| Background and PurposeErectile dysfunction is a common disease that affects men’s health all over the world.In China,the incidence of ED is also on the rise.With the rapid economic development and increasingly fierce social competition,men,especially young and middle-aged men,are facing increasing life and work pressure.In addition,in recent decades,with the continuous improvement of people’s living standards and the guarantee of material life,people also have more energy to pay attention to their own health and the basic needs of sex.ED,a common male disease,has attracted more and more attention.Currently on clinical treatment of ED in different ways,but drug treatment is still the preferred method,especially since the advent of the PDE5 i oral PDE5 i because of its convenience and exact curative effect,become the preferred method for the treatment of ED,but about the clinical usage and dosage of the drug treatment,there are many different sounds and debate about drug treatment can achieve the purpose of curing,is also each are not identical,which requires the majority of male urological doctors and researchers to make more clinical research and analysis.To investigate the clinical efficacy of long-term low-dose oral administration of two kinds of PDE5 i in the treatment of erectile dysfunction and the effect on the function of vascular endothelial cells.Objects210 organic ED patients admitted to the urology department of the first affiliated hospital of zhengzhou university from March 2017 to March 2018 were collected.The average age of the patients was 30.71±8.31 years,and the average disease was 4.61±2.65 years.MethodsThe above patients were randomly divided into group A,group B and group C.70 patients in group A received 50 mg of sildenafil orally every day,70 patients in group B received 5mg of tadalafil orally every day,and 70 patients in group C received 100 mg of sildenafil orally 1h before each sexual activity.All three groups had a course of treatment of 12 weeks.After treatment,the three groups of patients were evaluated with IIEF-5 score before treatment,at the end of treatment and 8 weeks after treatment,and EHS score respectively also.In addition,questions 2(SEP2)and 3(SEP3)in the user activity log(SEP)were used to evaluate the sexual function status of the three groups before and after treatment for 8 weeks.Fasting venous blood of three groups of patients before and after treatment were selected to measure the content of NO in serum.The adverse reaction events of the three groups were also recorded.Results1.IIEF-5:The IIEF-5 scores were 11.58±3.54,20.49±3.68 and 16.85±2.73 before treatment,at the end of treatment and 8 weeks after treatment in group A;and 11.28±3.86,20.51±3.60,17.17±2.20 in group B;11.64±3.32,18.68±2.73,12.95±2.87 in group C;After treatment and 8 weeks after treatment,the score of group C was lower than that of group A and B.The scores of each group were higher after treatment than before treatment,and higher at 8 weeks after treatment than before treatment,and lower at 8 weeks after treatment(P<0.05).There was no significant difference between group A and group B at 8 weeks after treatment(P>0.05).2.EHS: group A had 15/29/23/0 patients with level 1/2/3/4 before treatment,1/4/20/42 patients with level 1/2/3/4 after treatment,and 0/9/39/19 patients with level 1/2/3/4 after treatment for 8 weeks.In group B,patients with stage 1/2/3/4 before treatment were 17/28/24/0,patients with stage 0/4/20/45 after treatment,and patients with stage 0/11/34/24 after 8 weeks of treatment.In group C,ehs1/2/3/4 level was 11/28/17/0 before treatment,0/14/31/11 after treatment,8/27/21/0 after 8 weeks of treatment.At the end of treatment and 8 weeks after treatment,the grade of each group was compared,and the difference was statistically significant(P<0.05).The grade of group C was lower than that of group A and B.The difference was statistically significant(P<0.05).After treatment,the grade of group A and B was higher than that before treatment,and 8 weeks after treatment,the grade was higher than that before treatment and lower than that after treatment.After treatment,the grade of group C was higher than that before treatment,and 8 weeks after treatment was lower than that after treatment(P<0.05).There was no significant difference between group A and group B at 8 weeks after treatment(P>0.05).3.As for the answers to questions 2 and 3 of the SEP questionnaire in groups A and B,there was A significant increase in the number of people who answered "yes" 8 weeks after treatment compared with before treatment,while the number of people who answered "yes" increased in group C,but it was not obvious.4.Serum NO test results of group A before and after treatment were 52.72±9.56μmol/L and 72.60 ±9.69μmol/L,respectively.Group B: 51.57±8.22 μmol/L,75.10±9.57μmol/L;Group c: 52.08±10.55μmol/L,53.12±7.50μmol/L;After treatment,NO content in serum of group C showed NO significant difference compared with that before treatment,which was lower than that of group A and B(P < 0.05).After treatment,NO content in group A and B was higher than that before treatment(P < 0.05),and NO significant difference was found in group A and B at 8 weeks after treatment(P>0.05).5.The VCAM-1 contents in serum of patients in group A before and at the end of treatment were 310.34 29.50 ng/L and 293.35 20.06 ng/L,respectively.Group B: 307.66 26.16 ng/L,289.76 23.85 ng/L;Group c: 309.46 25.42ng/L,305.25 23.42 ng/L;A,B two groups of patients at the end of the measurement of serum VCAM-1 content significantly lower than before treatment,A statistically significant difference(P < 0.05),treatment group C after the determination of serum VCAM-1 value before the treatment has no obvious change,there was no statistically significant difference(P > 0.05),A,B two groups after treatment VCAM-1 content was lower than that in group C,statistically significant difference(P < 0.05).There were 3 cases in group A,1 case in group B,and 14 cases in group C.In group A,1 patient developed green vision after oral administration of sildenafil;in group B,5 patients developed back pain after oral administration of tadalafil;in 2 patients,slight headache occurred,In group C,3 patient developed green vision after oral administration of sildenafil;and the symptoms of continuous administration gradually disappeared.The above adverse reactions were transient and did not affect the treatment,while the other patients had no obvious adverse reactions.Conclusion1.Short-term effects of two PDE5 inhibitors,sildenafil and tadalafil,taken orally were significant.2.Long-term and regular oral administration of sildenafil and tadalafil as PDE5 inhibitors at low doses have good clinical effects on improving the erectile function of ED patients,and the clinical effects are still significant after a period of withdrawal.There was no significant difference between the two groups,and all of them were significantly superior to the treatment with oral sildenafil as needed.3.Low-dose long-term oral administration of sildenafil or tadalafil can increase the content of NO in serum and decrease the content of vcam-1 in serum,suggesting that it may improve the function of endothelial cells. |
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