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目的:评价口腔矫正器联合他达拉非治疗重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并勃起功能障碍(ED)患者的效果。方法:纳入重度OSAHS合并ED患者90例,随机分为3组:口腔矫正器治疗组(A组)、他达拉非治疗组(B组)及联合治疗组(C组),各30例,A组应用口腔矫正器连续治疗3个月,B组每日口服他达拉非1次,每次10 mg,C组联合应用口腔矫正器和口服他达拉非治疗。治疗3个月后,比较3组患者治疗前后“性活动日志”(SEP)阳性回答率、勃起功能国际问卷-5(IIEF-5)评分的变化及患者配偶性生活总体满意度。结果:A组、C组分别有1例、2例患者不能耐受口腔矫正器而放弃治疗,其余87例患者完成治疗,其中A组29例,B组30例,C组28例。治疗3个月后,C组患者IIEF-5评分增值(4.18±1.19)分显著高于A组(2.66±1.63)分及B组(2.77±1.74)分(P分别为0.009、0.026);C组患者插入阴道的成功率(85.7%)显著高于A组(58.6%)、B组(53.3%)(P分别为0.023、0.008);C组患者完成性生活的成功率(64.3%)显著高于A组(37.9%)、B组(33.3%)(P分别为0.047、0.018);A组、C组患者配偶对性生活总体满意程度显著高于B组(P分别为0.027、0.007)。结论:口腔矫正器联合他达拉非能有效治疗重度阻塞性睡眠呼吸暂停低通气综合征合并勃起功能障碍患者,其治疗效果优于单纯用口腔矫正器治疗或单纯他达拉非治疗。
OBJECTIVE: To evaluate the efficacy of oral orthotic plus tadalafil in patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with erectile dysfunction (ED). Methods: Ninety patients with severe OSAHS complicated with ED were enrolled in this study. They were randomly divided into three groups: oral orthodontic treatment group (A group), tadalafil group (B group) and combination therapy group (C group) Group A was treated with oral orthodontic for 3 months. Group B received tadalafil 10 mg once daily, while group C was treated with oral orthodontics and oral tadalafil. After 3 months of treatment, the positive rate of SEP and the score of IIEF-5 were compared between the three groups before and after treatment. The overall sexual satisfaction of the spouse was also compared. Results: In group A and group C, 1 patient was in each case, 2 patients were unable to tolerate oral appliance and their treatment was abandoned. The remaining 87 patients were treated, including 29 patients in group A, 30 patients in group B and 28 patients in group C. After 3 months of treatment, the added value of IIEF-5 score in group C was significantly higher than that in group A (2.66 ± 1.63) and group B (2.77 ± 1.74) (P = 0.009, 0.026 respectively); C The success rate of insertion into the vagina in group C (85.7%) was significantly higher than that in group A (58.6%) and group B (53.3%) (P 0.023 and 0.008 respectively). The success rate of completion of sex life in group C was 64.3% (P = 0.047, 0.018, respectively). The overall sexual satisfaction of spouses in group A and group C was significantly higher than that in group B (P = 0.027,0.007, respectively) . Conclusion: Oral appliances combined with tadalafil can effectively treat patients with severe obstructive sleep apnea-hypopnea syndrome complicated with erectile dysfunction. The treatment is superior to oral orthodontic treatment or tadalafil alone.