Objective To explore the effects of low-intensity extracorporeal shock wave (ESW) combined with medicine on the clinical symptoms and sexual function of patients with erectile dysfunction (ED). Methods 124 ED patients in our hospital from June 2015 to January 2017 were selected and randomly divided into the combined group and the control group,with 62 cases in each group. The control group was only given the tadalafil orally,and the combined group was treated with low-intensity ESW on this basis. The nocturnal penile tumescence(NPT) indexes (average effective erection frequency,average erection time,average erectile stiffness),sexual function [International Index of Erectile Function (IIEF-EF) scale,brief male sexual function scale (BMSFI) ], deep cavernosal artery hemodynamic parameters when sexual arousal [peak systolic velocity (PSV),pulsatility index (PI) ],messenger secretion level[serum nitric oxide (NO),nitric oxide synthase (NOS) ]and semen routine indexes (sperm density,sperm motility rate) were compared between the two groups before treatment and after 2 months of treatment. The occurrence of adverse drug reactions in the two groups within 2 months of treatment was analyzed. Results After 2 months of treatment,the levels of NPT indexes (average effective erection frequency, average erection time,average erectile stiffness),sexual function score (IIEF-EF score,BMSFI score),deep cavernosal artery hemodynamic parameters when sexual arousal and the messenger secretion were significantly increased compared with those before treatment,and the levels in the combined group were significantly higher than those in the control group,all with statistically significant differences (all P ＜ 0. 05). There was no significantchange in the sperm density and sperm motility rate after treatment compared with those before treatmentin the two groups,and there was no significant difference between the two groups (all P ＞ 0. 05). Within 2 months of treatment,there was no statistically significant difference in the incidence of adverse drug reactions between the two groups (P ＞ 0. 05). Conclusions Low-intensity ESW combined with medicine for ED has significant effects,which can effectively alleviate the patient's clinical symptoms and benefit its prognosis and sexual function recovery.%目的 探讨低强度体外冲击波(ESW)联合药物治疗对勃起功能障碍(ED)患者临床症状及性功能的影响.方法 选取2015年6月至2017年1月武汉市汉阳医院泌尿外科(湖北省泌尿外科疑难病例会诊中心)收治的124例ED患者作为研究对象.按照随机数表分为联合组与对照组各62例.对照组患者仅口服他达拉非治疗,联合组患者则在其基础上联合低强度ESW进行治疗.比较治疗前及治疗2个月后,两组患者夜间阴茎胀大试验(NPT)指标(平均有效勃起次数、平均每次勃起时间、平均勃起硬度)、性功能[国际勃起功能指数量表-专项维度(IIEF-EF)、简明男性性功能量表(BMSFI)]、性唤起时海绵体深动脉血流动力学参数[收缩期峰值血流速度(PSV)、搏动指数(PI)]、信使分子分泌水平[血清一氧化氮(NO)、一氧化氮合酶(NOS)]及精液常规检查指标(精子密度、精子活率)水平变化,分析治疗2个月内两组患者药物不良反应发生情况差异.结果 治疗2个月后,两组患者NPT指标(平均有效勃起次数、平均每次勃起时间、平均勃起硬度)、性功能评分(IIEF-EF评分、BMSFI评分)、性唤起时海绵体深动脉血流动力学参数水平及信使分子分泌水平均较治疗前有显著提升,且联合组明显高于同期对照组,差异均具有统计学意义(均P＜0.05);两组患者精子密度、精子活率均较治疗前无明显变化,且组间比较均无统计学意义(均P＞0.05).治疗2个月内,两组患者药物不良反应发生率比较无统计学意义(P＞0.05).结论 低强度ESW联合药物治疗ED效果显著,可有效缓解患者临床,对其预后性功能复旧有利.
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