Morales A, Condra M, Owen J A, Surridge D H, Fenemore J, Harris C
J Urol. 1987 Jun;137(6):1168-72. doi: 10.1016/s0022-5347(17)44436-3.
Yohimbine is an alpha-adrenoceptor blocker that has been used in the treatment of erectile dysfunction. Adequate trials of this substance in a clearly defined organically impotent population are not available. We conducted a randomized, controlled study with partial cross-over of yohimbine versus placebo in 100 organically impotent men. The first phase of the study showed a positive response in 42.6 per cent of the patients receiving yohimbine versus 27.6 per cent in the placebo group. Although favorable to the test medication these values did not reach statistical significance (p equals 0.42). A similar pattern was noted in the second phase of the study. The over-all response rate of 43.5 per cent was consistent with a previous noncontrolled trial but it was much lower than previous studies. The response rate of organically impotent patients to yohimbine is at best marginal. Owing to its ease of administration, safety and modest effect it still is used in those patients who do not accept more invasive methods. Adrenoceptors are involved in the erectile process, although other neurotransmitter systems also are putative modulators of penile erection, including cholinergic, dopaminergic and vasoactive intestinal polypeptide pathways. It is beyond reasonable expectation that a single agent be of value for all cases of organic impotence. However, yohimbine has shown modest effectiveness at the doses used in this trial (18 mg. per day). Higher doses or a different route of administration may produce different effects.
育亨宾是一种α-肾上腺素能受体阻滞剂，已被用于治疗勃起功能障碍。目前尚无在明确定义的器质性阳痿人群中对该药物进行充分试验的相关报道。我们对100名器质性阳痿男性进行了一项随机对照研究，将育亨宾与安慰剂进行部分交叉试验。研究的第一阶段显示，接受育亨宾治疗的患者中有42.6%有阳性反应，而安慰剂组为27.6%。尽管这些数值对试验药物有利，但未达到统计学显著性（p等于0.42）。在研究的第二阶段也观察到类似模式。43.5%的总体反应率与之前的一项非对照试验一致，但远低于之前的研究。器质性阳痿患者对育亨宾的反应率充其量只是微乎其微。由于其给药方便、安全性高且效果适中，它仍被用于那些不接受更具侵入性方法的患者。肾上腺素能受体参与勃起过程，尽管其他神经递质系统也被认为是阴茎勃起的调节因子，包括胆碱能、多巴胺能和血管活性肠多肽途径。期望单一药物对所有器质性阳痿病例都有价值是不合理的。然而，育亨宾在本试验所用剂量（每天18毫克）下已显示出一定疗效。更高剂量或不同给药途径可能会产生不同效果。
