目的 比較西地那非和酚妥拉明治療勃起功能障礙的臨床效果和安全性.方法 選取2011年6月—2014年6月南京市婦幼保健院收治的勃起功能障礙患者223例,隨機分為對照組(n=108例)和治療組(n=115例).對照組性交前0.5～1 h口服甲磺酸酚妥拉明片,1片/次;治療組在性交前0.5～1 h口服枸櫞酸西地那非片.首次使用時推薦劑量為50 mg,根據(jù)后期個體療效情況調(diào)節(jié)劑量,范圍在25～100 mg.兩組每日最多服用1次,每周至少1次但不超過4次,均連續(xù)治療8周.比較兩組的臨床療效,同時比較兩組患者治療前后勃起功能國際指數(shù)問卷表(IIEF-5)評分、勃起質(zhì)量量表(EQS)評分、平均起效時間和性交持續(xù)時間.結(jié)果 治療后,治療組和對照組的總有效率分別為86.9%、63.9%,兩組總有效率比較差異有統(tǒng)計學(xué)意義(P<0.05).治療后,兩組IIEF-5評分和EQS評分均較治療前顯著增加,同組治療前后差異有統(tǒng)計學(xué)意義(P<0.05),且治療后,治療組這兩項評分均顯著高于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05).治療組平均起效時間和平均性交持續(xù)時間均顯著長于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05).結(jié)論 西地那非治療勃起功能障礙有較好的臨床療效,療效優(yōu)于酚妥拉明,可進行臨床推廣使用.

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.