目的 觀察依帕司他聯(lián)合西地那非治療2型糖尿病勃起功能障礙的臨床療效。方法 選取鞍鋼集團(tuán)總醫(yī)院2013年1月-2014年1月收治的2型糖尿病并發(fā)勃起功能障礙患者60例,隨機(jī)分為對照組和治療組,每組30例。兩組患者均給予常規(guī)治療控制血糖。對照組患者在性生活前1 h服用枸櫞酸西地那非片,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。每日最多服用1次,每周至少1次但不超過4次。治療組在對照組基礎(chǔ)上口服依帕司他片,1片/次,3次/d。兩組共治療3個月。治療后6個月進(jìn)行復(fù)診。按勃起功能國際指數(shù)問卷表(IIEF-5)評分及硬度等級評定陰莖勃起變化,測定腓總神經(jīng)運(yùn)動傳導(dǎo)速度(PNCV)和脛神經(jīng)運(yùn)動傳導(dǎo)速度(TNCV)。記錄兩組發(fā)生的不良反應(yīng)情況。結(jié)果 兩組治療后及復(fù)診時IIEF-5評分均較治療前明顯提高,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組治療后和復(fù)診時勃起硬度Ⅳ級人數(shù)顯著多于治療前,Ⅰ級人數(shù)少于治療前,差異有統(tǒng)計(jì)學(xué)意義(P<0.05);復(fù)診時治療組患者勃起硬度Ⅳ級人數(shù)顯著多于對照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組不良反應(yīng)發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 依帕司他聯(lián)合西地那非治療2型糖尿病勃起功能障礙具有較好的臨床療效,可以改善患者預(yù)后生活質(zhì)量,值得臨床推廣應(yīng)用。

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.