氟西汀、帕罗西汀和氯丙米嗪治疗早泄的临床研究

目的 :比较氟西汀、帕罗西汀、氯丙米嗪治疗早泄的疗效和副作用。方法 :分别以口服氟西汀 2 0mg/d、帕罗西汀 2 0mg/d和氯丙米嗪 5 0mg/d治疗早泄 ,疗程 4周 ,通过问卷调查三种药物的疗效及副作用。 结果 :74例患者完成疗程 ,三种药物治疗早泄的有效率氟西汀为 70 .4 %、帕罗西汀为 73.0 %、氯丙米嗪为 76 .1% ,差异无统计学意义 (P >0 .0 5 )。其中氟西汀的副作用发生率较低。结论 :治疗早泄氟西汀能提高患者依从性 ,间接提高治疗成功率     

舍曲林治疗无效的早泄患者应用达泊西汀的疗效观察

目的观察达泊西汀用于舍曲林治疗无效的早泄患者的疗效。方法收集2017年10月至2020年10月应用舍曲林(50mg)治疗早泄的患者,按照治疗早泄的疗效分为舍曲林治疗有效组(有效组)和舍曲林治疗无效组(无效组),洗脱后两组均改用达泊西汀30mg按需口服,观察两组阴道内射精潜伏时间(IELT)、早泄评估量表(PEP)、临床总体印象评分(CGIC)及不良反应发生情况。结果 106例患者中,97例患者完成随访。有效组(56例)与无效组(41例)患者治疗前各项指标无统计学差异(P0.05),治疗后4、12周两组患者IELT、PEP、CGIC均较基线值明显改善,两组疗效相似,无明显的统计学差异(P0.05)。两组不良反应发生率无明显差别。结论口服舍曲林无效的患者改服达泊西汀仍然有较好的效果;达泊西汀治疗早泄的效果与舍曲林是否有效无关。     

盐酸达泊西汀治疗早泄的临床观察

目的:比较盐酸达泊西汀及舍曲林治疗早泄患者的疗效及不良反应。方法:门诊就诊的早泄患者按2∶1比例随机分配接受盐酸达泊西汀(30 mg,按需服用,n=78)或舍曲林(50 mg,每日1次,n=39)治疗,4周后随访,记录用药前后的阴道内射精潜伏时间(IELT),用药后临床总体印象变化(CGIC)评分,并记录不良反应。结果:经治疗后盐酸达泊西汀组及舍曲林组IELT均显著增加[盐酸达泊西汀:(0.87±0.31)min延长至(2.84±0.86)min;舍曲林:(0.84±0.28)min延长至(2.71±0.92)min]。应用CGIC评分,用药后效果很好或好的比率分别为36.5%及37.5%(盐酸达泊西汀vs舍曲林);CGIC评价有效(很好、好、稍好)的比率分别为63.5%和71.9%。舍曲林组头晕、恶心、头痛及腹泻的发生率稍高于盐酸达泊西汀组但差异不具显著性,但舍曲林组疲劳、嗜睡以及口干的发生率显著高于盐酸达泊西汀组(P0.05)。结论:按需口服盐酸达泊西汀治疗早泄患者安全有效。     

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.     

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。     

疏肝益阳胶囊联合舍曲林治疗早泄临床观察

目的:观察疏肝益阳胶囊联合盐酸舍曲林治疗早泄(PE)的临床疗效。方法:192例早泄患者随机分为盐酸舍曲林联合疏肝益阳胶囊治疗组和单用盐酸舍曲林对照组,对照组口服盐酸舍曲林片,50 mg/次,每晚1次。治疗组在对照组基础上,予疏肝益阳胶囊,4粒/次,3次/日口服。两组均连续治疗6周。评定治疗前、治疗6周后、停药6周后中国早泄患者性功能评价表(CIPE-5)评分及阴道内射精潜伏期(IELT)。结果:治疗组IELT:治疗前为(1.41±0.53)min,治疗6周后为(6.69±3.56)min;CIPE-5评分:治疗前(9.80±2.06)分,治疗6周后为(21.62±4.76)分。对照组IELT:治疗前为(1.43±0.48)min,治疗6周后为(5.37±2.91)min;CIPE-5评分:治疗前(9.41±1.97)分,治疗6周后为(20.85±4.83)分。两组患者各指标治疗6周后较治疗前均显著改善(P均0.05)。对照组停药6周后IELT时间[(1.19±1.34)min]与CIPE-5评分[(10.59±2.38)分]与治疗前相比较均无显著差异(P0.05);治疗组在停药6周后IELT时间[(3.77±1.63)min]、CIPE-5评分[(16.92±3.37)分],与治疗前相比较,差异均有显著性(P均0.05)。结论:疏肝益阳胶囊联合舍曲林治疗早泄疗效确切,效果持久。     

