| Purpose:To explore the clinical efficacy of visual accurate electrophysiology(VAE)combined with dapoxetine hydrochloride in the treatment of premature ejaculation(PE)and its impact on all scores.Method:According to the inclusion criteria and exclusion criteria of this trial,135 patients with premature ejaculation who volunteered to participate in the trial were selected from the outpatients of Gannan Medical College First Affiliated Hospital from April2021 to November 2022,and were divided into a combination group(dapoxetine+VAE)of 41 cases,a drug group(dapoxetine)of 54 cases and an electrophysiological group(VAE)of 40 cases.All subjects must be filled in or recorded the International Index of Erectile Function(IIEF-5),Erectile Hardness Scale(EHS),Intravaginal Ejaculation Latency Time(IELT),Premature Ejaculation Diagnostic Tool(PEDT),Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),Sleep Quality(SQ)score,Medical Infrared Thermography(MIT)and adverse reactions during treatment before treatment and after 10 days of treatment.Results:130 PE patients filled in the scoring scale,completed the examine of MIT and recorded the adverse reactions during the treatment pre-and post-treatment.One person in the combined group withdrew from the trial because he could not continue to come to the hospital for treatment,three people in the drug group withdrew from the trial because he refused to continue to take medicine for treatment due to dissatisfaction with the efficacy,and one person in the electrophysiological group withdrew from the trial because he could not continue to come to the hospital for treatment.General data: 40 patients in the combined group,aged 21-47 years,average age 32.88 ± 5.88 years,average Body Mass Index(BMI)23.45 ± 2.40 kg/m~2;There were 51 patients in the drug group,aged 21-44 years,with an average age of 29.69 ±4.87 years and an average BMI of 22.57 ± 2.85 kg/m~2;There were 39 patients in the electrophysiological group,aged 23-38 years,with an average age of 30.38 ± 4.33 years and an average BMI of 23.18 ± 2.82kg/m~2.The difference in age between groups was statistically significant(P <0.05),the combination group was older than the patients in the drug and electrophysiology groups,and there was no significant difference in BMI between groups(P> 0.05).1.Changes in MIT: All patients were reviewed by MIT after the end of treatment,and the abnormal temperature area was improved or normal compared with before treatment.2.Changes in premature ejaculation score(IELT,PEDT): the mean combination group of IELT and PEDT before treatment was 87.00 ± 54.79,12.33 ± 3.01,Drug group was 67.65 ± 45.73 and 12.55 ± 2.95,The electrophysiological group was 87.69± 76.60 and 12.72 ± 3.09,After the end of treatment,the mean combination group of IELT and PEDT was 302.25 ± 203.57 and 8.03 ± 3.03,Drug group was 174.71 ±200.32 and 10.84 ± 3.97,The electrophysiological group was 151.92 ± 136.62 and10.15 ± 3.49.Comparison of pre-and post-treatment IELT mean values(P <0.05).Comparison of pre-and post-treatment PEDT mean values decreased in the three groups(P <0.05).The difference in IELT score was significant,higher in the combination group(P <0.05);no difference between drug and electrophysiology groups(P> 0.05).PEDT score mean difference between groups,the combination group was lower than the drug and electrophysiological groups,significant(P <0.05);no difference between the drug and electrophysiological groups(P> 0.05).3.Changes in erectile function score(IIEF-5,ESH): 18.53 ± 3.72,3.40 ± 0.59 in the IIEF-5 and ESH combination group before treatment,Group was 17.16 ± 6.01 and3.29 ± 0.58,The electrophysiological group was 16.59 ± 5.31 and 3.26 ± 0.75,After completion of treatment,the IIEF-5 and ESH combination groups were 20.38 ± 3.63 and 3.30 ± 0.56,Drug group was 16.96 ± 6.03 and 3.24 ± 0.55,The electrophysiological group was 17.90 ± 4.47 and 3.26 ± 0.75.Comparison of the pre-treatment and post-treatment IIEF-5 means in both the combination and electrophysiological groups was statistically significant(P <0.05)and not in the drug group(P> 0.05).Comparison of pre-and post-treatment ESH mean values was not significant between the three groups(P> 0.05).The mean value of IIEF-5 scores was different between groups,and the combination group was higher than the drug and electrophysiological groups(P <0.05);there was no difference between the drug and electrophysiological groups(P> 0.05).There was no statistical difference in the mean comparison of patient ESH scores between groups(P> 0.05).4.Changes in psychiatric symptom scores(PHQ-9,GAD-7): the combined PHQ-9 and GAD-7 were 6.90 ± 4.66,4.65 and 4.60 ± 3.65,Drug group was 6.63± 4.69 and 4.47 ± 4.03,Electrophysiological group was 7.74 ± 5.18,5.41 ±4.67,After completion of treatment,the PHQ-9 and GAD-7 combination groups were4.90 ± 3.69 and 1.45 ± 1.20,The drug group was 5.86 ± 4.21 and 3.88 ±3.50,The electrophysiological group was 5.41 ± 4.21 and 3.72 ± 4.01.Comparison of pre-treatment and post-treatment PHQ-9 mean values was statistically significant in all three groups(P <0.05).Comparcomparison of pre-treatment and post-treatment GAD-7 mean,both the combination and electrophysiological groups were statistically significant(P <0.05)and no significant difference in the drug group(P> 0.05).There was no significant difference in mean PHQ-9 scores between groups(P> 0.05).Statistical difference in GAD-7 scores between groups,lower than the combination group and electrophysiological group(P <0.05);no significant difference between drug group and electrophysiological group(P> 0.05).5.Change in sleep quality(SQ)score: The pre-treatment SQ combination was4.60 ± 3.65 in the patient group,4.47 ± 4.03 in the drug group,5.41 ± 4.67 in the electrophysiology group,1.45 ± 1.20 in the SQ combination group,3.88 ±3.50 in the drug group,and 3.72 ± 4.01 in the electrophysiology group.Comparison of the pre-treatment and post-treatment SQ mean in both the combination and electrophysiological groups was statistically significant(P <0.05)and no significant difference in the drug group(P> 0.05).There was no significant difference in mean SQ scores between groups(P> 0.05).6.Occurrence of adverse reactions: none of the patients in the electrophysiological group experienced diarrhea,abdominal pain,dizziness,treatment site pain,allergy and other discomfort.Three patients in the combination group experienced dizziness,abdominal pain and other discomfort during the treatment,and after a period of adaptation and dietary adjustment,the discomfort symptoms were gradually relieved;5 patients in the drug group experienced dizziness,abdominal pain and other discomfort,and the discomfort symptoms disappeared after 2 days of withdrawal.7.Clinical efficacy(effective rate): the total effective rate of clinical efficacy in the combination group,drug group and electrophysiology group was 67.5%,31.4%and 28.1% respectively,the difference was statistically significant(P <0.01),and the efficacy of the combination group was better than that in the drug group and electrophysiology group.Conclusion:VAE is safe and effective for PE,and can improve erectile function,mental symptoms and sleep quality;VAE and dapoxetine are more effective than single treatment regimen for premature ejaculation,which is worth clinical application. |
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