Montorsi F, Strambi L F, Guazzoni G, Galli L, Barbieri L, Rigatti P, Pizzini G, Miani A
Institute of Human Anatomy, Scientific Institute H. San Raffaele, Milan, Italy.
Urology. 1994 Nov;44(5):732-6. doi: 10.1016/s0090-4295(94)80216-5.
The aim of this study was to determine the effectiveness and safety of yohimbine and trazodone used together for the treatment of pure psychogenic impotence.
Sixty-three patients who had psychogenic impotence diagnosed on the basis of sexual history, results of physical examination, laboratory analysis, polysomnographic recording of nocturnal erections, and dynamic color Doppler sonography of the cavernosal arteries were entered into a randomized, double-blind, placebo-controlled, partial crossover study comparing placebo with yohimbine (15 mg per day orally) and trazodone (50 mg per day orally) used together. Treatment consisted of two 8-week courses. Patients who initially received placebo for 8 weeks were then switched to the 2-drug combination for 8 weeks. Erectile function, ejaculation, interest in sex, and sexual thoughts were investigated at the end of drug treatment and at 3- and 6-month follow-up. For statistical analysis chi-square, McNemar, and Student's t test for unpaired data were used.
Fifty-five patients (87%) completed the whole treatment schedule. Positive clinical results (complete and partial responses) were obtained in 39 (71%) patients at the end of the drug treatment phase. These results were significantly better than those obtained with placebo (p < 0.01). Positive results were maintained in 32 (58%) and 31 (56%) patients at 3- and 6-month follow-up, respectively. Minor drug-related adverse effects occurred in 6 (11%) of the patients in the yohimbine-trazodone group and in 2 (4%) in the placebo group.
The combination of yohimbine and trazodone is a safe and effective first-line treatment for psychogenic impotence.
本研究旨在确定育亨宾与曲唑酮联合使用治疗单纯性心因性阳痿的有效性和安全性。
63例根据性病史、体格检查结果、实验室分析、夜间勃起的多导睡眠图记录以及海绵体动脉动态彩色多普勒超声诊断为心因性阳痿的患者，进入一项随机、双盲、安慰剂对照、部分交叉研究，比较安慰剂与联合使用的育亨宾（每日口服15毫克）和曲唑酮（每日口服50毫克）。治疗包括两个8周疗程。最初接受8周安慰剂治疗的患者随后改用两种药物联合治疗8周。在药物治疗结束时以及3个月和6个月随访时，对勃起功能、射精、性兴趣和性想法进行了调查。统计分析采用卡方检验、麦克尼马尔检验和非配对数据的学生t检验。
55例患者（87%）完成了整个治疗方案。在药物治疗阶段结束时，39例（71%）患者获得了阳性临床结果（完全和部分反应）。这些结果明显优于安慰剂组（p<0.01）。在3个月和6个月随访时，分别有32例（58%）和31例（56%）患者维持了阳性结果。育亨宾-曲唑酮组6例（11%）患者和安慰剂组2例（4%）患者出现了轻微的药物相关不良反应。
育亨宾与曲唑酮联合使用是治疗心因性阳痿的一种安全有效的一线治疗方法。
