盐酸舍曲林治疗早泄的临床研究

目的:观察盐酸舍曲林(左洛复)治疗早泄的疗效和副作用。方法:以盐酸氟西汀(百忧解)为阳性对照,分别以口服盐酸舍曲林50mg/d和盐酸氟西汀20mg/d治疗早泄患者,疗程4周,通过问卷调查两种药物的疗效及副作用。结果:66例患者完成研究,两种药物治疗早泄的有效率盐酸舍曲林为73.7%(28/38)、盐酸氟西汀为71.4%(20/28),差异无统计学意义(P>0.05);两种药物的副作用发生率也无明显差异。结论:抗抑郁药盐酸舍曲林与盐酸氟西汀一样,也有良好的治疗早泄作用,但具有更好的患者依丛性。     

帕罗西汀与氯丙咪嗪治疗早泄的临床对照研究

目的：研究氯丙咪嗪与帕罗西汀治疗早泄的疗效和副作用。方法：选择先例DSM-Ⅳ上泄诊断标准的病人80名，随机分为帕罗西汀和氯丙咪嗪两个治疗组，病人每天服用帕罗西汀20mg或氯丙咪嗪30mg，4周后用自行编制的问卷评价治疗结果。结果：帕罗西汀组有5个病人脱落，氯丙咪嗪组脱落7个，两组之间在疗效和起效时间方面没有明显差异，氯丙咪嗪组副作用略多于帕罗西汀组。结论：两种药都可以用于治疗早泄，鉴于大剂量服用氯丙咪嗪有一定危险性，建议由有经验的医生使用。     

氟西汀治疗早泄的效果观察

目的 :评价氟西汀对早泄的治疗效果及停药后效果维持状况。方法 :将 6 8例早泄患者随机分为A组 :2 4例 ,每天口服氟西汀 2 0mg至研究结束 ;B组 :2 4例 ,每天口服氟西汀 2 0mg至 12周 ,然后改口服安慰剂至研究结束 ;C组 :2 0例 ,每天口服安慰剂至研究结束。分别测定治疗前 4周、治疗后 1周、12周、14～ 16周平均射精潜伏时间。结果 :3组治疗前平均射精潜伏时间差异无统计学意义 (P >0 .0 5 )。A组与B组平均射精潜伏时间经氟西汀治疗前后比较及与C组比较均有明显延长 ,差异有统计学意义 (P <0 .0 1) ;但B组在改服安慰剂后14～ 16周的平均射精潜伏时间与治疗前及对照组相比无统计学意义 (P >0 .0 5 )。结论 :氟西汀能显著延长射精潜伏时间 ,但停药后其疗效并不能维持。     

早泄的分类治疗

目的 :选择不同药物交叉治疗原发性和继发性两类早泄 ,并观察早泄分类疗法的效果。　方法 :将原发性早泄 4 8例随机分成A组 2 3例和B组 2 5例两组 ,将继发性早泄 5 2例随机分成C组 2 4例和D组 2 8例两组。给予A组和C组病人中药制剂回春如意胶囊 3粒 ,3次 /d ,口服 ;给予B组和D组病人帕罗西汀片 (Paroxetine) 2 0mg ,1次 /d ,口服 ,以上各组治疗 2 0d。以问卷方式了解治疗效果。　结果 :问卷结果表明 ,治疗后A组 5例 ( 2 2 % )有效 ,C组17例 ( 71% )有效 ,提示回春如意胶囊治疗继发性早泄的疗效显著优于原发性早泄 (P <0 .0 0 5 )。B组 17例 ( 68% )有效 ,D组 11例 ( 3 9% )有效 ,提示帕罗西汀片治疗原发性早泄的疗效显著优于继发性早泄 (P <0 .0 5 )。　结论 :有必要对早泄进行分类 ,根据早泄的类型选择药物治疗能够提高疗效。     

自拟固精汤联合帕罗西汀治疗早泄的临床观察

正早泄(premature ejaculation,PE)是男性性功能障碍中的一种常见疾病,发病率约为20%~30%,严重影响到夫妻的性生活质量,可导致焦虑、抑郁等精神症状~([1])。目前常用治疗早泄药物为选择性5-羟色胺再摄取抑制剂(SSRI),如达泊西汀、帕罗西汀、舍曲林、氟西汀等,但停药后复发率较高~([2])。本研究采用中药自拟固精汤联合帕罗西汀治疗早泄,取得较好的临床疗效,报道如下。     

