他达拉非治疗勃起功能障碍无效的原因分析及对策
Causes of tadalafil failure and rechallenging treatment
目的 分析他达拉非治疗勃起功能障碍( erectile dysfunction,ED)无效的原因及正确指导用药后的效果. 方法 应用他达拉非治疗无效的ED患者80例.年龄22~54岁,平均32岁.病程26个月~4年,平均2.6年.行关于药物使用方法的问卷调查,根据调查结果分析不正确用药的原因,进行用药指导.患者服用他达拉非治疗2周后随访,采用2004年国际ED咨询委员会推荐的治疗评价指标性生活日记(SEP)中问题2(是否能够成功插入阴道)和问题3(是否维持足够勃起以成功完成性生活)作为疗效评价指标. 结果 80例患者有1个或多个不正确服用他达拉非的方式:21.2%的患者不知道性刺激是他达拉非起效所必需的,87.5%的患者尝试次数<4次,57.5%的患者未服用最大推荐剂量20 mg,84.0%的患者服药时情绪紧张或焦虑.65例接受他达拉非再治疗,再治疗的有效率为46.2%( 30/65). 结论 不正确用药是导致他达拉非治疗无效的常见原因,对患者进行性教育和正确的用药指导可提高他达拉非的治疗效果.
更多Objective To assess the cause of tadalafil failure and the feasibility of successfully rechallenging nonresponding patients. Methods A total of 80 consecutive erectile dysfunction ( ED ) patients who claimed poor response to tadalafil were enrolled into the study.A self-administered tadalafil-use questionnaire composed of eight questions was applied to assess how they had used tadalafil.Subjects were given thorough instruction based on individual answers and four doses of tadalafil 20mg.After a 2-week follow-up,end point efficacy of rechallenge was evaluated using the sexual encounter profile (SEP),which was recommended by international advisory panel in 2004. Results A total of 45 subjects had one or more areas of major suboptimal use of tadalafil:21.2% did not know that sexual stimulation was necessary for tadalafil to work,87.5% attempted to use tadalafil less than four times,57.5% took a maximal dose less than 20 mg,and 84% felt nervous or anxious.Of the 65 patients undergoing tadalafil rechallenge,30 patients answered “yes” to SEP2 and SEP3.The response rate to rechallenge was 46.2% ( 30/65 ). Conclusions Inappropriate use of tadalafil was major cause of tadalafil non-pesponse.The efficacy of tadalafil could be improved to a better extent by education of patients.
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