目的 比较西地那非和酚妥拉明治疗勃起功能障碍的临床效果和安全性.方法 选取2011年6月—2014年6月南京市妇幼保健院收治的勃起功能障碍患者223例,随机分为对照组(n=108例)和治疗组(n=115例).对照组性交前0.5～1 h口服甲磺酸酚妥拉明片,1片/次;治疗组在性交前0.5～1 h口服枸橼酸西地那非片.首次使用时推荐剂量为50 mg,根据后期个体疗效情况调节剂量,范围在25～100 mg.两组每日最多服用1次,每周至少1次但不超过4次,均连续治疗8周.比较两组的临床疗效,同时比较两组患者治疗前后勃起功能国际指数问卷表(IIEF-5)评分、勃起质量量表(EQS)评分、平均起效时间和性交持续时间.结果 治疗后,治疗组和对照组的总有效率分别为86.9%、63.9%,两组总有效率比较差异有统计学意义(P<0.05).治疗后,两组IIEF-5评分和EQS评分均较治疗前显著增加,同组治疗前后差异有统计学意义(P<0.05),且治疗后,治疗组这两项评分均显著高于对照组,两组比较差异有统计学意义(P<0.05).治疗组平均起效时间和平均性交持续时间均显著长于对照组,两组比较差异有统计学意义(P<0.05).结论 西地那非治疗勃起功能障碍有较好的临床疗效,疗效优于酚妥拉明,可进行临床推广使用.

Objective To compare the clinical efficacy and safety between sildenafil and phentolamine in the treatment of essential hypertension. Methods Erectile dysfunction patients (223 cases) who came to Nanjing Maternity and Child Health Care Center from June 2011 to June 2014 were randomly divided into control (n = 108 ) and treatment (n = 115) groups. The patients in the control group were po administered with Mesylate Phentolamine Tablets 0.5 — 1 h before sexual intercourse, 1 tablet/time. The patients in the treatment group were po administered with Citrate Sildenafil Tablets 0.5 — 1 h before sexual intercourse. For the first time, the recommended dosage was 50 mg, then the adjusting dosage ranged from 25 mg to 100 mg according to the individual effect. The patients in two groups took the drugs at least one time daily but not more than 4 times a week, and the patients in the two groups were treated for 8 weeks. After the treatment, the efficacy was evaluated, while IIEF-5 score, EQS score, average working time, and duration of sexual intercourse in two groups were compared. Results The efficacies in the treatment and control groups were 86.9% and 63.9%, respectively, with differences between the two groups (P < 0.05). After treatment, IIEF-5 score and EQS score in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the two scores in the treatment group were significantly higher than those of the control group, with significant difference between two groups (P < 0.05). The times of average working and duration of sexual intercourse in treatment group were longer than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Sildenafil has the good clinical effect in treatment of essential hypertension, and the curative effect is better than that of phentolamine, which can be used widely in clinical.