赛乐特治疗早泄的临床研究

目的 :观察抗抑郁剂赛乐特 (盐酸帕罗西汀 )治疗早泄的疗效及副反应。　方法 :每日中午口服赛乐特 2 0mg ,疗程 4周 ;采用《抗抑郁剂治疗早泄疗效评定问卷》并进行修订 ,在治疗前后由病人填写调查问卷和疗效、副作用评价问卷。　结果 :4 3例门诊早泄病人纳入临床研究 ,治疗后病人射精潜伏期、性生活满意度及配偶性生活满意度均有较大改善 ,与治疗前比较 ,差异有极显著性 (P <0 .0 0 1) ;早泄改善起效时间平均为服药后 (11.2 6± 5 .79)d ;32例在停药后平均 (2 0 .94± 8.0 4 )d ,早泄反复到治疗前状态 ;7例病人性欲及性高潮程度升高 ,2例性欲降低 ;少数病人出现便秘、口干、失眠及皮肤瘙痒等不适。　结论 :抗抑郁剂赛乐特对早泄有较好的治疗作用。     

达泊西汀治疗早泄的临床观察

目的了解达泊西汀(第一个被批准用于治疗早泄的药物)治疗中国男性早泄患者的疗效。方法本研究为前瞻性、开放的自身对照研究。收集2014年2~4月在我院门诊就诊的早泄患者,所有患者接受30mg×6粒达泊西汀治疗,4周后随访,记录患者用药情况及副作用,比较用药前后患者阴道内射精潜伏时间、评估早泄量表及临床总体印象评分的变化。结果应用临床总体印象评分,63.6%(21/33例)的患者报告有效;患者治疗前阴道内射精潜伏时间平均为0.88min,治疗后平均为2.54min。副作用包括头晕、恶心、失眠、腹泻及射精困难,均轻微,可耐受。结论达泊西汀治疗中国早泄患者安全、有效。     

伊木萨克片联合盐酸氟西汀治疗早泄的临床研究

目的 研究伊木萨克片和盐酸氟西汀联合治疗早泄的可行性和效果.方法 将114例早泄患者随机分为3组,每组38例.A组患者单用伊木萨克片,1.5 g/d;B组患者单用盐酸氟西汀,20 mg/d;C组患者同时服用伊木萨克片和盐酸氟西汀,剂量同A、B组,连续服用4周.比较3组治疗前后的平均阴道内射精潜伏期(IELT)、国际勃起功能指数(IIEF)问卷中的患者及配偶性交满意度评分,观察治疗期间的不良反应.结果 114例早泄患者全部完成临床研究,所有患者平均IELT、患者及其配偶的性交满意度评分在治疗后较治疗前均显著增加,差异具统计学意义(P<0.01),单用盐酸氟西汀B组患者的IELT和性交满意度评分略好于单用药伊木萨克片A组,但两组间差异无统计学意义(P>0.05).联合用药C组患者的IELT和性交满意度评分则显著高于单用药A组和B组,差异均具有统计学意义(P<0.05).联合用药患者出现不良反应7例(18.4%),与单用药组比较差异无统计学意义.结论 联合应用伊木萨克片和盐酸氟西汀治疗早泄,疗效显著高于单用两种药物.     

盐酸氟西汀每日用药与按需给药在早泄治疗中的比较研究

目的 比较盐酸氟西汀每日用药与按需给药在早泄治疗中的不同疗效.方法 早泄患者84例,随机分成A和B组,每组42例.A组患者每口服用盐酸氟两汀,20 mg/d.B组患者按需给药盐酸氟西汀,30 mg/次.两组患者连续口服3月后,比较其治疗前后的平均阴道内射精潜伏期、国际勃起功能指数(IIEF)问卷中的配偶性交满意度评分及治疗期间的不良反应.结果 两组患者平均阴道内射精潜伏期,患者及其配偶的性交满意度评分在治疗后均显著增加(P＜0.01),盐酸氟两汀按需给药在射精潜伏期和性交满意度评分上比每日用药好些,但没有显著差异(P＞0.05).按需给药不良反应少于每日用药.结论 盐酸氟西汀可有效治疗早泄,按需给药优于每日用药.     

