氟西汀治療早泄有效性和安全性的Meta分析_《中國循證醫學雜志》

作者：

王聰 ¹ , 趙雯迪 ¹ ,  鐘朝暉 ²

1. 重慶醫科大學（重慶 400016）；2. 重慶醫科大學公共衛生與管理學院（重慶 400016）;

關鍵詞：

氟西汀 5-HT再攝取抑制劑早泄射精潛伏期時間 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20120232

視頻：

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目的　系統評價氟西汀治療早泄的有效性和安全性。
方法　計算機檢索MEDLINE、EMbase、PubMed、Ovid、CENTRAL、CBM和CNKI，收集氟西汀治療早泄的隨機對照試驗，檢索時限均從1996年7月至2012年5月。由2位評價員按照納入與排除標準獨立篩選文獻、提取資料和評價質量后，采用RevMan5.0軟件進行Meta分析。
結果　最終納入6個研究，共221例患者。Meta分析結果顯示在療效方面，治療前兩組患者的陰道內射精潛伏時間（IELT）差異無統計學意義［WMD=–0.21，95%CI（–4.79，4.37），P=0.93］，治療后氟西汀組（治療組）患者的IELT明顯長于安慰劑組（對照組），其差異有統計學意義［WMD=134.54，95%CI（79.78，189.30），P lt;0.000 01］。敏感性分析結果顯示，治療組患者的IELT長于對照組，其差異有統計學意義［WMD=155.19，95%CI（130.64，179.75），P lt;0.000 01］。在安全性方面，治療組患者的不良反應發生率較對照組高，其差異有統計學意義［OR=5.49，95%CI（2.43，12.38），P lt;0.000 1］。
結論　現有研究表明，氟西汀能改善早泄患者癥狀，明顯延長患者陰道內射精潛伏時間，提高性生活質量，且不良反應較輕，能夠耐受，適合長期服用。受納入研究的數量限制，我們認為有必要進一步明確早泄的診斷及治療標準，使用目前國際通用的指標來輔助設計和開展更多多中心、大樣本的臨床研究，并進行長期隨訪，以獲取更多證據。

引用本文： 王聰,趙雯迪,鐘朝暉. 氟西汀治療早泄有效性和安全性的Meta分析. 中國循證醫學雜志, 2012, 12(12): 1510-1515. doi: 10.7507/1672-2531.20120232 復制

1.	Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med, 2005, 2(3): 358-367.
2.	Symonds T, Roblin D, Hart K, et al. How does premature ejaculation impact a man’s life? J Sex Marital Ther, 2003, 29(5): 361-370.
3.	Sotomayor M. The burden of premature ejaculation: the patient’s perspective. J Sex Med, 2005, 2 (Suppl 2): 110-114.
4.	Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation:a double-blind, randonfised, placebo controlled study. Am J Psychiat, 1994, 151(9): 1377-1379.
5.	Kara H, Aydin S, Yücel M, et al. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J Urol, 1996, 156(5): 1631-1632.
6.	Mattos RM, Lucon AM, Srougi M. Tadalafil and fluoxetine in premature ejaculation: prospective, randomized, double-blind, placebo-controlled study. Urol Int, 2008, 80(2): 162-165.
7.	Waldinger MD. The neurobiological approach to premature ejaculation. J Urol, 2002, 168(6): 2359-2362.
8.	Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: A double-blind, placebo controlled study. J Urol, 1998, 159(2): 425-427.
9.	Yilmaz U, Tatli?en A, Turan H, et al. The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation. J Urol Jan, 1999, 161(1): 107-111.
10.	潘壽華, 謝立平. 氟西汀治療早泄的療效觀察. 臨床泌尿外科雜志, 2004, 19(7): 400-401.
11.	Haensel SM, Klem TM, Hop WC, et al. Fluoxetine and Premature Ejaculation: A Double-Blind, Crossover, Placebo-Controlled Study. J Clin Psychopharm, 1998, 18(1):72-77.
12.	Wang WF, Chang L, Minhas S, et al. Selective serotonin reuptake inhibitors in the treatment of premature ejaculation. Chinese Med J, 2007, 120 (11): 1000-1006.
13.	Mousatizadeh K, Ghafourifar P, Sadeghi-nejad H. Calcium channel blocking activity of thiordazine, clomipramine and fluoxetine inisolated vas deferens: A relarive potency measurement study. J Urol, 2002, 168(6): 2716-2719.
14.	Seo KK, Kim SC, Lee MY. Comparison of peripheral inhibitory effects of clomipramine with selective serotonin reuptake inhibitors on contraction of vas deferens: In vitro and in vivo studies. J Urol, 2001, 165(6): 2110-2114.
15.	孫中義, 李彥鋒, 周波, 等. 鹽酸氟西汀每日用藥與按需給藥在早泄治療中的比較研究. 中華男科學雜志, 2010, 24 (3): 50, 51, 59.
16.	Gurkan L, Oommen M, Wayne JG. et al. Premature ejaculation: current and future treatments. Asina J Androl, 2008, 10(1): 102-109.
17.	Manasia P, Pomerol J, Ribè N, et al. Comparison of The Efficacy and Safety of 90 mg Versus 20 mg Fluoxetine in the Treatment of Premature Ejaculation. J Urol, 2003, 170(1): 164-165.

