疏血通穴位注射治疗慢性前列腺炎/慢性盆腔疼痛综合征合并早泄的临床观察
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摘要
目的:观察穴位注射疏血通治疗慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)合并早泄(PE)的临床疗效。方法:将80例CP/CPPS合并PE的患者随机分成治疗组(n=40)和对照组(n=40),治疗组采取穴位注射疏血通注射液治疗,对照组予以安慰针治疗,15 d为1个疗程,两组均治疗2个疗程。于治疗前后进行美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)和早泄诊断工具(PEDT)量表评分,评估两组治疗效果。结果:治疗组38例和对照组40例完成试验。治疗组NIH-CPSI评分总有效率为63. 2%,PEDT评分总有效率为47. 4%,恶化率为7. 9%;对照组NIH-CPSI评分总有效率为27. 5%,PEDT评分总有效率为25. 0%,恶化率为17. 5%,两组均有明显统计学差异(P <0. 05)。治疗组NIH-CPSI评分治疗前后分别为(24. 82±5. 89)、(15. 45±6. 74)分,PEDT评分分别为(14. 87±3. 70)、(10. 29±4. 25)分,差异均有显著性(P <0. 05);对照组NIH-CPSI评分治疗前后分别为(26. 10±6. 59)、(22. 10±8. 42)分,PEDT评分分别为(14. 98±3. 09)、(13. 00±4. 53)分,差异均有显著性(P <0. 05);且治疗后NIH-CPSI、PEDT评分治疗组均显著低于对照组。直线回归分析显示,治疗组NIH-CPSI评分治疗前后差值与PEDT评分治疗前后差值有显著正相关(R=0. 340,P=0. 037),而对照组两者无相关性(R=0. 133,P=0. 413)。结论:穴位注射疏血通注射液能显著改善CP/CPPS患者的症状,并且对合并的PE症状也有较好的疗效。
Objective:To observe the clinical efficacy of acupoint injection of Shuxuetong(SXT) in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) complicated by premature ejaculation(PE).Methods:A total of 78 cases of CP/CPPS complicated by PE were randomly assigned to receive acupuncture injection of SXT(n = 38) and placebo acupuncture as the control(n = 40) for two 15-day courses.The therapeutic effects were evaluated based on the patients' scores on National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI) and Premature Ejaculation Diagnostic Tool(PEDT) before and after treatment.Results:Compared with the controls,the SXT group showed a significantly higher total effectiveness rate based on either NIHCPSI(27.5% vs 63.2%,P < 0.05) or PEDT(25% vs 47.4%,P < 0.05) and a lower deterioration rate(17.5% vs 7.9%,P < 0.05).Statistically significant differences were observed between the baselines and post-treatment scores on NIH-CPSI in the SXT group(24.82 ± 5.89 vs 15.45 ± 6.74,P < 0.05) and the controls(26.10 ± 6.59 vs 22.10 ± 8.42,P < 0.05) as well as on PEDT in the SXT group(14.87 ± 3.70 vs 10.29 ± 4.25,P < 0.05) and the controls(14.98 ± 3.09 vs 13.00 ± 4.53,P < 0.05),and both the NIH-CPSI and PEDT scores were markedly lower in the SXT than in the control group after treatment(P <0.05).Linear regression analysis exhibited a positive correlation between the NIH-CPSI and PEDT scores before and after treatment in the SXT group(R = 0.340,P < 0.037) but not in the control group(R = 0.133,P < 0.413).Conclusion:Acupoint injection of Shuxuetong can significantly improve the symptoms of CP/CPPS and CP/CPPS-induced PE as well.
Objective:To observe the clinical efficacy of acupoint injection of Shuxuetong(SXT) in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) complicated by premature ejaculation(PE).Methods:A total of 78 cases of CP/CPPS complicated by PE were randomly assigned to receive acupuncture injection of SXT(n = 38) and placebo acupuncture as the control(n = 40) for two 15-day courses.The therapeutic effects were evaluated based on the patients' scores on National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI) and Premature Ejaculation Diagnostic Tool(PEDT) before and after treatment.Results:Compared with the controls,the SXT group showed a significantly higher total effectiveness rate based on either NIHCPSI(27.5% vs 63.2%,P < 0.05) or PEDT(25% vs 47.4%,P < 0.05) and a lower deterioration rate(17.5% vs 7.9%,P < 0.05).Statistically significant differences were observed between the baselines and post-treatment scores on NIH-CPSI in the SXT group(24.82 ± 5.89 vs 15.45 ± 6.74,P < 0.05) and the controls(26.10 ± 6.59 vs 22.10 ± 8.42,P < 0.05) as well as on PEDT in the SXT group(14.87 ± 3.70 vs 10.29 ± 4.25,P < 0.05) and the controls(14.98 ± 3.09 vs 13.00 ± 4.53,P < 0.05),and both the NIH-CPSI and PEDT scores were markedly lower in the SXT than in the control group after treatment(P <0.05).Linear regression analysis exhibited a positive correlation between the NIH-CPSI and PEDT scores before and after treatment in the SXT group(R = 0.340,P < 0.037) but not in the control group(R = 0.133,P < 0.413).Conclusion:Acupoint injection of Shuxuetong can significantly improve the symptoms of CP/CPPS and CP/CPPS-induced PE as well.
