早泄的药物治疗进展_West China Medical Journal

Authors：

 蒲春晓 , 董强 ,  韩平

四川大学华西医院泌尿外科（成都，610041）;

Corresponding author：

韩平, Email: hanpingwestchina@126.com

Keywords：

早泄; 抗抑郁药; 局部麻醉药; 治疗

DOI：

10.7507/1002-0179.20140546

Video：

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Abstract Full text Figures/Tables Video References Cited by

早泄是最常见的男性性功能障碍，药物一直是早泄治疗的焦点。选择性5-羟色胺再摄取抑制剂（SSRIs）是目前临床证据最多、应用最广泛的药物，其中达泊西汀是唯一被批准用于治疗早泄的短效SSRI；局部麻醉药物疗效确切，可按需使用，且不良反应少，是治疗早泄的理想药物；α1-肾上腺素能受体阻滞剂、5型磷酸二酯酶抑制剂、曲马多的有效性和安全性尚缺乏大量确切临床证据，今后有望成为治疗早泄的新方法。随着对生理性射精过程和相关神经递质的深入研究，将会为早泄的药物治疗提供新的思路和选择。

Citation： 蒲春晓, 董强, 韩平. 早泄的药物治疗进展. West China Medical Journal, 2014, 29(9): 1795-1799. doi: 10.7507/1002-0179.20140546 Copy