综合治疗单纯性早泄的临床观察

目的:观察综合疗法治疗早泄的临床效果。方法:110例早泄患者随机分成2组:综合治疗组60例(心理、性知识指导,局部涂抹中药酊剂、口服盐酸舍曲林50mg),对照组50例仅口服盐酸舍曲林50mg。以射精潜伏期、夫妻对性生活满意度为疗效判断标准,对治疗4周结束时及停药4周后疗效评估。结果:治疗4周时总有效率综合治疗组为91.6%,对照组为76%,两组比较差异有显著性(P<0.05),停药4周总有效率综合治疗组为68.3%,对照组为42%,两组比较差异有显著性(P<0.01)。结论:应用综合疗法治疗早泄临床效果、效果稳定性满意。     

舍曲林和伐地那非治疗合并勃起功能障碍的早泄患者的临床观察

目的:评价舍曲林和伐地那非治疗合并勃起功能障碍(ED)的早泄患者的临床疗效和安全性。方法:60例诊断为合并ED的早泄患者随机分为舍曲林组和伐地那非组,每组30例。舍曲林组每天服用舍曲林50 mg,疗程2个月。伐地那非组每次性生活前服用伐地那非10~20 mg,疗程2个月。以治疗前后IIEF-5评分的改变来评价ED治疗效果,以治疗前后阴道内射精潜伏期(IELT)的变化来评价早泄治疗效果。结果:伐地那非组勃起功能改善24例,有效率为80%;而舍曲林组仅8例勃起功能改善,有效率为27%,两者差异有显著性(P<0.05)。伐地那非组早泄改善20例,有效率为67%;而舍曲林组早泄改善12例,有效率为40%,两者差异有显著性(P<0.05)。两组患者中,勃起功能改善者的早泄治疗的有效率均显著高于勃起功能无改善者。两组的不良反应均为轻度,无停药者。结论:对合并ED的早泄患者,改善患者的勃起功能是关键。     

盐酸达泊西汀联合小剂量他达拉非治疗原发性早泄的前瞻性随机对照临床研究

目的:评价盐酸达泊西汀联合小剂量他达拉非治疗原发性早泄(PE)的临床疗效。方法:收集原发性PE患者97例,随机分成对照组(n=46)和治疗组(n=51),对照组性交前按需口服盐酸达泊西汀30mg;治疗组性交前按需口服盐酸达泊西汀片30mg,同时每日服用(OAD)小剂量他达拉非片5mg,疗程12周。嘱患者在治疗期间规律性生活,每月性生活≥4次,治疗前后行中国早泄患者性功能评价表5(CIPE-5)评分及阴道内射精潜伏期(IELT)测评并做好相关记录。结果:与治疗前比较,治疗后两组CIPE-5评分及IELT均明显提高,差异有统计学意义(P0.05)。与对照组比较,治疗后治疗组的CIPE-5评分及IELT改善更为明显,差异有统计学意义(P0.05)。两组患者治疗期间不良事件发生率差异无统计学意义(P0.05),不良事件可自行缓解。结论:盐酸达泊西汀联合小剂量他达拉非治疗原发性PE安全有效。     

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。     

舍曲林个体化治疗原发性早泄的疗效分析

目的 比较不同剂量舍曲林治疗原发性早泄的临床疗效.方法选择86例符合原发性早泄诊断的患者,治疗前评估国际勃起功能评分表、中国早泄患者性功能评价表.第一阶段治疗4周,每日服用盐酸舍曲林50 mg并配合行为疗法.4周后,根据疗效和不良反应将患者分为3组进入第二阶段治疗4周:有效且无或有轻微不良反应者继续原治疗;无效但无明显不良反应者,舍曲林剂量凋整为每日100 mg;有效但有明显不良反应者舍曲林剂量调整为每日25 mg;无效且有明显不良反应、不能耐受者退出观察.结果86例第一阶段4周治疗后,有效63例(73.3%),无效23例(26.7%).其中,无明显不良反应53例(61.6%),有不良反应33例(38.4%).第二阶段治疗中,有效组中35例无明显不良反应和12例有轻微不良反应者继续原治疗,16例有明显不良反应且不能耐受者舍曲林剂量调整为每日25 mg.无效组中,18例无明显不良反应者将舍曲林剂量凋整为每日100 mg,5例退出观察.8周治疗后,50 mg组47例均有效,无明显不良反应;25 mg组中有效10例,无效6例,2例有轻微不良反应且可耐受;100 mg组中有效8例(44.4%),13例(72.2%)有不良反应但可以耐受,2例因明显不良反应退出治疗,1例无效且无明显不良反应.8周总有效率80.2%(65/81),总不良反应发生率21.0%(17/81).结论舍曲林治疗原发性早泄安全有效,个体化治疗方案有效率无明显变化,不良反应发生率显著降低,患者对治疗的依从性增加.

