国产枸橼酸西地那非片治疗男性勃起功能障碍疗效和安全性的临床研究

目的　评价口服国产枸橼酸西地那非片治疗男性勃起功能障碍的临床有效性和安全性。方法　采用多中心、随机、双盲、安慰剂、平行对照的方法 ,对 2 40例患者进行为期 8周的临床观察 ,评价标准包括 :国际勃起功能指数 (IIEF)、记事本、总评题。结果　西地那非组IIEF评分明显高于安慰剂组 (P <0 0 1) ,记事本、总评题结果西地那非组亦明显优于安慰剂组 ,无不良反应中断研究者。结论　国产枸橼酸西地那非片是治疗男性勃起功能障碍的有效和安全的药物。     

仙鹿口服液联合西地那非治疗男性勃起功能障碍的疗效观察

目的 探讨仙鹿口服液联合西地那非治疗勃起功能障碍的临床疗效.方法 选取2019年8月—2020年9月河南省中医院接诊的120例男性勃起功能障碍患者,随机分为对照组和治疗组,每组各60例.对照组在性生活0.5～4 h前口服枸橼酸西地那非片,50 mg/次,1次/d;治疗组在对照组治疗基础上口服仙鹿口服液,10 mL/次,...     

西地那非和酚妥拉明治疗勃起功能障碍的临床疗效比较

目的：比较西地那非和酚妥拉明治疗勃起功能障碍的临床效果和安全性。方法选取2011年6月—2014年6月南京市妇幼保健院收治的勃起功能障碍患者223例,随机分为对照组（n=108例）和治疗组（n=115例）。对照组性交前0.5～1 h口服甲磺酸酚妥拉明片,1片/次;治疗组在性交前0.5～1 h口服枸橼酸西地那非片。首次使用时推荐剂量为50 mg,根据后期个体疗效情况调节剂量,范围在25～100 mg。两组每日最多服用1次,每周至少1次但不超过4次,均连续治疗8周。比较两组的临床疗效,同时比较两组患者治疗前后勃起功能国际指数问卷表（IIEF-5）评分、勃起质量量表（EQS）评分、平均起效时间和性交持续时间。结果治疗后,治疗组和对照组的总有效率分别为86.9%、63.9%,两组总有效率比较差异有统计学意义（P＜0.05）。治疗后,两组IIEF-5评分和EQS评分均较治疗前显著增加,同组治疗前后差异有统计学意义（P＜0.05）,且治疗后,治疗组这两项评分均显著高于对照组,两组比较差异有统计学意义（P＜0.05）。治疗组平均起效时间和平均性交持续时间均显著长于对照组,两组比较差异有统计学意义（P＜0.05）。结论西地那非治疗勃起功能障碍有较好的临床疗效,疗效优于酚妥拉明,可进行临床推广使用。     

小剂量西地那非联合右归丸治疗再婚中年男性勃起功能障碍疗效观察

目的:探讨小剂量西地那非联合右归丸治疗再婚中年男性勃起功能障碍临床疗效.方法:采用随机平行对照法将我院收治的81例再婚中年男性勃起功能障碍患者进行分组,对照组40例采用右归丸治疗,观察组41例在对照组的基础上加用小剂量西地那非治疗.比较两组治疗后临床疗效及治疗前后勃起功能障碍问卷评分(IIEF-5).结果:两组治疗后IIEF-5评分均有所升高,但观察组治疗后IIEF-5评分明显高于对照组,差异具有统计学意义(P<0.05);观察组治疗后临床总有效率95.12%明显高于对照组的80.00%,差异具有统计学意义(P<0.05).结论:小剂量西地那非联合右归丸治疗再婚中年男性ED可改善预后,提高IIEF-5评分及临床总有效率,值得临床推广.     