1.	Laumann EO,Nicolosi A,Glasser DB,et al.Sexual problems among women and men aged 40-80 y:prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors[J].Int J Impot Res,2005,17(1):39-57.
2.	Porst H,Montorsi F,Rosen RC,et al.The premature ejaculation prevalence and attitudes (PEPA) survey:prevalence,comorbidities,and professional help-seeking[J].Eur Urol,2007,51(3):816-823.
3.	Metz ME,Pryor JL,Nesvacil LJ,et al.Premature ejaculation:a psychophysiological review[J].J Sex Marital Ther,1997,23(1):3-23.
4.	Melnik T,Althof S,Atallah AN,et al.Psychosocial interventions for premature ejaculation[J].Cochrane Database Syst Rev,2011(8):D8195.
5.	Kim SC,Seo KK.Efficacy and safety of fluoxetine,sertraline and clomipramine in patients with premature ejaculation:a double-blind,placebo controlled study[J].J Urol,1998,159(2):425-427.
6.	Waldinger MD,Zwinderman AH,Olivier B.On-demand treatment of premature ejaculation with clomipramine and paroxetine:a randomized,double-blind fixed-dose study with stopwatch assessment[J].Eur Urol,2004,46(4):510-516.
7.	Waldinger MD,Zwinderman AH,Schweitzer DH,et al.Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation:a systematic review and meta-analysis[J].Int J Impot Res,2004,16(4):369-381.
8.	Waldinger MD,Zwinderman AH,Olivier B,et al.The majority of men with lifelong premature ejaculation prefer daily drug treatment:an observation study in a consecutive group of Dutch men[J].J Sex Med,2007,4(4 Pt 1):1028-1037.
9.	Mcmahon CG,Abdo C,Incrocci L,et al.Disorders of orgasm and ejaculation in men[J].J Sex Med,2004,1(1):58-65.
10.	Waldinger MD,Schweitzer DH,Olivier B.On-demand SSRI treatment of premature ejaculation:pharmacodynamic limitations for relevant ejaculation delay and consequent solutions[J].J Sex Med,2005,2(1):121-131.
11.	Angulo J,Peiró C,Sanchez-Ferrer CF,et al.Differential effects of serotonin reuptake inhibitors on erectile responses,NO-production,and neuronal NO synthase expression in rat corpus cavernosum tissue[J].Br J Pharmacol,2001,134(6):1190-1194.
12.	Kadioglu M,Muci E,Ozyavuz R,et al.Paroxetine inhibited the relaxations induced by EFS in mice corpus cavernosum:is it a NOS inhibition?[J].Fundam Clin Pharmacol,2010,24(1):55-61.
13.	Koyuncu H,Serefoglu EC,Ozdemir AT,et al.Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation[J].Int J Impot Res,2012,24(5):171-173.
14.	Modi NB,Dresser MJ,Simon M,et al.Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride,a novel agent for the treatment of premature ejaculation[J].J Clin Pharmacol,2006,46(3):301-309.
15.	Porst H,Mcmahon CG,Althof SE,et al.Baseline characteristics and treatment outcomes for men with acquired or lifelong premature ejaculation with mild or no erectile dysfunction:integrated analyses of two phase 3 dapoxetine trials[J].J Sex Med,2010,7(6):2231-2242.
16.	Mcmahon CG,Althof SE,Kaufman JM,et al.Efficacy and safety of dapoxetine for the treatment of premature ejaculation:integrated analysis of results from five phase 3 trials[J].J Sex Med,2011,8(2):524-539.
17.	Buvat J,Tesfaye F,Rothman M,et al.Dapoxetine for the treatment of premature ejaculation:results from a randomized,double-blind,placebo-controlled phase 3 trial in 22 countries[J].Eur Urol,2009,55(4):957-968.
18.	Mcmahon C,Kim SW,Park NC,et al.Treatment of premature ejaculation in the Asia-Pacific region:results from a phase Ⅲ double-blind,parallel-group study of dapoxetine[J].J Sex Med,2010,7(1 Pt 1):256-268.
19.	Kaufman JM,Rosen RC,Mudumbi RV,et al.Treatment benefit of dapoxetine for premature ejaculation:results from a placebo-controlled phase Ⅲ trial[J].BJU Int,2009,103(5):651-658.
20.	Frink MC,Hennies HH,Englberger W,et al.Influence of tramadol on neurotransmitter systems of the rat brain[J].Arzneimittelforschung,1996,46(11):1029-1036.
21.	Safarinejad MR,Hosseini SY.Safety and efficacy of tramadol in the treatment of premature ejaculation-a double-blind,placebo-controlled,fixed-dose,randomized study[J].J Clin Psychopharmacol,2006,26(1):27-31.
22.	Wu T,Yue X,Duan X,et al.Efficacy and safety of tramadol for premature ejaculation:a systematic review and meta-analysis[J].Urology,2012,80(3):618-624.
23.	Wong BL,Malde S.The use of tramadol "on-demand" for premature ejaculation:a systematic review[J].Urology,2013,81(1):98-103.