引文
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[16]Qin Z,Wu J,Zhou J,et al.Systematic review of acupuncture for chronic prostatitis/chronic pelvic pain syndrome.Medicine,2016,95(11):1-10.
[17]Chang SC,Hsu CH,Hsu CK,et al.The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome:A systemic review and meta-analysis.Neurourol Urodyn,2017,36(2):474-481.
[18]孙一鸣,余长飞,李岳,等.桂枝茯苓丸加味联合穴位注射治疗前列腺增生症50例临床观察.中医杂志,2015,56(11):945-947.
[19]白敏,王强平.针灸治疗早泄疗效的Meta分析.西部医学,2012,24(2):261-264.
[20]王玉明.浅谈穴位注射疗法的创新体会.针灸临床杂志,2012,28(3):66-67.
[21]王琦主编.王琦男科学.郑州:河南科学技术出版社,2007.644-645.
[22]王怡冰.封髓固精汤治疗Ⅲ型前列腺炎合并早泄临床研究.中医学报,2016,31(5):743-745.
[2]米华,陈凯,莫曾南.中国慢性前列腺炎的流行病学特征.中华男科学杂志,2012,18(7):579-582.
[3]Baranowski AP.Chronic pelvic pain.Best Pract Res Clin Gastroenterol,2009,23(4):593-610.
[4]Müller A,Mulhall JP.Sexual dysfunction in the patient with prostatitis.Curr Opin Urol,2005,15(6):404-409.
[5]Berghuis JP,Heiman JR,Rothman I,et al.Psychological and physical factors involved in chronic idiopathic prostatitis.J Psychosom Res,1996,41(4):313-325.
[6]Lee JH,Lee SW.Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome.J Sex Med,2015,12(3):697-704.
[7]Hatzimouratidis K,Giuliano F,Moncada I,et al.EAU guidelines on erectile dysfunction,premature ejaculation,penile curvature and priapism 2018.European Association of Urology Guidelines.2018 edition.Arnhem:European Association of Urology Guidelines Office.Presented at the EAU Annual Congress Copenhagen 2018.https://uroweb.org/guideline/malesexual-dysfunction/.
[8]Huang YP,Chen B,Ping P,et al.The Premature ejaculation diagnostic tool(PEDT)linguistic validity of the Chinese version.J Sex Med,2014,11(9):2232-2238.
[9]李宏军,黄宇烽主编.实用男科学.北京:科学出版社,2015.324-327.
[10]Althof SE,Mc Mahon CG,Waldinger MD,et al.An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation(PE).J Sex Med,2014,11(6):1392-1422.
[11]戚广崇主编.实用中医男科学.上海:上海科学技术出版社,2018.102,165.
[12]Litwin MS,Mc Naughton-Collins M,Fowler FJ Jr,et al.The National Institutes of Health chronic prostatitis symptom index:Development and validation of a new outcome measure.Chronic Prostatitis Collaborative Research Network.J Urol,1999,162(2):369-375.
[13]Bonkat G,Pickard R,Bartoletti R,et al.EAU guidelines on urological infections 2018.European Association of Urology Guidelines.2018 edition.Arnhem,:European Association of Urology Guidelines Office.Presented at the EAU Annual Congress Copenhagen 2018.https://uroweb.org/guideline/urological-infections/.
[14]Engeler D,Baranowski AP,Borovicka J,et al.EAU guidelines on chronic pelvic pain 2018.European Association of Urology Guidelines.2018 edition.Arnhem:European Association of Urology Guidelines Office.Presented at the EAU Annual Congress Copenhagen 2018.https://uroweb.org/guideline/chronic-pelvic-pain/.
[15]Sahin S,Bicer M,Eren GA,et al.Acupuncture relieves symptoms in chronic prostatitis/chronic pelvic pain syndrome:A randomized,sham-controlled trial.Prostate Cancer Prostatic Dis,2015,18(3):249-254.
[16]Qin Z,Wu J,Zhou J,et al.Systematic review of acupuncture for chronic prostatitis/chronic pelvic pain syndrome.Medicine,2016,95(11):1-10.
[17]Chang SC,Hsu CH,Hsu CK,et al.The efficacy of acupuncture in managing patients with chronic prostatitis/chronic pelvic pain syndrome:A systemic review and meta-analysis.Neurourol Urodyn,2017,36(2):474-481.
[18]孙一鸣,余长飞,李岳,等.桂枝茯苓丸加味联合穴位注射治疗前列腺增生症50例临床观察.中医杂志,2015,56(11):945-947.
[19]白敏,王强平.针灸治疗早泄疗效的Meta分析.西部医学,2012,24(2):261-264.
[20]王玉明.浅谈穴位注射疗法的创新体会.针灸临床杂志,2012,28(3):66-67.
[21]王琦主编.王琦男科学.郑州:河南科学技术出版社,2007.644-645.
[22]王怡冰.封髓固精汤治疗Ⅲ型前列腺炎合并早泄临床研究.中医学报,2016,31(5):743-745.