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用彩色多普勒超声法研究西地那非不响应和响应者的不同血液动力学反应
Aim:To determine if there are different penile hemodynamic patterns between sildenafil non-responders and responders by using color Doppler ultrasonography. Methods: A total of 69 erectile dysfunction (ED) patients aged 22-79 years were enrolled into the present study. Thirty-eight (55.1%) men with ED who did not respond to four attempts of treatment with 100 mg sildenafil after re-education were classified as sildenafil non-responders. A combination of three vasodilator drugs, 1.25 mg papaverine, 0.4 mg phentolamine and 5 μg prostaglandin El, was given by intracavernous injection before penile Doppler ultrasonography was carried out. The erectile response to intracavernous injection and vascular parameters including peak systolic velocity (PSV), resistance index (RI), end diastolic velocity (EDV) and cavernosa artery diameter (CD) were measured and the results between sildenafil nonresponders and responders were compared. Results: No statistical difference in vascular parameters measured by Doppler ultrasonography studies between non-responders and responders was noted. Sildenafil non-responders had a poorer penile rigidity response to intracavernous injection than responders (P ＜ 0.05). Among patients with adequate PSV (≥ 30 cm/s) and abnormal EDV (＞ 5 cm/s), individuals in the non-responder group had fewer positive responses to intracavernous vasodilator injection than in the responder group (35.3% vs. 72.2%, P ＜ 0.05). Advanced age and comorbidity with diabetes mellitus were significantly associated with sildenafil non-response (P ＜ 0.05).Conclusion: Sildenafil non-responders were characterized by a poorer penile rigidity response to intracavernous injection and had an associated impaired veno-occlusive mechanism. Advanced age and comorbidity with diabetes mellitus were two common factors associated with non-response.
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韩国红参对治疗勃起功能障碍的疗效研究
Aim: To examine the treatment efficacy of Korean Red Ginseng (KRG) in impotent men with erectile dysfunction (ED). Methods: A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind,placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg (3 times daily) of KRG or a placebo. Results: The five-item version of the International Index of Erectile Function (IIEF-5) score after the treatment was significantly higher in the KRG group compared with that before the treatment (from 16.4 ± 2.9 to 21.0 ± 6.3, P ＜ 0.0001). In contrast, there was no difference before and after the treatment in the placebo group (from 17.0 ± 3.1 to 17.7 ± 5.6, P ＞ 0.05). In the KRG group, 20 patients (66.6%),reported improved erection, significant in the global efficacy question (P ＜ 0.01); in the placebo group there was no significance. Scores on questions 2 (rigidity), 3 (penetration), 4 and 5 (maintenance), were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment (P ＜ 0.01).When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score (IIEF-5 score) in questions 3 and 5 for the KRG-treated group (P ＜ 0.001 and P ＜ 0.0001,respectively). The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group (P ＞ 0.05). Conclusion: Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.
