益肾疏肝止泻方加减联合帕罗西汀治疗早泄肝郁肾虚证临床研究OA

Objective:To explore the clinical efficacy of a modified Yishen Shugan Zhixie formula combined with paroxetine in treating premature ejaculation with liver depression and kidney deficiency syndrome.Methods:Seventy patients were randomly divided into a control group(dapoxetine hydrochloride,35 cases)and a treatment group(modified Yishen Shugan Zhixie formula combined with paroxetine,35 cases).After 4 weeks of treatment,the effica-cy of traditional Chinese medicine(TCM),TCM syndrome scores,intra vaginal ejaculation latency time(IELT),Pre-mature ejaculation profile(PEP)scores,ejaculatory control,and personal distress improvement were compared,along with adverse reactions and recurrence rates.Results:The total effective rate in the treatment group was 88.57％,higher than that in the control group(68.57％)(P＜0.05).After 4 weeks of treatment,both groups showed significantly reduced TCM syndrome scores and total scores(P＜0.001),with the treatment group lower than the control group(P＜0.05).During a 6-month follow-up,the control group exhibited significant rebounds in all scores compared to post-treatment levels(P＜0.05),while the treatment group showed no significant changes(P＞0.05)and outper-formed the concurrent control group(P＜0.05).Both groups demonstrated significant improvements in IELT and PEP items compared to pre-treatment levels(P＜0.001),with the treatment group showing superior improvements in ejaculatory control,sexual satisfaction,ejaculatory-related personal distress,and interpersonal difficulties(P＜0.05).During the 6-month follow-up,the control group exhibited significant declines in some IELT and PEP scores compared to post-treatment levels(P＜0.05),while the treatment group showed no significant differences(P＞0.05)and outperformed the control group(P＜0.05).The proportion of patients achieving ≥1-point improve-ment in ejaculatory control and personal distress scores was higher in the treatment group than in the control group(P＜0.05).No significant abnormalities were observed in either group,with adverse reaction rates of 14.29％and 8.57％(P＞0.05),respectively.The recurrence rate in the treatment group was 9.30％,lower than that in the con-trol group(37.50％)(P＜0.05).Conclusion:The modified Yishen Shugan Zhixie formula combined with paroxetine demonstrates significant efficacy in treating premature ejaculation with liver depression and kidney deficiency syn-drome,effectively alleviating symptoms,prolonging IELT,improving ejaculatory control,enhancing sexual satisfac-tion,and featuring high safety and low recurrence rates.