Spine：研究发现勃起功能障碍与处方类止痛药相关

MedSci导读：今天在网络版Spine杂志公布的一项研究表明，长期使用阿片肽使获得ED处方的可能性增加50%。最常用的阿片类处方药物是氢可酮，羟考酮和吗啡。研究人员定义“长期”的时间是使用阿片肽服用10片或更多至少4个月或者超过3个月。

  两年前，在泌尿学杂志发表的一项研究表明，经常服用非处方非激素类抗炎药物如阿司匹林，布洛芬和萘普生的男性比较少服用或未服用此类药物的男性更有可能有勃起问题。
  现在，对于在痛苦中的男性来说，更多潜在的坏消息是：今天在网络版Spine杂志公布的一项研究表明，勃起功能障碍可能与处方类止痛药（阿片类）相关。
  最常用的阿片类处方药物是氢可酮，羟考酮和吗啡。
  研究人员研究了11,327人的案例，他们都是加入俄勒冈州和华盛顿Kaiser Permanente健康计划，在2004年因背部疼痛看过医生的。研究者查看了患者背部疼痛前后六个月的药房记录，以了解记录上是否填满了阿片类处方药和睾酮替代品或勃起功能障碍，ED，药物治疗。
  他们发现，长期使用阿片肽使获得ED处方的可能性增加50%。研究人员定义“长期”的时间是使用阿片肽服用10片或更多至少4个月或者超过3个月。
  服用大量阿片类药物至少4个月的男性，19%以上也收到睾酮替代品或ED药物。少于7%的患者未使用阿片类药物而收到ED药物。
  “这并不意味着这些药物引起了ED，” 这项研究的第一作者Richard A. Deyo博士说，“但是这些联系是患者和临床医生在决定阿片类药物是否用于治疗背部疼痛时应该注意的。”
Deyo是Kaiser Permanente健康研究中心的研究员和俄勒冈健康与科学大学的循证家庭医学教授。

Prescription painkillers, erectile dysfunction linked, Kaiser Permanente researchers find
Two years ago, a study published in The Journal of Urology indicated that men routinely taking such over-the-counter nonsteroidal anti-inflammatory drugs as aspirin, ibuprofen and naproxen were more likely to have erection problems than men who took the drugs less often or not at all.
Now, more potentially bad news for men in pain: A study published online today in the journal Spine indicates erectile dysfunction may be linked to prescription painkillers known as opiods.
The most commonly prescribed opiods are hydrocodone, oxycodone and morphine.
Researchers studied the records of 11,327 men in Oregon and Washington enrolled in the Kaiser Permanente health plan who had visited their doctors for back pain in 2004. Investigators looked at the patients' pharmacy records for six months before and after the back-pain visit to learn whether they'd filled prescriptions for opiods and for testosterone replacement or erectile dysfunction, or ED, medications.
They found that long-term opiod use increased by 50 percent the likelihood of also getting an ED prescription. Researchers defined long-term as men who took opiods for at least four months or for more than three months with 10 or more refills.
More than 19 percent of men who took high-dose opiods for at least four months also received testosterone replacement or ED drugs; fewer than 7 percent of men who did not take opiods received ED drugs.
"This doesn't mean that these medications cause ED," said Dr. Richard A. Deyo, the study's lead author, "but the association is something patients and clinicians should be aware of when deciding if opiods should be used to treat back pain."
Deyo is an investigator with the Kaiser Permanente Center for Health Research and a professor of evidence-based family medicine at Oregon Health & Science University.