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目的探讨奥美沙坦酯及苯磺酸氨氯地平对男性高血压患者性功能的影响。方法选取2012年1月—2014年6月在江阴市中医院门诊就诊的男性高血压患者160例(高血压分级为1~2级),采用随机数字表法将患者分为奥美沙坦酯组和苯磺酸氨氯地平组,各80例。奥美沙坦酯组给予奥美沙坦酯20 mg/d口服,苯磺酸氨氯地平组给予苯磺酸氨氯地平5 mg/d口服,疗程均为24周。观察两组治疗前后性功能和血清睾酮、雌二醇水平的变化。性功能评定按照勃起功能国际问卷-5(IIEF-5)进行问卷调查,主要通过勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值评价男性性功能。结果奥美沙坦酯组和苯磺酸氨氯地平组各有5例患者因血压持续不达标而退出。两组患者治疗后收缩压、舒张压比较,差异均无统计学意义(t=0.802、0.811,P>0.05)。治疗前两组勃起功能、性交满意度、达到高潮能力、性欲、总体满意度分值比较,差异均无统计学意义(P>0.05);治疗后两组性交满意度、达到高潮能力、总体满意度分值比较,差异均无统计学意义(P>0.05);奥美沙坦酯组勃起功能、性欲评分均高于苯磺酸氨氯地平组,差异有统计学意义(P<0.05);奥美沙坦酯组治疗后勃起功能、性欲评分高于治疗前,差异均有统计学意义(P<0.05)。两组治疗前勃起功能障碍(ED)发生率比较,差异无统计学意义(χ~2=0.027,P=0.870);两组治疗后ED发生率比较,差异无统计学意义(χ~2=2.807,P=0.094)。奥美沙坦酯组治疗后ED发生率低于治疗前,差异有统计学意义(χ~2=4.120,P<0.05);苯磺酸氨氯地平组治疗后ED发生率与治疗前比较,差异无统计学意义(χ~2=2.811,P=0.094)。治疗前两组睾酮、雌二醇水平比较,差异均无统计学意义(P>0.05);治疗后两组雌二醇水平比较,差异无统计学意义(P>0.05);奥美沙坦酯组睾酮水平高于苯磺酸氨氯地平组,差异有统计学意义(P<0.05)。奥美沙坦酯组治疗后睾酮水平高于治疗前,差异有统计学意义(P<0.05)。结论奥美沙坦酯能提高男性高血压患者睾酮水平,改善性功能。
Objective To investigate the effects of olmesartan medoxomil and amlodipine besylate on the sexual function of male patients with essential hypertension. Methods From January 2012 to June 2014, 160 male hypertensive patients (grade 1 to 2) were enrolled in the clinic of Jiangyin Hospital of Chinese Medicine. Patients were divided into the olmesartan medoxomil group And amlodipine besylate group, each 80 cases. The olmesartan medoxomil group was given olmesartan medoxomil 20 mg / d orally, and the amlodipine besylate group was given orally with amlodipine besylate 5 mg / d for 24 weeks. The changes of sexual function, serum testosterone and estradiol level before and after treatment were observed. Sexual function assessment According to the erectile dysfunction International Questionnaire-5 (IIEF-5) conducted a questionnaire survey, mainly through erectile function, sexual satisfaction, climax, sexual desire, overall satisfaction score evaluation of male sexual function. Results In the olmesartan medoxomil group and the amlodipine besylate group, 5 patients each withdrew due to the continuous non-compliance of blood pressure. After treatment, systolic blood pressure and diastolic blood pressure were not significantly different between the two groups (t = 0.802,0.811, P> 0.05). Before treatment, there was no significant difference in scores of erectile function, sexual satisfaction, climax, sexual desire and overall satisfaction between the two groups (P> 0.05) (P> 0.05). The scores of erectile function and libido in the olmesartan medoxomil group were significantly higher than those in the amlodipine besylate group (P <0.05) The scores of erectile function and sexual desire in the treatment group were significantly higher than those before treatment (P <0.05). There was no significant difference in the incidence of pre-treatment erectile dysfunction between the two groups (χ ~ 2 = 0.027, P = 0.870). There was no significant difference in the incidence of ED between the two groups (χ ~ 2 = 2.807, P = 0.094). The incidence of ED in the olmesartan medoxomil group was lower than that before treatment (χ ~ 2 = 4.120, P <0.05). The incidence of ED after the treatment with amlodipine besylate group was significantly lower than that before treatment No statistical significance (χ ~ 2 = 2.811, P = 0.094). There was no significant difference in testosterone and estradiol levels between the two groups before treatment (P> 0.05). There was no significant difference in estradiol levels between the two groups after treatment (P> 0.05) Testosterone levels were higher than amlodipine besylate group, the difference was statistically significant (P <0.05). The level of testosterone in the olmesartan medoxomil group was significantly higher than that before treatment (P <0.05). Conclusion Olmesartan medoxomil can increase testosterone in male patients with hypertension and improve sexual function.