Abstract：

Objective To compare the therapeutic effects with different dosages of sertraline on patients suffering from idiopathic premature ejaculation. Methods IIEF-5 and CIPE questionnaires were completed before the treatment, and 86 patients who met the diagnostic standard of idiopathic premature ejaculation were finally recruited. Subjects were administered sertraline 50 mg/d combined with behavior therapy at stage Ⅰ for 4 weeks. Then, according to the therapeutic effects and the adverse events, all of the patients were divided into 3 groups for stage Ⅱ (another 4 weeks) as ①subjects with good effectiveness but with no or slight adverse events,would continue the treatments ②subjects with no therapeutic effects and with no obvious adverse events were allowed to increase the dosage of sertraline to 100 mg/d;③patients with effectiveness and obvious adverse events were al follows:lowed to reduce the dosage of sertraline to 25 mg/d. Those who had obvious adverse events and no effectiveness quit the study. Results During stage Ⅰ , 63 of 86 patients were effective (73.3%), and 23 patients had no improvement (26. 7%). Thirty-three patients had adverse events (38. 4%), and the remaining 53 patients had no obvious adverse events (61.6%). During stage Ⅱ , of the patients that responded to treatment, 35 patients who had no adverse events and 12 who had slight adverse events continued the treatment. Furthermore, 16 with intolerable adverse events were allowed to reduce the dosage to 25 mg/d. Meanwhile, of those without improvement, 18 subjects without obviousadverse events were allowed to increase the dosage to 100 mg/d, and 5 patients discontinued the treatment. Eight weeks later, among the patients taking 50 mg/d, 47 subjects were effectively with no obvious adverse events. Among the patients taking 25 mg/d, 10 showed improvement, 6 showed no improvement, and 2 had tolerable slight adverse events. Among the patients taking sertraline 100 mg/d,8 witnessed effectiveness, 13 had tolerable adverse events and 2 discontinued the treatment, with 1 having neither effectiveness nor obvious adverse events. The adverse events rate was 21.0% and the total effective rate of 8 weeks of treatment was 80.2 %. Conclusions Sertraline administration is an effective and safe way to treat idiopathic premature ejaculation. Although the effectiveness of the individualized treatment had no obvious improvement comparing routine therapy, there was a notable reduction in the adverse events rate, which increased the patient compliance.     

Treatment of premature ejaculation with sertralin

To evaluate the efficacy of oral sertralin in the treatment of premature ejaculation, out of 22 patients with premature ejaculation 16 received oral sertralin, 50 mg a day for at least 2 weeks. Four patients were lost to follow-up. Two patients interrupted treatment due to side effects of sertralin. Out of 16 patients who completed at least a two-week period of treatment 14 (87.5%) responded clinically. Clinical response was achieved in the first week of treatment in 11 of 16 responders (68.75%). We conclude that low dose oral sertralin may be useful with a reasonable side effect rate in the treatment of patients suffering from premature ejaculation.     

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.     

