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目的:评估他达拉非3种不同给药方案对初次性生活失败的年轻男性勃起功能障碍(ED)患者疗效。方法:将夜间阴茎勃起硬度检查正常、心理治疗无效的初次性生活失败的年轻男性ED患者分为他达拉非每日小剂量口服组(每日夜间睡前1~2 h口服他达拉非5 mg)、按需治疗组(性生活前1~2 h口服他达拉非10~20 mg,根据勃起硬度调整剂量)、每日小剂量与按需治疗联合组(无性生活时每日夜间口服他达拉非5 mg,性生活当日于性生活前1~2 h一次性服用他达拉非10~20 mg、其剂量根据勃起硬度确定)共3组,分别给予相应治疗2~3个月。以国际勃起功能指数(IIEF)5个专项评分分别评估疗效。结果:3组IIEF勃起功能、性高潮、插入满意度、总体满意度专项评分较治疗前均显著提高(P均<0.05或0.01);按需治疗较每日小剂量治疗显著提高勃起功能和性高潮专项评分(P<0.05),但在性欲专项评分方面,其效果低于每日小剂量治疗;当给予联合治疗时,5个专项评分均得到了最佳改善(P均<0.05)。结论:由于缺乏专业的性心理治疗机构和医生,单纯心理治疗对心理性ED患者疗效较差,以每日小剂量口服联合按需服用他达拉非可明显提高初次性生活失败的年轻男性ED患者疗效。
PURPOSE: To evaluate the efficacy of three different tadalafil dosing regimens in young male patients with erectile dysfunction (ED) who failed first-time sexual life. Methods: Young male ED patients with nocturnal penile erection hardness test and failed first-episode psychotherapy were divided into low-dose oral group of tadalafil daily (1 ~ 2 h daily before bedtime) 5 mg), on-demand treatment group (tadalafil 10 to 20 mg 1 to 2 h prenatal sex adjusted dose based on erectile stiffness), daily low-dose and on-demand treatment combination group (asexual daily nighttime Tadalafil 5 mg orally, 1 to 2 h before sexual life before sex 1 to 2 h of tadalafil 10 to 20 mg, the dose determined according to erectile stiffness) were 3 groups were given the corresponding treatment of 2 to 3 month. Efficacy was evaluated by five special scores of International Erectile Function Index (IIEF). Results: The erectile function, orgasm, insertion satisfaction and overall satisfaction score of IIEF were significantly higher than those before treatment (all P <0.05 or 0.01). On-demand treatment significantly improved erectile function and sexual function Orgasm (P <0.05), but the effect was lower than that of daily low-dose treatment in terms of sexual desire specific score. When the combination therapy was given, the five special scores were the best improvement (all P <0.05). CONCLUSIONS: Due to the lack of specialized psychotherapy institutions and physicians, simple psychotherapy has poor curative effect on patients with psychological ED. Taking small daily oral doses of tadalafil on a daily basis can significantly improve the young men’s ED Patient efficacy.