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专家账号密码找回目的 探讨选择性5⁃羟色胺再摄取抑制剂（SSRIs）联合α₁受体阻滞剂治疗继发性早泄（SPE）合并下尿路症状（LUTS）患者的临床疗效与安全性。方法 将57例SPE合并LUTS患者随机分为SSRIs组（n=20）、α₁受体阻滞剂组（n=17）和联合用药组（n=20）。SSRIs组患者接受盐酸舍曲林片治疗，α₁受体阻滞剂组患者接受盐酸坦洛新缓释片治疗，联合用药组患者接受盐酸舍曲林片联合盐酸坦洛新缓释片治疗，3组患者均连续治疗12周。比较3组患者治疗前后阴道内射精潜伏时间（IELT）、国际前列腺症状量表（IPSS）评分、早泄诊断工具（PEDT）评分、精囊宽径等指标，以及临床总体印象变化（CGIC）有效率和不良反应发生情况。结果 与治疗前相比，治疗后3组患者的IELT延长、PEDT评分降低，联合用药组和α₁受体阻滞剂组的IPSS评分降低（P<0.05），但3组患者治疗前后精囊宽径差异无统计学意义（P>0.05）。治疗后，联合用药组患者的IELT长于α₁受体阻滞剂组和SSRIs组，PEDT评分低于α₁受体阻滞剂组和SSRIs组（P<0.05）；治疗后，SSRIs组患者的IPSS评分高于α₁受体阻滞剂组和联合用药组（P<0.05）。3组患者治疗后的精囊宽径、CGIC有效率，以及治疗期间的不良反应总发生率差异无统计学意义（P>0.05）。结论 SSRIs、α₁受体阻滞剂均可改善SPE合并LUTS患者的症状，且联合用药的疗效优于单药治疗，安全性良好，其疗效独立于精囊宽径变化。
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论著·临床研究
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更新时间：2026-08-10
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SSRIs联合α₁受体阻滞剂治疗继发性早泄合并下尿路症状患者疗效观察
Efficacy observation of SSRIs combined with α1⁃receptor blockers for the treatment of patients with secondary premature ejaculation and concomitant lower urinary tract symptoms
广西医学 页码：1008-1014
作者机构：张迅，硕士，主任医师，研究方向为男性生殖与性医学研究。
基金信息：广西壮族自治区卫生健康委员会自筹经费科研课题（Z20201155）
- 中文简介
- 英文简介
- 参考文献
Objective To investigate the clinical efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) combined with α1⁃receptor blockers for the treatment of patients with secondary premature ejaculation (SPE) and concomitant lower urinary tract symptoms (LUTS). Methods A total of 57 patients with SPE and concomitant LUTS were randomly divided into three groups: SSRIs group (n=20), α1⁃receptor blockers group (n=17), or drug combination group (n=20). Patients in the SSRIs group received Sertraline Hydrochloride Tablets, those in the α1⁃receptor blockers group received Tamsulosin Hydrochloride Sustained⁃Release Tablets, and those in the drug combination group received both 2 drugs as above. All patients among the three groups as above were treated continuously for 12 weeks. Indices including intravaginal ejaculatory latency time (IELT), International Prostate Symptom Scale (IPSS) score, premature ejaculation diagnostic tool (PEDT) score, and seminal vesicle width were compared between the three groups before and after treatment. In addition, the clinical global impression of change (CGIC) effective rate and the occurrence of adverse reactions were also compared between the three groups. Results Compared with before treatment, IELT was prolonged and PEDT score was reduced in all three groups after treatment, moreover, IPSS score was reduced in the drug combination group and the α1⁃receptor blockers group (P<0.05), whereas no statistically significant difference was observed in seminal vesicle width before and after treatment in any of the three groups (P>0.05). After treatment, IELT in the drug combination group was longer than that in the α1⁃receptor blockers group and the SSRIs group, and PEDT score in the drug combination group was lower than that in the remaining two groups (P<0.05). After treatment, IPSS score in the SSRIs group was higher than that in the α1⁃receptor blockers group and the drug combination group (P<0.05). No statistically significant difference was found between the three groups in seminal vesicle width and CGIC effective rate after treatment, or total incidence rate of adverse reactions during treatment (P>0.05). Conclusion Both SSRIs and α1⁃receptor blockers can improve symptoms in SPE patients and concomitant LUTS, and the drug combination therapy demonstrates superior efficacy to monotherapy, with a favorable safety profile. The therapeutic effect is independent of changes in seminal vesicle width.
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