西地那非治疗酒精依赖患者勃起功能障碍的疗效观察

目的:探讨枸橼酸西地那非治疗酒精依赖勃起功能障碍的临床疗效以及对患者生活质量的影响。方法:采用自身对照、运用One-way ANOVA研究的方法,参照《国际疾病分类》第10版(ICD-10)选择被诊断为酒精依赖(AD)且伴有勃起功能障碍的45名男性患者。受试者每次性生活前1小时服用50mg西地那非,每周至少2次性生活,治疗持续12周。根据国际勃起功能指数问卷(IIEF-5),幸福与生活质量满意度问卷及一般健康自评问卷来评价疗效。结果:45例患者均完成全部的基线和最终评估。治疗后患者总改善率为82.2%(以IIEF-5为标准),IIEF-5评分由治疗前的14.6±2.1升至22.7±1.8(F_(1.43)=43.53,P<0.05)。简明幸福与生活质量满意度问卷(Q-LES-Q-SF)由治疗前的46.2±8.3升至治疗后的54.1±10.5(F_(1.43)=23.27,P<0.01),12项一般健康问卷(GHQ-12)由治疗前的3.7±2.5降至治疗后的2.4±2.0(F_(1.43)=89.22,P<0.01)。结论:西地那非能改善酒精依赖伴勃起功能障碍的勃起功能,对生活质量和满意度也有明显改善。     

中医药行气活血配合西地那非治疗勃起功能障碍

目的 提出男子“以血为用”的新观点,观察运用中医行气活血方药配合口服西地那非（万艾可）治疗勃起功能障碍（ED）的疗效。方法 将146例ED患者随机分为两组,治疗组86例,内服行气活血中药,房事前1h 口服万艾可50mg;对照组60例仅房事前1h口服万艾可50mg。两组均以30d为1个疗程。结果 治疗组显效78例,无效8例,有效率90．7％;对照组显效49例,无效11例,有效率81．7％。两组有效率比较,差异有显著意义（P〈0．05）。结论 中医药行气活血配合万艾可能显著提高ED治疗的有效率。     

蚕茸柱天胶囊联合西地那非治疗勃起功能障碍的临床研究

目的 观察蚕茸柱天胶囊联合西地那非治疗勃起功能障碍的有效性与安全性。方法 选择2015年6月—2017年6月在延安市人民医院治疗的勃起功能障碍患者120例,随机分成对照组和治疗组,每组各60例。对照组患者性交前30 min口服枸橼酸西地那非片,初始剂量为50 mg/次,1次/d,每周至少1次但不超过4次,剂量25～100 mg。治疗组患者在对照组基础上口服蚕茸柱天胶囊,2粒/次,2次/d。两组患者均连续治疗3个月。观察两组患者临床疗效,同时比较治疗前后两组患者阴茎勃起硬度、国际勃起功能-5（ⅡEF-5）和勃起质量量表（QEQ）评分及不良反应情况。结果 治疗后,对照组和治疗组临床有效率分别为80.00%、95.00%,两组比较差异具有统计学意义（P<0.05）。治疗后,治疗组患者阴茎勃起硬度Ⅰ级和Ⅱ级患者人数显著少于对照组（P<0.05）,且阴茎勃起硬度Ⅲ级和Ⅳ级患者人数显著多于对照组（P<0.05）。治疗后,两组患者ⅡEF-5和QEQ评分均显著升高（P<0.05）,且治疗组患者ⅡEF-5和QEQ评分比对照组升高的更明显（P<0.05）。治疗期间,治疗组不良反应发生率为5.00%,明显低于对照组的20.00%,两组比较差异具有统计学意义（P<0.05）。结论 蚕茸柱天胶囊联合西地那非治疗勃起功能障碍具有疗效好、副作用低,同时能够改善患者的生活质量,具有一定的临床推广应用价值。     

