盐酸舍曲林治疗早泄的探讨

目的探讨口服盐酸舍曲林治疗早泄的治疗效果。方法65例病人采用服药前后自身对照法,每晚口服50mg舍曲林,记录病人用药前后的射精潜伏期和夫妻双方对性生活的满意度。结果64例病人口服舍曲林2～4疗程后60例射精潜伏期延长,48对夫妇双方对性生活均感到满意,12对夫妇基本满意,4对夫妇不满意。结论口服舍曲林是治疗早泄的一种有效方法。     

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.     

舍曲林治疗早泄的有效性和安全性系统评价

目的 应用Meta分析评价舍曲林治疗早泄的临床疗效和安全性.方法 检索国内外有关比较舍曲林和安慰剂用于治疗早泄的随机对照试验和随机交叉实验,由两名评价员独立按Cochrane系统评价方法对文献进行质量评价和提取资料后,采用RevMan 5.2统计软件进行Meta分析.结果 共纳入5个随机对照试验和随机交叉实验,共208例患者.结果显示,舍曲林治疗组可以明显延长患者的射精潜伏期[MD =2.00,95％ CI（1.38,2.61）,P＜0.00001],提高患者的性生活满意度[RR=1.90,95％ CI（1.38,2.62）,P＜0.0001],但舍曲林治疗组的药物不良反应发生率较安慰剂组高[RR =2.29,95％ CI（1.40,3.77）,P=0.001].结论 舍曲林治疗组可以明显延长患者的射精潜伏期,提高患者的性生活满意度.由于文献纳入较少,需要更多大样本的随机对照试验进一步证实.     

舍曲林治疗青年脑卒中后继发性早泄的临床研究

目的 评价舍曲林治疗青年脑卒中后继发性早泄患者的临床疗效和安全性.方法 114例诊断为继发性早泄患者随机分为治疗组(58名)和对照组(56名).两组在常规心理、行为治疗的基础上,治疗组每天服用舍曲林片50mg,对照组每天服用甲钴胺片0.5mg,疗程8周.以治疗4周、8周、12周后阴道内射精潜伏时间、配偶性生活满意度评分,以及性能力恢复自评分的变化来评价早泄治疗效果.结果 两组性功能均有较大改善,但治疗组在治疗4周、8周、12周后上述各项指标均优于对照组差异均具统计学意义(P＜0.05或P＜0.01).两组患者中的不良反应均为轻度.结论 舍曲林治疗青年脑卒中后继发性早泄安全有效.     

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。     

西地那非联合多沙唑嗪治疗早泄的临床观察

目的 探讨枸橼酸两地那非联合多沙唑嗪控释片治疗早泄的临床效果.方法 记录30例患者治疗前后阴道内射精潜伏期,同时记录夫妻性生活的满意程度.结果 治疗前,阴道内射精潜伏期为(0.80±0.20)min,治疗后为(3.60±0.56)min,差异有显著性(P<0.01).治疗后夫妻性生活满意度显著提高.结论 枸橼酸西地那非联合多沙唑嗪片可延长阴道内射精潜伏期,治疗早泄有良好疗效.     

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。     

盐酸曲唑酮联合西地那非治疗早泄的疗效观察

目的:探讨盐酸曲唑酮联合西地那非并配合心理行为治疗早泄的临床疗效。方法:68例早泄患者随机均分为实验组(盐酸曲唑酮加西地那非加行为疗法)和对照组(盐酸曲唑酮加行为疗法),记录治疗前后阴道内射精潜伏期并进行组内和组间比较,同时记录夫妻对性生活的满意情况。结果:治疗前,实验组和对照组阴道内射精潜伏期分别为(0.79±0.34)min、(0.85±0.38)min,治疗后分别为(4.32±2.30)min、(2.84±1.45)min,差异有统计学意义(P<0.01),且实验组阴道内射精潜伏期较对照组相比差异有统计学意义(P<0.01)。夫妻双方对性生活的情况:满意率实验组(64.5%)明显高于对照组(35.3%),差异有统计学意义(P<0.05),而总满意率(满意加基本满意)实验组(84.6%)亦高于对照组(70.6%),但差异无统计学意义(P>0.05)。结论:盐酸曲唑酮联合西地那非并配合心理行为疗法在延长射精潜伏期,改善夫妻双方性生活满意度方面明显优于盐酸曲唑酮配合心理行为疗法,两药合用在治疗早泄方面有一定的应用前景。     

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.     

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。     

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。     

EFFICACY AND SAFETY OF FLUOXETINE, SERTRALINE AND CLOMIPRAMINE IN PATIENTS WITH PREMATURE EJACULATION: A DOUBLE-BLIND, PLACEBO CONTROLLED STUDY

Purpose

We compared the efficacy and safety of fluoxetine, sertraline, clomipramine and placebo for the oral pharmacotherapy of premature ejaculation.

Materials and Methods

The study included 36 men (mean age 44 years) who had intravaginal ejaculation latency of less than 2 minutes. Patients took each of 3 drugs and the placebo consecutively during a 4-week period per each agent. Efficacy and side effects data were obtained by a self-reported patient questionnaire that rated intravaginal ejaculation latency, sexual satisfaction of patient and partner, and possible side effects.