24.	Eassa BI,El-Shazly MA.Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation[J].Asian J Androl,2013,15(1,SI):138-142.
25.	Cicero TJ,Adams EH,Geller A,et al.A postmarketing surveillance program to monitor ultram (tramadol hydrochloride) abuse in the United States[J].Drug Alcohol Depend,1999,57(1):7-22.
26.	Lanier RK,Lofwall MR,Mintzer MZ,et al.Physical dependence potential of daily tramadol dosing in humans[J].Psychopharmacology (Berl),2010,211(4):457-466.
27.	McMahon CG,Stuckey BG,Andersen M,et al.Efficacy of sildenafil citrate (viagra) in men with premature ejaculation[J].J Sex Med,2005,2(3):368-375.
28.	Atan A,Basar MM,Tuncel A,et al.Comparison of efficacy of sildenafil-only,sildenafil plus topical EMLA cream,and topical EMLA-cream-only in treatment of premature ejaculation[J].Urology,2006,67(2):388-391.
29.	McMahon CG,McMahon CN,Leow LJ,et al.Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation:a systematic review[J].BJU Int,2006,98(2):259-272.
30.	Gökçe A,Halis F,Demirtas A,et al.The effects of three phosphodiesterase type 5 inhibitors on ejaculation latency time in lifelong premature ejaculators:a double-blind laboratory setting study[J].BJU Int,2011,107(8):1274-1277.
31.	Mattos RM,Marmo Lucon A,Srougi M.Tadalafil and fluoxetine in premature ejaculation:prospective,randomized,double-blind,placebo-controlled study[J].Urol Int,2008,80(2):162-165.
32.	Asimakopoulos AD,Miano R,Finazzi AE,et al.Does current scientific and clinical evidence support the use of phosphodiesterase type 5 inhibitors for the treatment of premature ejaculation? a systematic review and meta-analysis[J].J Sex Med,2012,9(9):2404-2416.
33.	Rosen RC,Giuliano F,Carson CC.Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH)[J].Eur Urol,2005,47(6):824-837.
34.	Cavallini G.Alpha-1 blockade pharmacotherapy in primitive psychogenic premature ejaculation resistant to psychotherapy[J].Eur Urol,1995,28(2):126-130.
35.	Başar MM,Yilmaz E,Ferhat M,et al.Terazosin in the treatment of premature ejaculation:a short-term follow-up[J].Int Urol Nephrol,2005,37(4):773-777.
36.	Sato Y,Tanda H,Nakajima H,et al.Silodosin and its potential for treating premature ejaculation:a preliminary report[J].Int J Urol,2012,19(3):268-272.
37.	Xin ZC,Chung WS,Choi YD,et al.Penile sensitivity in patients with primary premature ejaculation[J].J Urol,1996,156(3):979-981.
38.	Xin ZC,Choi YD,Rha KH,et al.Somatosensory evoked potentials in patients with primary premature ejaculation[J].J Urol,1997,158(2):451-455.
39.	Pu C,Yang L,Liu L,et al.Topical anesthetic agents for premature ejaculation:a systematic review and meta-analysis[J].Urology,2013,81(4):799-804.
40.	Xin ZC,Choi YD,Seong DH,et al.Sensory evoked potential and effect of SS-cream in premature ejaculation[J].Yonsei Med J,1995,36(5):397-401.
41.	Xin ZC,Choi YD,Lee WH,et al.Penile vibratory threshold changes with various doses of SS-cream in patients with primary premature ejaculation[J].Yonsei Med J,2000,41(1):29-33.
42.	Choi HK,Jung GW,Moon KH,et al.Clinical study of SS-cream in patients with lifelong premature ejaculation[J].Urology,2000,55(2):257-261.
43.	Tian L,Xin ZC,Xin H,et al.Effect of renewed SS-cream on spinal somatosensory evoked potential in rabbits[J].Asian J Androl,2004,6(1):15-18.
44.	Busato W,Galindo CC.Topical anaesthetic use for treating premature ejaculation:a double-blind,randomized,placebo-controlled study[J].BJU Int,2004,93(7):1018-1021.
45.	Atikeler MK,Gecit I,Senol FA.Optimum usage of prilocaine-lidocaine cream in premature ejaculation[J].Andrologia,2002,34(6):356-359.
46.	Dinsmore WW,Hackett G,Goldmeier DA,et al.Topical eutectic mixture for premature ejaculation (Tempe):a novel aerosol-delivery form of lidocaine-prilocaine for treating premature ejaculation[J].BJU Int,2007,99(2):369-375.
47.	Dinsmore WW,Wyllie MG.PSD502 improves ejaculatory latency,control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation:results of a phase Ⅲ,multicentre,double-blind,placebo-controlled study[J].BJU Int,2009,103(7):940-949.
48.	Carson C,Wyllie M.Improved ejaculatory latency,control and sexual satisfaction when PSD502 is applied topically in men with premature ejaculation:results of a phase Ⅲ,double-blind,placebo-controlled study[J].J Sex Med,2010,7(9):3179-3189.