西地那非联合帕罗西汀治疗难治性早泄

目的评价两地那非联合帕罗西汀治疗难治性早泄的临床疗效。方法评估指标：早泄指数(PE) 0～8分(没有=0分,几乎每次=8分),阴道内射精潜伏期评分(1VELT评分)0～3分(超过5min=0分,小于lmin=3分),并记录配偶性交满意频度(SSR)。本组共28例,口服帕罗西汀片剂20mg,每天1次,连续4周为1疗程,性交前2～3h口服两地那非50mg；疗程共3次(持续约4月余),全部病例完成用药并获随访。用药前及3月后分别评估病人早泄指数、IVELT评分,记录阴道内射精潜伏时间和配偶性交满意频度。结果治疗前早泄指数平均为5．69±0．13,IVELT评分为2．81±0．21,治疗后早泄指数平均为1．77±0．22,IVELT为0．16±0．36。治疗前后比较差异均有统计学意义(P＜0．01)。早泄改善者共26例,总有效率为92．86%,其中22例(78．26%)显效。不良反应未经特殊处理自动缓解。结论两地那非与帕罗西汀联合应用能明显改善难治性早泄患者的临床症状。     

Effect of fluoxetine alone and in combination with sildenafil in patients with premature ejaculation

INTRODUCTION: The aim of this study was to compare the efficacy of fluoxetine alone and combined with sildenafil in patients complaining of premature ejaculation. PATIENTS AND METHODS: Ninety-one married potent men, 21-43 years old, with premature ejaculation but without any obvious organic cause were enrolled. Pretreatment evaluation included history, physical examination, and self-administration of the International Index of Erectile Function questionnaire. The patients were randomly divided into two groups: group A patients (n = 48) received 20 mg fluoxetine daily for 4 weeks and then 20 mg as needed 2-3 h before sexual activity for 4 months, and group B patients (n = 43) received group A regimen plus 50 mg sildenafil as needed 1 h before sexual activity for 4 months. RESULTS: Ejaculatory latency time and intercourse satisfaction significantly improved in group B as compared with group A (p < 0.05). CONCLUSION: Fluoxetine combined with sildenafil seems to provide significantly better ejaculatory latency time and intercourse satisfaction as compared with fluoxetine alone in patients with premature ejaculation.     

TREATMENT OF PREMATURE EJACULATION WITH PAROXETINE HYDROCHLORIDE AS NEEDED: 2 SINGLE-BLIND PLACEBO CONTROLLED CROSSOVER STUDIES

PURPOSE: We evaluate the efficacy of paroxetine hydrochloride as needed for the treatment of premature ejaculation. MATERIALS AND METHOD: Study 1 comprised 26 potent men with a mean age of 39.5 years with premature ejaculation who were randomized to receive 20 mg. oral paroxetine (group A) or placebo (group B) as needed 3 to 4 hours before planned intercourse in a controlled single-blind crossover trial. Study 2 comprised 42 potent men with a mean age of 40.5 years with premature ejaculation who were randomized to receive 10 mg. paroxetine daily for 3 weeks and then 20 mg. paroxetine as needed (group C) for 4 weeks or placebo daily for 3 weeks and then placebo as needed (group D) for 4 weeks. RESULTS: Mean pretreatment ejaculatory latency time was 0.3 minute for study 1. At 4 weeks mean ejaculatory latency time was 3.2 minutes in the paroxetine as needed and 0.45 in the placebo as needed phase for group A (p < 0.001), and 0.6 in the placebo as needed and 3.5 in the paroxetine as needed phase for group B (p < 0.001). There were no adverse effects with paroxetine or placebo in study 1. Mean pretreatment ejaculatory latency time was 0.5 minute for study 2. At 3 weeks mean ejaculatory latency time was 4.3 minutes in the paroxetine daily and 5.8 in the paroxetine as needed phase, and 0.9 in the placebo daily and 0.6 in the placebo as needed phase for group C (p < 0.001). At 3 weeks mean ejaculatory latency time was 0.8 minutes in the placebo daily and 1.1 in the placebo as needed phase, and 3.3 in the paroxetine daily and 6.1 in the paroxetine as needed phase for group D (p < 0.001). Adverse effects in 7 of 42 men (17%) given paroxetine daily included an ejaculation in 3, anorexia in 1, gastrointestinal upset in 3 and reduced libido in 2. Mean ejaculatory latency time was greater in the paroxetine as needed phase of study 2 than that of study 1 (p < 0.05), suggesting that ejaculatory control achieved with paroxetine as needed is significantly better if patients are initially treated with the drug daily. CONCLUSIONS: Paroxetine appears to be superior to placebo in the pharmacological treatment of premature ejaculation when administered on a chronic or as needed basis.     