西地那非治疗原发性勃起功能障碍的效果分析

目的:探讨西地那非治疗原发性勃起功能障碍的疗效和安全性.方法:2013年5月~2015年10月我院收治原发性ED患者116例.随机分为观察组和对照组,每组58例.观察组均按需要服药.对照组不愿或拒绝药物治疗.两组治疗3个月后停止用药1个月和3个月时再次评估疗效.结果:治疗后,观察组IIEF-5评分明显高于对照组,差异显著(P<0.05).观察组总有效率明显高于对照组(P<0.05).观察组药物不良反应发生率明显高于对照组,差异显著(P<0.05).结论:原发性ED主要是由心理因素所致,通过进行性知识教育可改善症状,增加西地那非治疗能有效提高患者对性生活的信心,纠正焦虑、抑郁情绪,不良反应短暂、轻微,不影响治疗,疗效安全而可靠.     

依帕司他联合西地那非治疗2型糖尿病勃起功能障碍的疗效观察

目的观察依帕司他联合西地那非治疗2型糖尿病勃起功能障碍的临床疗效。方法选取鞍钢集团总医院2013年1月—2014年1月收治的2型糖尿病并发勃起功能障碍患者60例,随机分为对照组和治疗组,每组30例。两组患者均给予常规治疗控制血糖。对照组患者在性生活前1 h服用枸橼酸西地那非片,首次使用时推荐剂量为50 mg,根据后期个体疗效情况调节剂量,范围在25~100 mg。每日最多服用1次,每周至少1次但不超过4次。治疗组在对照组基础上口服依帕司他片,1片/次,3次/d。两组共治疗3个月。治疗后6个月进行复诊。按勃起功能国际指数问卷表(IIEF-5)评分及硬度等级评定阴茎勃起变化,测定腓总神经运动传导速度(PNCV)和胫神经运动传导速度(TNCV)。记录两组发生的不良反应情况。结果两组治疗后及复诊时IIEF-5评分均较治疗前明显提高,差异有统计学意义(P0.05);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。治疗组治疗后和复诊时勃起硬度Ⅳ级人数显著多于治疗前,Ⅰ级人数少于治疗前,差异有统计学意义(P0.05);复诊时治疗组患者勃起硬度Ⅳ级人数显著多于对照组,两组比较差异有统计学意义(P0.05)。两组不良反应发生率比较差异无统计学意义。结论依帕司他联合西地那非治疗2型糖尿病勃起功能障碍具有较好的临床疗效,可以改善患者预后生活质量,值得临床推广应用。     

国内伐地那非治疗勃起功能障碍临床疗效的Meta分析

目的:系统评价国内伐地那非治疗勃起功能障碍的临床疗效。方法:计算机检索2004年～2009年6月CBMdisc、VIP、CNKI以及万方数据库等,获得5篇符合纳入标准的文献,对其进行Meta分析,并评价Meta分析结果的稳定性和发表偏倚。结果:异质性检验Chi-square=206.56,P<0.00001。采用随机效应模型进行Meta分析,合并WMD=9.64,95%CI为(8.92,10.35),总体效应检验,Z=26.44,P<0.00001,具有统计学意义。固定效应模型WMD值和95%CI与随机效应模型、剔除小样本后随机效应模型的结果基本一致,且本研究的发表偏倚得到了较好控制。结论:伐地那非能明显改善男性勃起功能障碍。     

