么 ?万艾可是ｃＧＭＰ 特异的磷酸二酯酶 (…     

Sildenafil for Treatment of Erectile Dysfunction in Men With Diabetes: A Randomized Controlled Trial

Context  Erectile dysfunction is common in men with diabetes. Objective  To assess the efficacy and safety of oral sildenafil citrate in the treatment of erectile dysfunction in men with diabetes. Design  A multicenter, randomized, double-blind, placebo-controlled, flexible dose-escalation study conducted May through November 1996. Setting  Patients' homes and 19 clinical practice centers in the United States. Patients  A total of 268 men (mean age, 57 years) with erectile dysfunction (mean duration, 5.6 years) and diabetes (mean duration, 12 years). Interventions  Patients were randomized to receive sildenafil (n=136) or placebo (n=132) as needed, but not more than once daily, for 12 weeks. Patients took the study drug or placebo 1 hour before anticipated sexual activity. The starting dose of sildenafil citrate was 50 mg, with the option to adjust the dose to 100 mg or 25 mg based on efficacy and tolerability, to be taken as needed. Main Outcome Measures  Self-reported ability to achieve and maintain an erection for sexual intercourse according to the International Index of Erectile Function and adverse events. Results  Two hundred fifty-two patients (94%) completed the study (131/136 in the sildenafil group, 121/132 in the placebo group). By intention-to-treat analysis, at 12 weeks, 74 (56%) of 131 patients in the sildenafil group reported improved erections compared with 13 (10%) of 127 patients in the placebo group (P<.001). The proportion of men with at least 1 successful attempt at sexual intercourse was 61% (71/117) for the sildenafil group vs 22% (25/114) for the placebo group (P<.001). Adverse events related to treatment were reported for 22 (16%) of 136 patients taking sildenafil and 1 (1%) of 132 patients receiving placebo. The most common adverse events were headache (11% sildenafil, 2% placebo), dyspepsia (9% sildenafil, 0% placebo), and respiratory tract disorder (6% sildenafil, 2% placebo), predominantly sinus congestion or drainage. The incidence of cardiovascular adverse events was comparable for both groups (3% sildenafil, 5% placebo). Conclusion  Oral sildenafil is an effective and well-tolerated treatment for erectile dysfunction in men with diabetes.      

Sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi

This prospective open-label extension study was carried out to evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi, Kenya. A total of 219 adult male patients with erectile dysfunction were instructed to take 50 mg, 25 mg, or 100 mg of sildenafil orally 1 hour prior to planned sexual activity, but not more than once every 24 hours. Patients were reviewed at 4-week intervals for 16 weeks to assess the efficacy and adverse effects of the drug. The age range was 33-80 years with a mean of 62.5 years and a peak incidence in the 60-69 year age group. The causes of erectile dysfunction were organic (n = 119, 54.34%), psychogenic (n = 85, 38.81%), and mixed (n = 15). 200 patients (91.32%) had improved sexual function after treatment with Viagra. This improvement included improved erectile and orgasmic functions and overall sexual satisfaction. 157 patients responded to the 50-mg treatment regimen; 40, to the 25-mg regimen; and 3, to the 100-mg regimen. No improvement in sexual function was reported in 19 patients (8.68%) after Viagra administration. In addition, 7 patients reported mild and transient adverse effects of the drug, including mild headache, dyspepsia, facial flushing, nausea, and vomiting. In conclusion, oral sildenafil (Viagra) is an effective well-tolerated and simple treatment for male erectile dysfunction in the majority of cases. However, the cost of treatment may prohibit and limit its wide use by many deserving patients in this area.     

Analogues of erectile dysfunction drugs: an under-recognised threat.

OBJECTIVES: To investigate the problem of drug analogue adulteration in male erectile dysfunction health products. DESIGN: Survey of over-the-counter male erectile dysfunction health products available in convenience stores and pharmacies in Hong Kong. SETTING: Tertiary referral centre for clinical toxicology analysis in Hong Kong. MAIN OUTCOME MEASURES: The pattern and extent of adulteration of male erectile dysfunction health products with sildenafil, tadalafil, and vardenafil as well as their structurally modified analogues. RESULTS: Of 26 products studied, one (4%) was found to contain undeclared sildenafil, while 14 (54%) contained drug analogues of different kinds. The latter included acetildenafil, hydroxyacetildenafil, hydroxyhomosildenafil, and piperidenafil. The first three were analogues of sildenafil and the last was an analogue of vardenafil. One young patient presented with ataxia after taking an acetildenafil-containing product. CONCLUSIONS: The positive rate of concealed drug analogues in male erectile dysfunction health products is alarmingly high. Such analogues are difficult to detect by ordinary laboratory methods, and might be used in an attempt to evade regulatory inspection. Without going through the stringent drug testing process, the adverse effects of these chemicals remain largely unknown and unpredictable. Effective surveillance system and control measures are needed urgently. The medical profession and the public should be alerted to this under-recognised threat.     