1. Patrick DL, Althof SE, Pryor JL, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med, 2005, 2(3): 358-367.
2. Symonds T, Roblin D, Hart K, et al. How does premature ejaculation impact a man’s life? J Sex Marital Ther, 2003, 29(5): 361-370.
3. Sotomayor M. The burden of premature ejaculation: the patient’s perspective. J Sex Med, 2005, 2 (Suppl 2): 110-114.
4. Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation:a double-blind, randonfised, placebo controlled study. Am J Psychiat, 1994, 151(9): 1377-1379.
5. Kara H, Aydin S, Yücel M, et al. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. J Urol, 1996, 156(5): 1631-1632.
6. Mattos RM, Lucon AM, Srougi M. Tadalafil and fluoxetine in premature ejaculation: prospective, randomized, double-blind, placebo-controlled study. Urol Int, 2008, 80(2): 162-165.
7. Waldinger MD. The neurobiological approach to premature ejaculation. J Urol, 2002, 168(6): 2359-2362.
8. Kim SC, Seo KK. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: A double-blind, placebo controlled study. J Urol, 1998, 159(2): 425-427.
9. Yilmaz U, Tatli?en A, Turan H, et al. The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation. J Urol Jan, 1999, 161(1): 107-111.
10. 潘壽華, 謝立平. 氟西汀治療早泄的療效觀察. 臨床泌尿外科雜志, 2004, 19(7): 400-401.
11. Haensel SM, Klem TM, Hop WC, et al. Fluoxetine and Premature Ejaculation: A Double-Blind, Crossover, Placebo-Controlled Study. J Clin Psychopharm, 1998, 18(1):72-77.
12. Wang WF, Chang L, Minhas S, et al. Selective serotonin reuptake inhibitors in the treatment of premature ejaculation. Chinese Med J, 2007, 120 (11): 1000-1006.
13. Mousatizadeh K, Ghafourifar P, Sadeghi-nejad H. Calcium channel blocking activity of thiordazine, clomipramine and fluoxetine inisolated vas deferens: A relarive potency measurement study. J Urol, 2002, 168(6): 2716-2719.
14. Seo KK, Kim SC, Lee MY. Comparison of peripheral inhibitory effects of clomipramine with selective serotonin reuptake inhibitors on contraction of vas deferens: In vitro and in vivo studies. J Urol, 2001, 165(6): 2110-2114.
15. 孫中義, 李彥鋒, 周波, 等. 鹽酸氟西汀每日用藥與按需給藥在早泄治療中的比較研究. 中華男科學雜志, 2010, 24 (3): 50, 51, 59.
16. Gurkan L, Oommen M, Wayne JG. et al. Premature ejaculation: current and future treatments. Asina J Androl, 2008, 10(1): 102-109.
17. Manasia P, Pomerol J, Ribè N, et al. Comparison of The Efficacy and Safety of 90 mg Versus 20 mg Fluoxetine in the Treatment of Premature Ejaculation. J Urol, 2003, 170(1): 164-165.

《中國循證醫學雜志》

氟西汀治療早泄有效性和安全性的Meta分析

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《中國循證醫學雜志》

氟西汀治療早泄有效性和安全性的Meta分析

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