氟西汀治疗早泄有效性和安全性的Meta分析_《中国循证医学杂志》

作者：

王聪 ¹ , 赵雯迪 ¹ ,  钟朝晖 ²

1. 重庆医科大学（重庆 400016）；2. 重庆医科大学公共卫生与管理学院（重庆 400016）;

关键词：

氟西汀 5-HT再摄取抑制剂早泄射精潜伏期时间 Meta分析随机对照试验

DOI：

10.7507/1672-2531.20120232

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价氟西汀治疗早泄的有效性和安全性。
方法　计算机检索MEDLINE、EMbase、PubMed、Ovid、CENTRAL、CBM和CNKI，收集氟西汀治疗早泄的随机对照试验，检索时限均从1996年7月至2012年5月。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价质量后，采用RevMan5.0软件进行Meta分析。
结果　最终纳入6个研究，共221例患者。Meta分析结果显示在疗效方面，治疗前两组患者的阴道内射精潜伏时间（IELT）差异无统计学意义［WMD=–0.21，95%CI（–4.79，4.37），P=0.93］，治疗后氟西汀组（治疗组）患者的IELT明显长于安慰剂组（对照组），其差异有统计学意义［WMD=134.54，95%CI（79.78，189.30），P lt;0.000 01］。敏感性分析结果显示，治疗组患者的IELT长于对照组，其差异有统计学意义［WMD=155.19，95%CI（130.64，179.75），P lt;0.000 01］。在安全性方面，治疗组患者的不良反应发生率较对照组高，其差异有统计学意义［OR=5.49，95%CI（2.43，12.38），P lt;0.000 1］。
结论　现有研究表明，氟西汀能改善早泄患者症状，明显延长患者阴道内射精潜伏时间，提高性生活质量，且不良反应较轻，能够耐受，适合长期服用。受纳入研究的数量限制，我们认为有必要进一步明确早泄的诊断及治疗标准，使用目前国际通用的指标来辅助设计和开展更多多中心、大样本的临床研究，并进行长期随访，以获取更多证据。

引用本文： 王聪,赵雯迪,钟朝晖. 氟西汀治疗早泄有效性和安全性的Meta分析. 中国循证医学杂志, 2012, 12(12): 1510-1515. doi: 10.7507/1672-2531.20120232 复制

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9.	Yilmaz U, Tatlişen 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.	潘寿华, 谢立平. 氟西汀治疗早泄的疗效观察. 临床泌尿外科杂志, 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.	孙中义, 李彦锋, 周波, 等. 盐酸氟西汀每日用药与按需给药在早泄治疗中的比较研究. 中华男科学杂志, 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, Tatlişen 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. 潘寿华, 谢立平. 氟西汀治疗早泄的疗效观察. 临床泌尿外科杂志, 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. 孙中义, 李彦锋, 周波, 等. 盐酸氟西汀每日用药与按需给药在早泄治疗中的比较研究. 中华男科学杂志, 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.

《中国循证医学杂志》

氟西汀治疗早泄有效性和安全性的Meta分析

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《中国循证医学杂志》

氟西汀治疗早泄有效性和安全性的Meta分析

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