1. Laumann EO,Nicolosi A,Glasser DB,et al.Sexual problems among women and men aged 40-80 y:prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors[J].Int J Impot Res,2005,17(1):39-57.
2. Porst H,Montorsi F,Rosen RC,et al.The premature ejaculation prevalence and attitudes (PEPA) survey:prevalence,comorbidities,and professional help-seeking[J].Eur Urol,2007,51(3):816-823.
3. Metz ME,Pryor JL,Nesvacil LJ,et al.Premature ejaculation:a psychophysiological review[J].J Sex Marital Ther,1997,23(1):3-23.
4. Melnik T,Althof S,Atallah AN,et al.Psychosocial interventions for premature ejaculation[J].Cochrane Database Syst Rev,2011(8):D8195.
5. Kim SC,Seo KK.Efficacy and safety of fluoxetine,sertraline and clomipramine in patients with premature ejaculation:a double-blind,placebo controlled study[J].J Urol,1998,159(2):425-427.
6. Waldinger MD,Zwinderman AH,Olivier B.On-demand treatment of premature ejaculation with clomipramine and paroxetine:a randomized,double-blind fixed-dose study with stopwatch assessment[J].Eur Urol,2004,46(4):510-516.
7. Waldinger MD,Zwinderman AH,Schweitzer DH,et al.Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation:a systematic review and meta-analysis[J].Int J Impot Res,2004,16(4):369-381.
8. Waldinger MD,Zwinderman AH,Olivier B,et al.The majority of men with lifelong premature ejaculation prefer daily drug treatment:an observation study in a consecutive group of Dutch men[J].J Sex Med,2007,4(4 Pt 1):1028-1037.
9. Mcmahon CG,Abdo C,Incrocci L,et al.Disorders of orgasm and ejaculation in men[J].J Sex Med,2004,1(1):58-65.
10. Waldinger MD,Schweitzer DH,Olivier B.On-demand SSRI treatment of premature ejaculation:pharmacodynamic limitations for relevant ejaculation delay and consequent solutions[J].J Sex Med,2005,2(1):121-131.
11. Angulo J,Peiró C,Sanchez-Ferrer CF,et al.Differential effects of serotonin reuptake inhibitors on erectile responses,NO-production,and neuronal NO synthase expression in rat corpus cavernosum tissue[J].Br J Pharmacol,2001,134(6):1190-1194.
12. Kadioglu M,Muci E,Ozyavuz R,et al.Paroxetine inhibited the relaxations induced by EFS in mice corpus cavernosum:is it a NOS inhibition?[J].Fundam Clin Pharmacol,2010,24(1):55-61.
13. Koyuncu H,Serefoglu EC,Ozdemir AT,et al.Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation[J].Int J Impot Res,2012,24(5):171-173.
14. Modi NB,Dresser MJ,Simon M,et al.Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride,a novel agent for the treatment of premature ejaculation[J].J Clin Pharmacol,2006,46(3):301-309.
15. Porst H,Mcmahon CG,Althof SE,et al.Baseline characteristics and treatment outcomes for men with acquired or lifelong premature ejaculation with mild or no erectile dysfunction:integrated analyses of two phase 3 dapoxetine trials[J].J Sex Med,2010,7(6):2231-2242.
16. Mcmahon CG,Althof SE,Kaufman JM,et al.Efficacy and safety of dapoxetine for the treatment of premature ejaculation:integrated analysis of results from five phase 3 trials[J].J Sex Med,2011,8(2):524-539.
17. Buvat J,Tesfaye F,Rothman M,et al.Dapoxetine for the treatment of premature ejaculation:results from a randomized,double-blind,placebo-controlled phase 3 trial in 22 countries[J].Eur Urol,2009,55(4):957-968.
18. Mcmahon C,Kim SW,Park NC,et al.Treatment of premature ejaculation in the Asia-Pacific region:results from a phase Ⅲ double-blind,parallel-group study of dapoxetine[J].J Sex Med,2010,7(1 Pt 1):256-268.
19. Kaufman JM,Rosen RC,Mudumbi RV,et al.Treatment benefit of dapoxetine for premature ejaculation:results from a placebo-controlled phase Ⅲ trial[J].BJU Int,2009,103(5):651-658.
20. Frink MC,Hennies HH,Englberger W,et al.Influence of tramadol on neurotransmitter systems of the rat brain[J].Arzneimittelforschung,1996,46(11):1029-1036.
21. Safarinejad MR,Hosseini SY.Safety and efficacy of tramadol in the treatment of premature ejaculation-a double-blind,placebo-controlled,fixed-dose,randomized study[J].J Clin Psychopharmacol,2006,26(1):27-31.
22. Wu T,Yue X,Duan X,et al.Efficacy and safety of tramadol for premature ejaculation:a systematic review and meta-analysis[J].Urology,2012,80(3):618-624.
23. Wong BL,Malde S.The use of tramadol "on-demand" for premature ejaculation:a systematic review[J].Urology,2013,81(1):98-103.