Erectile Dysfunction Symptoms in Polydrug Dependents Seeking Treatment

Objective: To assess erectile dysfunction (ED) symptom prevalence, sexual behavior conditions, and risk factors associated to ED in a male polydrug dependent sample. Methods: A cross-sectional design study was conducted with 102 substance-dependent male polydrug users who sought outpatient treatment in São Paulo, Brazil. Sociodemographic data, drug of choice, chronic disease questions, sexually transmitted infections, International Index of Erectile Function (IIEF) scale, Sexual Addiction Screening Test (SAST), and WHOQOL-Bref instrument were used. Results: The erectile dysfunction prevalence was 32.3% and it was related to the marital status (single) (p < 0.001), occupational status (fully unemployed) (p < 0.001), presenting a chronic disease (p = 0.027), and with types of sexual partnerships (occasional partner) (p < 0.001). Alcohol (73.5%), tobacco (79.4%), cannabis (83.3%), and cocaine (snorted 78.4% and smoked 42.2%) were the drugs of choice. The ED risk decreased when marital status was married (odds ratio = 3.2 CI95% 1.411–7.518) and with chronic disease (odds ratio 0.06 CI95% 0.00–0.97), while having occasional sexual partners increased 14 times ED risk (OR 14.0 CI95%1.62–122.18). There were no significant associations between quality of life, DOC and ED. Conclusion: Approximately one third of the substance dependents in this sample presented ED. There is a need to integrate psychiatric and clinical care in substance treatment services, and to improve the provision of sexual health care and support available for this population.     

Population Dose-Response Model for Tadalafil in the Treatment of Male Erectile Dysfunction

PURPOSE: To determine the population dose-response relationship for tadalafil during on-demand (as-needed) administration for treatment of erectile dysfunction (ED). METHODS: A total of 212 male patients with mild, moderate, or severe ED participated in a multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Patients were randomized to receive placebo or 2, 5, 10, or 25 mg tadalafil, taken on demand over an 8-week period. Efficacy was assessed on the basis of questions 2 and 3 of the Sexual Encounter Profile (SEP) and questions 3 and 4 of the International Index of Erectile Function (IIEF) questionaires. These scores were modeled using logistic regression. A fifth patient response, the IIEF EF (erectile function) domain score, was modeled as a continuous variable. RESULTS: The dose-response relationship for each efficacy variable was best described with an Emax model, in which maximum effect increased with ED severity at baseline. Response scores increased substantially between 10 and 25 mg tadalafil doses, and the dose-response parameter estimates suggested possibly higher responses at even higher doses. CONCLUSIONS: Population dose-response modeling of all five oucome measures indicated that efficacy in all ED severity groups in the studied population generally increased across the 2 to 25 mg tadalafil dose range. Estimates of maximal improvement (Emax) in the IIEF EF domain score were 7.5, 11.4, and 16.3 points for patients with mild, moderate, and severe ED, respectively. Corresponding tadalafil doses to attain half-maximal improvement (ED50 estimates) were 4.7 mg, 7.1 mg, and 10.1 mg.     

Sildenafil citrate does not affect cardiac contractility in human or dog heart

SUMMARY

Objective: This study evaluated whether sildenafil citrate, an oral treatment for erectile dysfunction and a selective inhibitor of phosphodiesterase type 5 (PDE5) with modest vasodilating properties, affects cardiac contractility in vitro.

Research design and methods: Slices of freshly obtained human (n?=?2) or dog (n?=?3) atrial appendage were suspended in organ baths containing Krebs—Ringer bicarbonate buffer (pH 7.4, 37°C) bubbled continuously with 95% O2 and 5% CO2, and isometric tension was recorded using a Gould physiograph. Contractions were elicited by 1-Hz electric pacing. After 15min of equilibration, 1\M sildenafil was added to the bath, followed 15min later (human and dog) by 5|iM epinephrine, an inotropic agent, and 10min later (dog) by 88|iM 3-isobutyl-1 -methylxanthine

(IBMX), a nonselective PDE inhibitor. In a separate experiment, cyclic guanosine monophosphate levels and PDE, protein kinase G, and protein kinase A activities were determined.

Results: Addition of 1 |iM sildenafil to isolated dog or human atrial tissue had no significant effect on force of cardiac contraction, whereas epinephrine produced a robust increase in contractile force in the same muscle strip. The addition of IBMX produced a marked stimulation of contractile force in dog atrial tissue. Very low amounts of PDE5 were found in extracts of human heart, consistent with its known primary location in the smooth muscle of systemic vasculature.

Conclusions: Sildenafil is unlikely to directly produce inotropic effects on cardiac muscle in patients being treated for erectile dysfunction.     

