Damásdi Miklós, Vágási Katalin, Molnár Gergå A, Farkas László, Wittmann István
Department of Urology, University of Pécs, Pécs, Hungary.
Clin Nephrol. 2013 Jan;79 Suppl 1:S46-8.
Erectile dysfunction (ED) is a major complication in diabetes mellitus. A novel method, high-tone external muscle stimulation (HTEMS), has been proven to be useful in the therapy of diabetic and uremic peripheral polyneuropathy. The aim of this study was to test the potential effect of HTEMS on ED in diabetic patients.
An open-label, self-controlled interventional prospective study was conducted at the 2nd Department of Internal Medicine and N.C. University of Pécs, Hungary. Six Type 2 diabetic patients (mean age 59 ± 7 years) with severe ED (International Index of Erectile Function (IIEF) score: 7.7 ± 8.5) and impaired renal function (eGFR: 61 ± 16 ml/min) were involved.
The thigh muscles of the patients were treated with HTEMS for 1 h 3 times per week for a duration of 4 weeks.
Penile peak systolic velocity (PSV) (in the flaccid state and semi-rigid (after 10 mg intracavernous papaverine injection)), IIEF score, quality of life and laboratory parameters. At the beginning also the acute effect of HTEMS on penile PSV was investigated.
Under basal conditions penile PSV was rather low. The first HTEMS session of the thighs induced an insignificant increase of PSV in the flaccid state (4.1 ± 1.2 to 6.3 ± 3.3 cm/s) and a significant rise of PSV in the semi-rigid penis (from 6.5 ± 2.5 to 8.9 ± 2.2 cm/s (p = 0.009)). After 4 weeks of HTEMS treatment, under basal conditions no significant change of penile PSV (flaccid and semirigid) was observed. Similarly, IIEF score did not improve over the time period (7.7 ± 8.1 vs. 6.7 ± 8.5, p > 0.05). Also, metabolic parameters and eGFR were not influenced.
In a pilot study of diabetic patients with severe ED HTEMS of the thighs induced an acute rise of penile PSV in the semi-rigid state. However, after 4 weeks of HTEMS therapy the basal PSV and symptoms of ED were not improved.
勃起功能障碍（ED）是糖尿病的主要并发症。一种新方法，即高音调外部肌肉刺激（HTEMS），已被证明对糖尿病和尿毒症周围多发性神经病的治疗有效。本研究的目的是测试HTEMS对糖尿病患者ED的潜在影响。
在匈牙利佩奇大学医学院第二内科进行了一项开放标签、自我对照的前瞻性干预研究。纳入6例2型糖尿病患者（平均年龄59±7岁），均患有重度ED（国际勃起功能指数（IIEF）评分：7.7±8.5）且肾功能受损（估算肾小球滤过率（eGFR）：61±16 ml/min）。
对患者的大腿肌肉进行HTEMS治疗，每周3次，每次1小时，持续4周。
阴茎收缩期峰值流速（PSV）（疲软状态和半勃起状态（海绵体内注射10mg罂粟碱后））、IIEF评分、生活质量和实验室参数。在开始时还研究了HTEMS对阴茎PSV的急性影响。
在基础状态下，阴茎PSV相当低。首次对大腿进行HTEMS治疗时，疲软状态下PSV有不显著增加（从4.1±1.2 cm/s增至6.3±3.3 cm/s），半勃起阴茎的PSV有显著升高（从6.5±2.5 cm/s增至8.9±2.2 cm/s（p = 0.009））。经过4周的HTEMS治疗后，在基础状态下未观察到阴茎PSV（疲软和半勃起状态）有显著变化。同样，IIEF评分在该时间段内也未改善（7.7±8.1 vs. 6.7±8.5，p>0.05）。此外，代谢参数和eGFR也未受影响。
在一项针对重度ED糖尿病患者的初步研究中，对大腿进行HTEMS可使半勃起状态下阴茎PSV急性升高。然而，经过4周的HTEMS治疗后，基础PSV和ED症状并未改善。
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