早泄与延迟射精的当代共识及未来研究方向：第五届国际性医学咨询会议的建议
早泄与延迟射精的当代共识及未来研究方向：第五届国际性医学咨询会议的建议
Contemporary consensus and emerging directions in premature and delayed ejaculation: recommendations from the 5th International Consultation on Sexual Medicine
——《性医学评论》，第14卷第4期，2026年10月——
【摘要】引言：射精障碍（包括早泄和延迟射精）是临床常见病症，对男性的生活质量及其人际关系具有显著影响。本综述汇总了关于这些病症的病因学、流行病学、评估及管理方面的最新研究成果。本文旨在基于“第五届国际性医学咨询会议”（Fifth International Consultation on Sexual Medicine）的指导，就早泄和延迟射精的定义、分类及治疗提出循证建议。方法：由多学科专家组成的专家组对全球相关文献进行了综述，并采用改良德尔菲法（modified Delphi method）达成了共识建议。证据质量采用“推荐分级的评估、制定与评价”（GRADE）系统进行分级。结果：早泄是男性最常报告的性功能主诉，可分为终身性、获得性、变异性和主观性四种亚型。循证管理措施包括药物治疗（如选择性5-羟色胺再摄取抑制剂、外用麻醉剂）以及心理治疗。延迟射精虽然相对少见，但目前研究尚不充分，可用的药物及行为治疗手段也较为有限。这两种障碍的定义均已演变，现已纳入射精时间、心理困扰及控制能力等评估标准。结论：深入理解早泄和延迟射精的病理生理机制，并采取个体化的管理方案，有助于改善患者的预后。未来仍需开展更多研究，以完善循证治疗手段，尤其是针对延迟射精的治疗。
【关键词】获得性早泄；达泊西汀；延迟射精；国际性医学咨询会议（ICSM）；阴道内射精潜伏期（IELT）；终身性早泄；阴茎高敏感性；早泄；心理治疗；选择性5-羟色胺再摄取抑制剂（SSRIs）
[Abstract] Introduction: Disorders of ejaculation, including premature ejaculation (PE) and delayed ejaculation (DE), are common conditions with a substantial impact on men’s quality of life and their relationships. This review synthesizes the latest findings on their etiology, epidemiology, evaluation, and management. This study aims to present evidence-based recommendations for the definition, classification, and treatment of PE and DE, developed under the guidance of the Fifth International Consultation on Sexual Medicine. Methods: A multidisciplinary panel conducted a narrative review of global literature and utilized a modified Delphi method to develop consensus recommendations. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Results: Premature ejaculation is the most frequently reported male sexual complaint, classified into lifelong, acquired, variable, and subjective subtypes. Evidence-based management includes medical therapies such as selective serotonin reuptake inhibitors, topical anesthetics, and psychotherapeutic approaches. Although less common, DE remains under-researched, with limited pharmacological and behavioral treatment options. Definitions for both disorders have evolved to incorporate timing, distress, and control criteria. Conclusion: Understanding the pathophysiology and adopting individualized approaches to managing PE and DE can improve patient outcomes. Further research is needed to enhance the evidence-based therapies, particularly for DE.
[Key words] acquired premature ejaculation, dapoxetine, delayed ejaculation, International Consultation on Sexual Medicine (ICSM), intravaginal ejaculatory latency time (IELT), lifelong premature ejaculation, penile hypersensitivity, premature ejaculation, psychotherapy, selective serotonin reuptake inhibitors (SSRIs)
论文原文：Ege C Serefoglu, Alan W Shindel, Yan Zhang, et al. (2026). Contemporary consensus and emerging directions in premature and delayed ejaculation: recommendations from the 5th International Consultation on Sexual Medicine. Sexual Medicine Reviews, Volume 14, Issue 4, October 2026.
https://doi.org/10.1093/sxmrev/qeag068
（翻译兼责任编辑：MARY）
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