男性抑郁症与勃起功能障碍共病分析

目的 探讨男性抑郁症患者与勃起功能障碍(ED)的共病情况及其影响因素.方法 对60例年龄26～50岁的男性抑郁症患者采用国际勃起功能指数问卷(IIEF-5)、汉米尔顿抑郁量表(HAMD)进行评估,同时对单相与双相抑郁患者组以及抑郁症与ED共病组及非共病组IIEF-5、HAMD量表评分进行比较,并对抑郁症与ED的共病的影响因素进行Logistic回归分析.结果 ①抑郁症患者与ED共病率为78.3%,主要为轻度ED;②双相抑郁患者与ED共病率以及IIEF-5与HAMD评分均显著高于单相抑郁患者;③21～30,31～40,41～50岁年龄段的抑郁症患者,其与ED共病率分别为65.5%、85.7%、85.0%,三者共病率比较有显著性差异.④服用SSRI类药物及米氮平的抑郁症患者,与ED共病率分别为77.5%及78.9%,两者比较无显著性差异;⑤HAMD评分＞17患者组的IIEF-5评分及与ED共病率均显著高于HAMD评分≤17患者组;⑥抑郁症与ED共病组HAMD量表评分显著高于非共病组;⑦Logistic回归分析表明HAMD评分及体重指数为抑郁症患者与ED共病的危险因素.结论 男性抑郁症患者与ED的共病率高,抑郁程度重及体重指数高可能是抑郁症患者与ED共病的危险因素.     

西地那非联合十一酸睾酮治疗中老年勃起功能障碍

目的:观察西地那非联合十一酸睾酮治疗中老年勃起功能障碍(ED)的临床效果和安全性。方法:将伴有雄性激素缺乏综合征(PADAM)的中老年ED患者68例随机分为治疗组(46例)与对照组(22例)。治疗组采用西地那非联合十一酸睾酮治疗,对照组单用西地那非治疗。结果:国际勃起功能问卷-5(IIEF-5)和PADAM评分及夜间阴茎勃起试验(NPT)、血总睾酮(TT),治疗组效果显著优于对照组(P<0.01)。2组均未见明显副作用。结论:西地那非联合十一酸睾酮治疗伴有PADAM的中老年ED患者安全、有效。     

Erectile Dysfunction in Opioid Users: Lack of Association with Serum Testosterone

ABSTRACT

This study describes the prevalence of erectile dysfunction (ED) among 57 men using illicit opioids who presented to a primary care program for buprenorphine therapy. Participants’ mean age was 40 years and 34% reported ED. Low total testosterone was detected in 17% of those reporting ED, but total testosterone was not significantly associated with ED. Examining multiple comorbidities and laboratory parameters, only older age was significantly associated with ED (r = .27, P< .05). ED is highly prevalent among men abusing opioids, but low total testosterone is rarely the cause.     

Erectile Dysfunction among People Who Use Ketamine and Poly-Drugs

Despite the rise in recreational use of ketamine in Malaysia, there have been no studies of users or of the health-related consequences they face. This study was initiated to examine ketamine use and its health consequences. A structured questionnaire was used to elicit information. A final sample of 127 males was divided into persons who used only ketamine and those who were poly-drug users. Each group was further divided into long-period and short-period users. Urine toxicology screening for ketamine and other illicit drugs commonly used in Malaysia was also done. Our findings corroborate those of earlier studies that link ketamine use to urological problems such as frequent urination, dysuria, incontinence, painful bladder, nocturia, and urinary urgency. A new finding in this study is the significant association between ketamine use and erectile dysfunction, such that higher odds of reporting erectile dysfunction were linked to long-period users. Our findings strengthen the case for early intervention, as ketamine users are drawn from young and unmarried male participants. The association of ketamine use with erectile dysfunction, if substantiated, will help physicians in their diagnosis of erectile dysfunction, particularly among youths.