24. Eassa BI,El-Shazly MA.Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation[J].Asian J Androl,2013,15(1,SI):138-142.
25. Cicero TJ,Adams EH,Geller A,et al.A postmarketing surveillance program to monitor ultram (tramadol hydrochloride) abuse in the United States[J].Drug Alcohol Depend,1999,57(1):7-22.
26. Lanier RK,Lofwall MR,Mintzer MZ,et al.Physical dependence potential of daily tramadol dosing in humans[J].Psychopharmacology (Berl),2010,211(4):457-466.
27. McMahon CG,Stuckey BG,Andersen M,et al.Efficacy of sildenafil citrate (viagra) in men with premature ejaculation[J].J Sex Med,2005,2(3):368-375.
28. Atan A,Basar MM,Tuncel A,et al.Comparison of efficacy of sildenafil-only,sildenafil plus topical EMLA cream,and topical EMLA-cream-only in treatment of premature ejaculation[J].Urology,2006,67(2):388-391.
29. McMahon CG,McMahon CN,Leow LJ,et al.Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation:a systematic review[J].BJU Int,2006,98(2):259-272.
30. Gökçe A,Halis F,Demirtas A,et al.The effects of three phosphodiesterase type 5 inhibitors on ejaculation latency time in lifelong premature ejaculators:a double-blind laboratory setting study[J].BJU Int,2011,107(8):1274-1277.
31. Mattos RM,Marmo Lucon A,Srougi M.Tadalafil and fluoxetine in premature ejaculation:prospective,randomized,double-blind,placebo-controlled study[J].Urol Int,2008,80(2):162-165.
32. Asimakopoulos AD,Miano R,Finazzi AE,et al.Does current scientific and clinical evidence support the use of phosphodiesterase type 5 inhibitors for the treatment of premature ejaculation? a systematic review and meta-analysis[J].J Sex Med,2012,9(9):2404-2416.
33. Rosen RC,Giuliano F,Carson CC.Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH)[J].Eur Urol,2005,47(6):824-837.
34. Cavallini G.Alpha-1 blockade pharmacotherapy in primitive psychogenic premature ejaculation resistant to psychotherapy[J].Eur Urol,1995,28(2):126-130.
35. Başar MM,Yilmaz E,Ferhat M,et al.Terazosin in the treatment of premature ejaculation:a short-term follow-up[J].Int Urol Nephrol,2005,37(4):773-777.
36. Sato Y,Tanda H,Nakajima H,et al.Silodosin and its potential for treating premature ejaculation:a preliminary report[J].Int J Urol,2012,19(3):268-272.
37. Xin ZC,Chung WS,Choi YD,et al.Penile sensitivity in patients with primary premature ejaculation[J].J Urol,1996,156(3):979-981.
38. Xin ZC,Choi YD,Rha KH,et al.Somatosensory evoked potentials in patients with primary premature ejaculation[J].J Urol,1997,158(2):451-455.
39. Pu C,Yang L,Liu L,et al.Topical anesthetic agents for premature ejaculation:a systematic review and meta-analysis[J].Urology,2013,81(4):799-804.
40. Xin ZC,Choi YD,Seong DH,et al.Sensory evoked potential and effect of SS-cream in premature ejaculation[J].Yonsei Med J,1995,36(5):397-401.
41. Xin ZC,Choi YD,Lee WH,et al.Penile vibratory threshold changes with various doses of SS-cream in patients with primary premature ejaculation[J].Yonsei Med J,2000,41(1):29-33.
42. Choi HK,Jung GW,Moon KH,et al.Clinical study of SS-cream in patients with lifelong premature ejaculation[J].Urology,2000,55(2):257-261.
43. Tian L,Xin ZC,Xin H,et al.Effect of renewed SS-cream on spinal somatosensory evoked potential in rabbits[J].Asian J Androl,2004,6(1):15-18.
44. Busato W,Galindo CC.Topical anaesthetic use for treating premature ejaculation:a double-blind,randomized,placebo-controlled study[J].BJU Int,2004,93(7):1018-1021.
45. Atikeler MK,Gecit I,Senol FA.Optimum usage of prilocaine-lidocaine cream in premature ejaculation[J].Andrologia,2002,34(6):356-359.
46. Dinsmore WW,Hackett G,Goldmeier DA,et al.Topical eutectic mixture for premature ejaculation (Tempe):a novel aerosol-delivery form of lidocaine-prilocaine for treating premature ejaculation[J].BJU Int,2007,99(2):369-375.
47. Dinsmore WW,Wyllie MG.PSD502 improves ejaculatory latency,control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation:results of a phase Ⅲ,multicentre,double-blind,placebo-controlled study[J].BJU Int,2009,103(7):940-949.
48. Carson C,Wyllie M.Improved ejaculatory latency,control and sexual satisfaction when PSD502 is applied topically in men with premature ejaculation:results of a phase Ⅲ,double-blind,placebo-controlled study[J].J Sex Med,2010,7(9):3179-3189.

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