西地那非、舍曲林合用与舍曲林单用治疗早泄的疗效比较

目的:比较联合应用西地那非和舍曲林治疗早泄与单用舍曲林治疗早泄的疗效及不良反应。方法:本院男科门诊无器质性病变的早泄患者72例,年龄18~42岁,平均32.4岁,随机分成A、B组,每组36例,A组口服舍曲林50mg,1次/d,性生活前4~6h服用;B组除了同样服用舍曲林外,在性生活前1h左右加用西地那非50mg,共观察12周。比较两组治疗前后的平均阴道内射精潜伏期、国际勃起功能指数(IIEF)问卷中的性交满意度评分、每周性交频率以及治疗期间的不良反应,并评估在疗程结束时,患者及其配偶对性生活的满意程度。结果:A、B两组患者平均阴道内射精潜伏期在治疗后均显著增加,而B组较A组增加更显著(P<0.05);治疗后IIEF问卷中的性交满意度评分在A、B组均有显著性提高,B组较A组改善更明显(P<0.05);治疗后每周性交频率两组均显著增多,两组之间比较B组增加更明显(P<0.05)。治疗结束时,A组患者对性生活感到满意的有20例(55.6%),B组有28例(77.8%),B组满意比例较A组显著增高(P<0.05)。在不良反应方面,B组患者头痛、头晕(P<0.01)和潮红(P<0.001)的发生率较A组要高。结论:在对早泄患者的治疗上,联合应用西地那非和舍曲林比单用舍曲林疗效要好,但同时引起的不良反应也稍有增加。

Comparison between Sildenafil Plus Sertraline and Sertraline Alone in the Treatment of Premature Ejaculation

Objective: To compare the efficacy and safety of sildenafil plus sertraline with those of sertraline alone in the treatment of premature ejaculation (PE).Methods: Seventy-two patients with PE but without any obvious organic cause were enrolled in this study. They were randomly divided into Groups A and B of equal number. Group A received 50 mg sertraline daily 4 to 6 hours before planned sexual activity for 12 weeks, and Group B were given 50 mg sertraline daily plus 50 mg sildenafil as needed, 1 hour before planned sexual activity, for 12 weeks. Before and after the treatment, the mean intravaginal ejaculation latency time, the intercourse satisfaction, the mean number of coituses per week and the drug-related side effects were evaluated.Results: The mean intravaginal ejaculatory latency time was ((0.59)(0.12)), ((3.9)(0.15)) minutes (P<(0.001)) at baseline and post-treatment in Group A, and ((0.56)(0.11)), ((5.6)(0.12)) minutes (P<(0.001)) in Group B, improved in both of the 2 groups, but more significantly in Group B (P<(0.05)). Before and after the treatment, the mean intercourse satisfaction domain values of the IIEF were ((8.9)(1.2)), ((10.8)(1.1))(P<(0.05))and ((8.8)(1.1)), ((13.8)(1.3))(P<(0.001)) in Groups A and B, respectively, significantly greater in Group B than in Group A (P<(0.05)) after the treatment; the mean numbers of coituses per week in Groups A and B were ((0.9)(0.2)), ((1.9)(0.3))(P<(0.05))and ((1.0)(0.2)), ((2.7)(0.2))(P<(0.001))respectively, significantly larger in Group B (P<(0.05)) after the treatment. As for the side effects, there was a higher rate of headaches (P<(0.01)) and flushing episodes (P<(0.001)) in Group B than in Group A.Conclusion: Sertraline combined with sildenafil can produce significantly better results than sertraline alone in patients with premature ejaculation. However, the combined treatment is associated with a slight increase in the drug-related side effects.