Results

After 4 weeks of treatment with placebo, fluoxetine, sertraline and clomipramine the mean intravaginal ejaculation latency time was significantly increased from 46 seconds to 2.27 minutes, 2.30 minutes, 4.27 minutes and 5.75 minutes, respectively (all p <0.01). However, treatment with clomipramine or sertraline caused a greater increase in mean intravaginal ejaculation latency time than fluoxetine or placebo (p <0.01). Patient sexual satisfaction rate after treatment with clomipramine was significantly higher (p <0.05) than with sertraline, fluoxetine or placebo. Partner sexual satisfaction rate was also higher with clomipramine than with sertraline or fluoxetine but no statistical difference was found. The incidence of side effects with clomipramine was significantly higher (p <0.05) compared to that of fluoxetine, sertraline and placebo, while no significant difference among sertraline, fluoxetine and placebo was noted.

Conclusions

In men with premature ejaculation clomipramine was the most useful drug in terms of efficacy. Treatment with sertraline was nearly as effective and had a lower incidence of side effects.     

Relevance of seminal plasma nitric oxide levels and the efficacy of SSRI treatment on lifelong premature ejaculation

The aim of this study was to determine the relevance of seminal plasma nitric oxide (NO) levels and the efficacy of selective serotonin reuptake inhibitor (SSRI) treatment on premature ejaculation. A total of 16 men (aged 32.18 ± 3.32) with lifelong premature ejaculation [intravaginal ejaculation latency time (IELT) <1 min] and 11 healthy men (control group) were included in this study. The healthy men formed Group 1, and the patients were randomly categorised into two groups. Group 2 patients received 20 mg day^?1 of paroxetine, and Group 3 patients received 50 mg day^?1 of sertraline for 4 weeks. Baseline and post‐treatment findings were compared among the three groups. Mean baseline seminal NO levels in men with premature ejaculation were significantly higher than in the healthy control group (32.24 ± 5.61 μm  l^?1 versus 19.71 ± 3.50 μm  l^?1, respectively) (P < 0.001). There was no significant difference between the sertraline and paroxetine groups in terms of IIEF scores, IELT scores and NO levels. At the end of the first month, the mean IELT scores of the paroxetine and sertraline groups showed a significant improvement compared with the baseline values (P < 0.001). After treatment with paroxetine and sertraline, NO levels dec‐reased from baseline. Our study indicates that premature ejaculation is significantly related with a higher level of seminal NO. Baseline seminal plasma NO values obtained in patients with premature ejaculation were significantly higher than in the healthy control group. After treatment with SSRIs, decreased seminal NO may retard ejaculation. Further studies are needed to confirm this suggestion and the role of NO in the pathophysiology and treatment of premature ejaculation.     

Relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation: decreased nitric oxide is associated with premature ejaculation

The aim of the present study was to determine the relevance of serum nitric oxide levels and the efficacy of selective serotonin reuptake inhibitors (SSRI) treatment on premature ejaculation. Sixty married men (aged 20–50) with lifelong premature ejaculation and forty healthy men (aged 24–48) as control group were included in this study. The patients were evaluated by intravaginal ejaculation latency time (IELT) for premature ejaculation (PE). IELT<1 min is accepted PE. Patients with diabetes mellitus, chronic disorders or erectile dysfunction and heavy smokers were excluded. All patients were evaluated with history, physical examination, International Index of Erectile Dysfunction‐5 (IIEF‐5) score and IELT by stopwatch method. Nitric oxide levels were measured by Griess reaction, and all samples were frozen at ?80 °C. Patients were randomly categorised 4 group to receive fluoxetine 20 mg day^?1 (Group 1), paroxetine 20 mg day^?1 (Group 2), sertraline 50 mg day^?1 (Group 3) and healthy control (Group 4) for 4 weeks. Baseline and post‐treatment findings were compared between the four groups. At the end of 4 weeks, in fluoxetine, paroxetine, sertraline groups mean IELT values showed a statistically significant improvement from the baseline values (P < 0.001, P < 0.001, P = 0.03; respectively). Baseline and 1st month follow‐up mean IIEF scores were 24.5 and 23.05, 24.70 and 23.60 (P < 0.05) in group 1 and group 3 respectively; also 23.09 and 23.32 (P > 0.05) in group 2. Baseline serum NO levels were 31.8, 30.44, 30.8 and 42.84 in fluoxetine, paroxetine, sertraline and healthy control groups respectively. NO levels were statistically lower in patients with PE. After treatment of fluoxetine, paroxetine and sertraline, NO levels were increased baseline (35.8, 36.4, 38.08) (P < 0.05). Our findings indicated that PE is associated with decreased serum NO levels. After the SSRI treatment increased, NO may retard ejaculation presumably by central peripheral mechanism. Further studies are needed to confirm this suggestion and the role of NO in pathophysiology and treatment for premature ejaculation.     

Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation

The objective was to compare the efficacy and safety of the as needed use of clomipramine, sertraline, paroxetine, sildenafil and the pause-squeeze technique in treatment of primary premature ejaculation. A prospective double blind randomized crossover study involving 31 patients was performed. Treatment phases comprised five 4-week consecutive treatment periods, each separated by a two-week washout period. Patients were randomly assigned to receive each of the 4 drugs and use pause-squeeze on an as needed basis. Drugs were administered 3 to 5 hours before anticipated coitus. Anxiety score and ejaculation latency time were measured before treatment, after each treatment, and during washout periods. Sexual satisfaction score was measured after each treatment. The median ejaculation latency time was significantly increased from the pretreatment median of 1 minute to 4 minutes, 3 minutes, 4 minutes, 15 minutes and 3 minutes during treatment with clomipramine, sertraline, paroxetine, sildenafil and pause-squeeze technique, respectively (all P 0.0001). Sildenafil was superior to other modalities in terms of ejaculation latency and satisfaction (P = 0.0001). The three antidepressants were comparable to each other in terms of efficacy (P > 0.05). Paroxetine was superior to the pause-squeeze technique in terms of efficacy (P < 0.05). In conclusion, sildenafil appears to be superior to other modalities and a valid alternative in treatment of premature ejaculation. The 3 antidepressants were equivalent to each other in terms of efficacy and safety. Paroxetine was superior to pause-squeeze technique in terms of efficacy.     

口服佐洛复结合行为疗法治疗早泄

目的 :探讨口服佐洛复结合行为疗法治疗早泄的效果。　方法 :5 2例病人采用治疗前后自身对照研究 ,记录病人用药前后的射精潜伏期和夫妻对性生活的满意程度。　结果 :5 2例病人射精潜伏期延长 (P <0 .0 1) ,对性生活的满意程度提高。　结论 :口服佐洛复结合行为治疗是治疗早泄的一种有效方法     

Effect of age on pulmonary gas exchange during laparoscopy in the Trendelenburg lithotomy position

BACKGROUND: Physiological changes in respiratory mechanics caused by aging may lead to a deterioration in pulmonary gas exchange, an increase in the alveolar-arterial oxygen gradient [(A-a)D(O2)] and a difference between the arterial carbon dioxide (CO(2)) tension (P(a)(CO(2))) and expired end-tidal CO(2) tension (P(ET)(CO(2))) [P((a-ET))(CO(2))] during laparoscopy in the Trendelenburg lithotomy position (TLP). METHODS: The subjects were 51 gynecologic patients. Pressure-controlled ventilation was used to maintain P(ET)(CO(2)), measured by the side stream method, within the range 4-4.67 kPa. During laparoscopy with CO(2) insufflation in TLP, the tidal volume was increased to keep P(ET)(CO(2)) within +/- 20% of the pre-insufflation value. The subjects were divided into three groups by age: young group (< 45 years); middle-aged group (45-64 years); and elderly group ( > or = 65 years). RESULTS: Before pneumoperitoneum (PPN), significant differences were found between the young and elderly groups in the arterial oxygen tension (P(a)(O(2))), (A-a)D(O(2)), P(a)(CO(2)) and P((a-ET))(CO(2)). In all groups, the peak inspiratory pressure and P(a)(CO(2)) increased progressively during PPN in TLP. P((a-ET))(CO(2)) increased gradually after starting CO(2) insufflation in TLP only in the elderly group. CONCLUSIONS: An increase in P((a-ET))(CO(2)) was seen during PPN in TLP in the elderly group. With CO(2) insufflation in TLP, the setting of mechanical ventilation based on the value of P(ET)(CO(2)) (measured by the side stream method) should be determined with caution in elderly patients.     

Sertraline in the treatment of premature ejaculation: A double-blind placebo controlled study

This study investigated the efficacy and the adverse effects of sertraline in the treatment of premature ejaculation (PE). Thirty-seven patients with PE were randomly assigned to receive either sertraline or a placebo. Of them 22 were given 50 mg of sertraline per day and the other 15 patients were given an identical placebo one per day. After 4 weeks, the latency to ejaculation in the sertraline group was found to be significantly longer than that of the placebo group (p<0.01). None of the patients discontinued therapy due to adverse effects. These results indicate that sertraline is an effective therapy for PE.     

阴茎勃起障碍患者对西地那非用药依从性的研究

目的了解阴茎勃起功能障碍(ED)患者对西地那非用药的依从性以及健康教育对依从性的影响。方法216例ED患者随机分为健康教育联合药物组(甲组)和药物组(乙组),疗程2月。分别对治疗前、治疗期间、治疗后的依从性进行评价。结果216例患者中,117例(54.2%)愿意接受西地那非治疗,甲组的接受率显著高于乙组(69.6%:36.6%;P<0.001)。这117例在治疗期间的依从率为57.3%,两组比较有显著性差异(66.3%:37.8%;P<0.001)。治疗2月后,31.6%的患者表示愿意继续接受西地那非治疗,甲组的接受率显著高于乙组(37.5%:18.9%;P<0.05)。认为疗效不理想、担心药物的不良反应和经济原因是影响依从性的主要因素。结论ED患者对西地那非治疗的依从性差,健康教育有助于改善依从性。