盐酸达泊西汀治疗男性早泄及提高女性伴侣性满意度的临床观察

摘要

目的 比较盐酸达泊西汀及盐酸舍曲林治疗早泄患者及提高女性伴侣性满意度的疗效.方法 选取我院2014年11月至2016年5月门诊早泄患者206例随机分组,分为A组(103例,按需服用盐酸达泊西汀30mg),B组(103例,每日一次盐酸舍曲林50mg),4周后随访,记录治疗前后的阴道内射精潜伏时间(IELT),国际勃起功能评分表(IIEF-5)以及性伴侣的性满意度(非常满意、基本满意、平平、不满意、非常不满意),用药后临床总印象变化(CGIC)评分,并记录不良反应.结果 治疗后A组及B组IELT均显著提高[A组由(1.02±0.45)min提升到(5.17±2.13)min;B组由(0.96±0.37) min提升到(4.56±1.57)min].治疗后IIEF-5评分两组较前均有下降[A组由(23.7±1.9)分降低到(19.6±2.3)分;B组由(23.2±2.2)分降低到(16.9±3.4)分],差异有统计学意义(P＜0.05),治疗后IIEF-5评分B组较A组下降明显,差异有统计学意义(P＜0.05).应用CGIC评分,用药后效果A组与B组有效的比率分别为73％与68％;性伴侣的性满意度A组从25％提升到52％,B组从23％提升到53％.B组出现的食欲不振、恶心等不良反应明显多于A组,差异有统计学意义(P＜0.05).结论 按需服用盐酸达泊西汀治疗早泄患者能够提升IELT以及女性伴侣的性满意度,不良反应低,值得临床推广.%Objective To evaluate the efficacy and adverse effects between dapoxetine and sertraline in the treatment of male premature ejaculation and female sexual dissatisfaction.Methods Total of 206 patients with premature ejaculation in outpatient department were recruited during 2014.11-2016.5,they were randomly assigned to the treatment group (30 mg dapoxetine on demand,n =103) or the control group(50 mg sertraline qd for 4 weeks,n =103) in the proportion of 1:1.Follow-up was conducted after 4 weeks.The intravaginal ejaculatory latency time (IELT),International Index of Erectile Function (IIEF-5),female sexual function index (FSFI),clinical global impression of change (CGIC) score,and adverse reactions of the patients were recorded and compared between the two groups.Results IELT was significantly increased in both the dapoxetine group (from 1.02±0.45 to 5.17±1.23 min,P＜0.05) and the sertraline group (from 0.96±0.37 to 4.56±1.57 min,P＜0.05) after medication.IIEF-5 score were significantly declined in both groups (from23.7±1.9 to 18.6±2.3 in dapoxetine group,from23.2±2.2 to 16.9±3.4 in sertraline group).After treatment,the IIEF-5 score of group B was significantly lower than that of group A,P＜0.05.Based on the CGIC scores,the rate of effectiveness was 73％ in the dapoxetine group and 68％ in the sertraline group.The degree of sexual satisfaction was elevated from 25％ to 52％ in the dapoxetine group and from 23％ to 54％ in the sertraline group.The incidence rates of nausea,inappetence were significantly higher (P＜0.05) in the sertraline group.Conclusion On-demand oral medication ofdapoxetine is effective and well-tolerated for the treatment of male premature ejaculation and female sexual dissatisfaction.