The Efficacy of Fluoxetine in the Treatment of Premature Ejaculation: A Double-Blind Placebo Controlled Study

Purpose

The efficacy of the selective serotonin re-uptake inhibitor fluoxetine in the treatment of premature ejaculation was examined.

Materials and Methods

The study comprised 17 patients with premature ejaculation who presented to the urology clinic of our medical school. In this double-blind study the patients were randomized into treatment groups receiving 20 mg. fluoxetine daily for 1 week and 40 mg. daily afterward (group 1) or 1 capsule placebo daily for 1 week and 2 capsules daily afterward (group 2). The groups were evaluated according to the latent period of intravaginal ejaculation.

Results

The latent period of intravaginal ejaculation in group 1 was significantly longer than that in group 2. Nausea, headache and insomnia were reported side effects.

Conclusions

Fluoxetine may be regarded as a safe and effective alternative in the treatment of premature ejaculation.     

Effective daily treatment with clomipramine in men with premature ejaculation when 25 mg (as required) is ineffective

OBJECTIVE: To determine whether men with premature ejaculation who fail to respond to 25 mg clomipramine as needed improve when taking 10-30 mg clomipramine daily. SUBJECTS AND METHODS: Four men with premature ejaculation whose ejaculation latencies increased minimally or not at all when taking 25 mg clomipramine as needed participated in a prospective 12-week study consisting of four treatment phases, beginning with baseline (0 mg) and progressing through increasing daily doses of 10, 20, and 30 mg clomipramine. The subjects maintained daily logs of their sexual activities and estimated their ejaculatory response, sexual arousal and penile rigidity during intercourse. The subjects were contacted 8-15 weeks after the experiment to assess their satisfaction with and continued use of clomipramine. RESULTS: There was a dose-response effect on ejaculatory latency with increasing levels of clomipramine; 30 mg increased the latency from 25 s to 220 s, a clinically significant increase. In addition, 30 mg taken daily was significantly more effective than 25 mg as required. Other variables of sexual response (sexual interest, arousal and penile rigidity) were unaffected. At follow-up all four subjects expressed satisfaction and three continued the dose. CONCLUSION: Men with premature ejaculation who do not respond to clomipramine 'as required' are probably not insensitive to pharmacological treatment, but may simply require higher doses or a different regimen. All four subjects improved when taking daily clomipramine at varying doses. These results suggest that if initial treatment is unsuccessful, 20-30 mg daily clomipramine should be considered.     

西酞普兰治疗早泄的临床观察

目的:探讨西酞普兰治疗早泄的临床疗效和安全性。方法:将2011年5月至2012年5月男科门诊就诊的80例早泄患者随机分为治疗组和对照组,每组40例。治疗组每天口服西酞普兰20 mg,对照组口服安慰剂,记录治疗前、治疗2周和4周后患者阴道内射精潜伏时间(IELT)和性交满意度分值。结果:治疗组治疗2、4周后IELT分别为(5.64±1.31)min和(7.12±1.56)min,均比治疗前[(0.91±0.18)min]明显延长(P均<0.01),且西酞普兰治疗4周后的IELT明显高于2周后(P<0.01);治疗组治疗2、4周后性交满意度分别为(6.1±1.3)分和(6.3±1.1)分,与治疗前[(2.5±0.8)分]相比有明显提高(P<0.01),而治疗2周和4周后性交满意度无显著性差异(P>0.05)。对照组治疗2、4周后IELT和性交满意度分别为(1.02±0.24)min、1.01±0.21 min和(3.0±1.1)分、(3.1±1.3)分,与治疗前[(0.95±0.17)min和(3.2±1.2)分]比较,均无显著性差异(P均>0.05)。结论:每天口服西酞普兰20 mg,对早泄患者IELT和性交满意度均有明显改善,西酞普兰治疗早泄具有较好的临床疗效和安全性。     

复方玄驹胶囊联合性感集中训练法治疗早泄的疗效观察

目的:观察复方玄驹胶囊联合性感集中训练法治疗早泄的疗效。方法:52例早泄患者,分为治疗组(28例)和对照组(24例)。两组患者均采用性感集中训练,治疗组同时服用复方玄驹胶囊3粒,3次/d。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改善率和治愈率分别为67.86%和21.43%,均显著优于对照组。结论:复方玄驹胶囊联合性感集中训练法治疗早泄的临床有效率较高,不良反应较少。