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目的:分析睡眠相关性痛性勃起(SRPE)的病因、发病机制及治疗方法。方法:收集9例SRPE患者,年龄39~59岁,病史(13.5±1.2)个月,均行血常规、尿常规、凝血功能、焦虑与抑郁量表评分、IIEF-5评分、生殖激素、夜间阴茎勃起及多导联睡眠监测,根据各自的病情给予个体化的治疗方案,所有患者均在服药后1、4、8、12及24周各电话随访1次,询问治疗效果及药物的不良反应。结果:9例患者排除其它疾病后均诊断为原发性SRPE,6例采用氯米帕明或氯米帕明+其他药物联合治疗,3例采用抗雄治疗,4周疼痛完全缓解率为:77.78%,24周疼痛完全缓解率66.67%,3例患者在治疗24周后疼痛复发,根据病情调整治疗方案后1周疼痛消失。结论:氯米帕明或氯米帕明+其他药物联合治疗及抗雄治疗原发性SRPE,临床效果明显。
Objective: To analyze the etiology, pathogenesis and treatment of sleep-associated painful erection (SRPE). Methods: Nine patients with SRPE were collected, aged from 39 to 59 years and with a history of (13.5 ± 1.2) months. All patients underwent routine blood tests, urine tests, coagulation tests, anxiety and depression scale, IIEF-5 score, reproductive hormones, Penile erection and multi-lead sleep monitoring, according to their condition to give individualized treatment programs, all patients were taking the phone after 1,4,8,12 and 24 weeks of follow-up 1, asked about the therapeutic effect and adverse drug reactions . Results: Nine patients were diagnosed as primary SRPE after excluding other diseases, 6 patients were treated with clomipramine or clomipramine plus other drugs, 3 patients were treated with anti-androgen therapy, and the complete remission rate of 4 weeks pain was: 77.78%. The complete pain relief rate was 66.67% at 24 weeks. Three patients relapsed after 24 weeks of treatment. The pain disappeared one week after the treatment regimen was adjusted. Conclusion: Clomipramine or clomipramine combined with other drugs and anti-androgen treatment of primary SRPE, the clinical effect is obvious.