长期小剂量西地那非治疗勃起功能障碍58例

目的 探讨长期、小剂量西地那非治疗勃起功能障碍(ED)的疗效和相关机制.方法 分析2004年12月至2009年10月间我院门诊收治的部分ED患者长期、小剂量西地那非治疗勃起功能障碍的临床资料.结果 58例患者接受了为期6周的小剂量西地那非治疗.IIEF-5评分在服药第2周(16.47±2.71)、第6周(22.59±2...     

Management of male erectile dysfunction: a review

Male erectile dysfunction is common although some patients are embarrassed and delay seeking medical advice. Recent improvements in the understanding of the anatomy, physiology and pharmacotherapy of penile erections, and the introduction of intracavernosal pharmacotherapy has resolved most of the controversies regarding the aetiology of erectile dysfunction. Impotence is equally divided into organic and psychogenic causes. Arterial insufficiency, alcoholism, venosinusoidal, neurological and endocrine disorders are known to cause organic erectile dysfunction. Two most popular options in the management of erectile dysfunction are intracavernosal injections with vasoactive drugs like papavarine, phentolamine, and prostaglandin EI with discontinuation rates of 40-50%, and the use of external vacuum devices whose limitations include failure to achieve and maintain full erection. The use of inflatable penile prostheses is successful but limited with periprosthetic infection and cylinder erosion through the skin or urethra. Surgical procedures have included revascularisation of penile vessels without good results. Surgical ligation of penile veins for venosinusoidal incompetence has been successful compared to excision and embolisation which has disappointing results. Currently the role of oral medications in the treatment of erectile dysfunction is limited. However, there are now several new agents including sildenafil, a phosphodiasterase inhibitor, which is undergoing clinical trials that appear to be effective.     

心理行为疗法和西地那非治疗前列腺近距离放疗后勃起功能障碍的治疗体会

目的探讨采用心理行为疗法和西地那非治疗前列腺近距离放疗(PB)后患者勃起功能障碍(ED)的疗效。方法研究总共纳入22例单一的125I粒子置入前列腺近距离放疗后ED的患者,主要采用心理行为疗法进行治疗,在治疗开始时和以后每3个月完成国际勃起功能评分-5(IIEF-5)问卷调查,共随访12个月。在第3个月及后续随访期间时,如IIEF-5分数≤17分,则建议患者服用西地那非片。结果 22例患者的治愈率为86.4%,其中有15例患者仅采用心理行为疗法进行治疗,治愈率为93.3%;7例患者加用了西地那非片治疗(均在第3个月时),治愈率为71.4%。治疗开始时、第3个月和第12个月患者平均IIEF-5分数分别为:13.3、19.2和22.9(P<0.05)。结论心理行为疗法和西地那非治疗PB后ED能取得显著的疗效。     

Erectile dysfunction: comparison of efficacy and side effects of the PDE-5 inhibitors sildenafil,vardenafil and tadalafil--review of the literature

Since introduction of the PDE-5 inhibitor sildenafil 4 years ago, there has been a fundamental change in the treatment of erectile dysfunction (ED). Intracavernosal or intraurethral injections of vasoactive substances or penile implants as mechanical aids now play hardly any part in it. - The development of the PDE-5 inhibitors vardenafil and tadalafil prompts the question of whether and how these three substances differ in terms of their efficacy and adverse effects. - Sildenafil has proven to be a very effective medicinal product. Studies with a follow-up period of up to 6 years have been conducted. The success rate of sildenafil varies in the group of ED patients with an organic underlying disease from 43% in patients who have undergone radical prostatectomy to 85% in patients with a neurological underlying disease, and amounts to an average 82% (range 43-85%, 100mg). - In an evaluation of spontaneous reports of deaths associated with sildenafil, the FDA concluded that there was no deducible evidence of an increase in the mortality rate among sildenafil users compared to the general population. In fact, fewer deaths associated in time with the ingestion of sildenafil were reported than might have been expected purely statistically on the basis of the normal mortality rate for men in this age group. - According to the initial studies conducted, vardenafil and tadalafil demonstrate efficacy data approximately comparable to those of sildenafil. As yet, insufficient data are available to evaluate the adverse effects of vardenafil and tadalafil, particularly their long-term use and use in high-risk groups. - Sildenafil has already been used by over 20 million men in over 110 countries and is one of the best-studied pharmacological substances available. This adventage in terms of knowledge and safety data makes sildenafil a safe and reliable treatment for patients with erectile dysfunction.     

The use of sildenafil in patients with erectile dysfunction in relation to diabetes mellitus--a study of 1,511 patients

Erectile dysfunction (ED) seriously impairs the quality of life. Patients with diabetes mellitus (DM) are prone to ED due to various factors, including vasculopathy, neuropathy and sex hormone abnormalities. This is a retrospective study involving 1,511 patients taking sildenafil. Patients with DM have significantly more comorbidities like hypertension and ischaemic heart disease. They are also more likely to be on medications which may affect erectile function, including various antihypertensive drugs. 77.9% of patients with DM reported success with sildenafil, as compared to 86.5% of patients without DM. A significant number of patients with DM require a higher dose of sildenafil as compared to those without DM.     

Pharmacotherapy for erectile dysfunction

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