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[摘要]
目的 观察依帕司他联合西地那非治疗2型糖尿病勃起功能障碍的临床疗效。方法 选取鞍钢集团总医院2013年1月-2014年1月收治的2型糖尿病并发勃起功能障碍患者60例,随机分为对照组和治疗组,每组30例。两组患者均给予常规治疗控制血糖。对照组患者在性生活前1 h服用枸橼酸西地那非片,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。每日最多服用1次,每周至少1次但不超过4次。治疗组在对照组基础上口服依帕司他片,1片/次,3次/d。两组共治疗3个月。治疗后6个月进行复诊。按勃起功能国际指数问卷表(IIEF-5)评分及硬度等级评定阴茎勃起变化,测定腓总神经运动传导速度(PNCV)和胫神经运动传导速度(TNCV)。记录两组发生的不良反应情况。结果 两组治疗后及复诊时IIEF-5评分均较治疗前明显提高,差异有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。治疗组治疗后和复诊时勃起硬度Ⅳ级人数显著多于治疗前,Ⅰ级人数少于治疗前,差异有统计学意义(P<0.05);复诊时治疗组患者勃起硬度Ⅳ级人数显著多于对照组,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论 依帕司他联合西地那非治疗2型糖尿病勃起功能障碍具有较好的临床疗效,可以改善患者预后生活质量,值得临床推广应用。
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[Abstract]
Objective To evaluate the efficacy of epalrestat combined with sildenafil in treatment of type 2 diabetes complicated with erectile dysfunction. Methods The patients with type 2 diabetes complicated with erectile dysfunction (60 cases) of Ansteel Group Hospital from January 2013 to January 2014 were randomly divided into control (n=30) and treatment (n=30) groups. Patients in two groups were given conventional treatment to control blood glucose. The patients in the control group were po administered with Citrate Sildenafil Tablets 1 h before sexual intercourse. For the first time, the recommended dosage was 50 mg, and then the adjusting dosage ranged from 25 mg to 100 mg according to the individual effect. The patients took the drugs at least once daily but not more than four times a week. The patients in the treatment group were po administered with Epalrestat Tablets at the basis of control group, 1 tablet/time, three times daily. The patients in the two groups were treated for 3 months. All patients were accepted appointment 6 months after treatment. Changes of penile erection were evaluated according to International Index of Erectile Function Questionnaire (IIEF-5) and hardness level, and conduction velocity of common peroneal nerve (PNCV) and tibial nerve (TNCV) were determinate. The situations of adverse reactions in the two groups were recorded. Results IIEF-5 scores in two groups were significantly increased after treatment and follow-up, and the difference was statistically significant in the same group (P< 0.05). And the degree of the improvement in the treatment group was better than that of control group, with significant difference between two groups (P< 0.05). The number of erectile hardness grade Ⅳ after treatment and follow-up was significantly more than that before treatment, while the number of erectile hardness grade Ⅰ was less than that before treatment, and the difference was statistically significant in the same group (P< 0.05). The number of erectile hardness grade Ⅳ follow-up in the treatment group was significantly more than that in the control group, with significant difference between two groups (P< 0.05). There was no statistical significance about the incidence of adverse reactions between two groups. Conclusion Epalrestat combined with sildenafil has the good clinical effect in treatment of type 2 diabetes complicated with erectile dysfunction, and can improve the prognosis life quality of patients, which is worth clinical promotion.
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