物理治疗对男性早泄的疗效：一项系统综述与荟萃分析

Effectiveness of physiotherapy in male premature ejaculation. A systematic review and metaanalysis

——《性医学杂志》第23卷第5期，2026年5月——

<The Journal of Sexual Medicine>, Volume 23, Issue 5, May 2026

【摘要】引言：临床上将早泄（PE）定义为阴道内射精潜伏期（IELT）为1分钟或更短。尽管药物治疗已显示出快速且有效的疗效，但常伴随不良副作用。相比之下，物理治疗方法提供了一种更安全的替代方案，其产生不良反应的风险较低。目的：旨在评估物理治疗干预措施在延长被诊断为早泄的男性患者IELT方面的疗效，并将其与药物治疗进行比较。方法：研究人员对多个数据库（PubMed、PEDro、Scopus和Researchgate）进行了系统检索，以识别过去10年内发表的临床试验。符合纳入标准的研究包括那些在早泄男性患者中，以IELT作为主要结局指标，并将物理治疗与药物干预进行比较的研究。研究质量评估采用PEDro量表进行。随后对数据进行汇总，并完成了Meta分析。本系统综述依据《系统综述和Meta分析优先报告条目》（PRISMA）指南声明进行。该综述已在PROSPERO数据库注册，注册号为CRD42024613802（对审稿人实行盲法）。结果：共有6项研究符合纳入标准并被纳入分析，涵盖了总计416名参与者。汇总效应具有统计学意义（P = 0.03），显示IELT的平均差异为-0.80秒（95%置信区间：-1.53至-0.06），结果显著倾向于达泊西汀组；各研究之间存在高度异质性（I² = 83%）。结论：Meta分析结果表明，对于患有终生性早泄的男性而言，30 mg剂量的达泊西汀在延长IELT方面显著优于物理治疗。物理治疗可被视为一种安全且有益的干预手段，对于无法耐受药物治疗的患者而言，它是一种极具潜力的替代疗法。尽管如此，定性综述结果提示，采用综合治疗方案能在延长IELT方面取得最为显著的改善效果。

【关键词】早泄，物理治疗手段，药物治疗

[Abstract] Introduction: Premature ejaculation (PE) is clinically defined as an intravaginal ejaculatory latency time (IELT) of 1 min or less. While pharmacological treatments have demonstrated rapid and effective results, they are frequently associated with adverse side effects. In contrast, physiotherapeutic approaches offer a safer alternative, with a lower risk of undesirable reactions. Objectives: To assess the efficacy of physiotherapeutic interventions in increasing IELT, compared to pharmacological treatment, in men diagnosed with PE. Methods: A systematic search was conducted across multiple databases (PubMed, PEDro, Scopus, and Researchgate) to identify clinical trials published within the past 10 years. Eligible studies included those that compared physiotherapy with pharmacological interventions, using IELT as the primary outcome variable in male patients with PE. A quality assessment was performed using the PEDro scale. The data were pooled and a meta-analysis was completed. This systematic review was conducted in accordance with the (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) PRISMA guideline statement. It was registered in the PROSPERO database with registration number CRD42024613802 (blinded for reviewers). Results: Six studies, encompassing a total of 416 participants, met the inclusion criteria and were analyzed. The pooled effect is statistically significant (P = .03), showing a mean difference in IELT of −0.80 s (95% confidence interval, −1.53 to −0.06) which significantly favors dapoxetine, with a high heterogeneity between studies (I2 = 83%). Conclusion: The results of the meta-analyses suggest that dapoxetine at a dose of 30 mg is significantly more effective than physiotherapy for prolonging IELT in men with lifelong PE. Physiotherapy can be considered a safe and beneficial intervention, positioning it as a promising alternative for patients who are intolerant to pharmacological treatment. Nevertheless, the qualitative review suggests that a combined therapeutic approach yields the most significant improvements in IELT.

[Key words] premature ejaculation, physical therapy modalities, drug therapy

论文原文：Esther M Medrano-Sánchez, Ana López-del-Castillo, Maud Boisseau, et al. (2026). Effectiveness of physiotherapy in male premature ejaculation. A systematic review and metaanalysis. The Journal of Sexual Medicine, Volume 23, Issue 5, May 2026.

https://doi.org/10.1093/jsxmed/qdag096

（翻译兼责任编辑：MARY）

（需要英文原文的朋友，请联系微信：millerdeng95或iacmsp）