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。     

早泄患者精浆生化指标测定及其意义

目的:观察早泄患者精浆生化指标的变化,探讨其与早泄的关系。方法:根据WHO对早泄的定义,随机选取56例早泄患者,及无早泄正常生育男性60例作为对照。留取各自精液,分离精浆后,分别测定精浆α-葡萄糖苷酶(α-Glu)、酸性磷酸酶(ACP)和果糖(Fru)。结果:早泄组精浆中ACP、α-Glu和Fru的含量分别为:(36.37±31.33)U/ml、(39.97±22.09)U/ml、(3.40±1.92)mg/ml,与对照组(54.27±20.96)U/ml、(55.71±16.19)U/ml及(2.55±1.12)mg/ml相比,精浆中ACP、α-Glu的含量明显降低(P<0.01和P<0.05)。而精浆中Fru的含量两组相比无显著差异(P>0.05)。ACP合并α-Glu含量异常者,早泄组为31%,对照组为13%,两组相比有显著差异(P<0.05);ACP、α-Glu和Fru含量均正常者,早泄组为10%,对照组为33%,两组相比也有显著差异(P<0.05)。结论:早泄患者精浆ACP和α-Glu含量明显低于无早泄者,提示临床诊治早泄时,考虑前列腺和附睾功能异常并进行治疗,可能是治疗早泄的一个新途径。     

曲唑酮配合性感集中训练治疗功能性早泄

目的:探讨曲唑酮配合性感集中训练治疗功能性早泄的效果。方法:86例功能性早泄患者于先1周每日口服曲唑酮25mg,后3周每日50~100mg,同时进行性感集中训练,4周后观察疗效。结果:治疗后射精潜伏期较治疗前明显延长(P<0.01),治疗总有效率为89.5%,其中治愈40.7%,有效48.8%。仅15例出现嗜睡和困倦等反应。结论:曲唑酮配合性感集中训练是治疗早泄的一种有效安全的方法。     

The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation

PURPOSE: Fluoxetine, a selective serotonin re-uptake inhibitor, has been shown to increase the intravaginal latency of patients with premature ejaculation. We demonstrated the effects of fluoxetine on intravaginal latency, penile sensory threshold, and variables of sacral evoked response and cortical somatosensorial evoked potential in patients with premature ejaculation. MATERIALS AND METHODS: Of 48 patients 40 who presented to our clinic with premature ejaculation met the study criteria, gave written or oral consent, and were divided randomly in a double-blind fashion into 2 groups of 20 patients. The study group received 20 mg. fluoxetine daily and the control group received placebo for 1 month. The patients were evaluated during visits before and after treatment for intravaginal latency, penile sensory threshold values, and the variables of sacral evoked response and cortical somatosensory evoked potential tests. RESULTS: Patient ages, intravaginal latencies, penile sensory threshold values, and amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests in both groups were not significantly different at the beginning of treatment (p >0.05). At the end of treatment intravaginal latencies and penile sensory threshold values were increased in the study group compared to before treatment and the control group (p <0.05). No change was observed in either group for the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential tests (p >0.05). CONCLUSIONS: These findings suggest that fluoxetine is effective treatment for premature ejaculation probably due to its effect of increasing the penile sensory threshold, without changing the amplitudes and latencies of sacral evoked response and cortical somatosensory evoked potential.     

On-demand treatment of premature ejaculation with clomipramine and paroxetine: a randomized, double-blind fixed-dose study with stopwatch assessment

OBJECTIVE: To investigate the degree of ejaculation delay induced by on-demand treatment with 20 mg paroxetine and 25 mg clomipramine and to assess the type and severity of non-sexual side-effects of treatment at the day of and the day after treatment with these drugs. METHOD: A randomized, double-blind, fixed-dose, on-demand study in 30 men with lifelong premature ejaculation was performed. During a 1-month baseline period and a 4-week drug treatment period patients assessed the intravaginal ejaculation latency time (IELT) at home with a stopwatch. Only men with an IELT <1 min were randomly assigned to drug treatment. Patients assessed the drug coitus interval time (DCIT) and used the UKU side effect scale questionnaire at baseline, the day of and the day after intercourse. RESULTS: On-demand treatment with 25 mg clomipramine, with a mean DCIT of 5.14 h, led to a 4.05 (95%CI: 3.26-5.02) fold-increase of the IELT. On-demand treatment with 20 mg paroxetine, with a mean DCIT of 5.39 h, led to a 1.41 (95%CI: 1.22-1.63) fold-increase of the IELT. Both drugs had a high incidence of non-sexual side effects at the coitus day and the next day. At the day of coitus paroxetine led to significant sleepiness and yawning compared to clomipramine. At the day after coitus clomipramine induced significant nausea compared to paroxetine. CONCLUSION: On-demand treatment with 25 mg clomipramine led to a clinical relevant ejaculation delay. In contrast, 20 mg paroxetine had no clinical relevant ejaculation delay in men with lifelong premature ejaculation with an IELT of less than 1 minute. Both drugs exert mostly mild yet annoying non-sexual side effects both at the coitus day and the next day.