经尿道前列腺钬激光剜除术联合济生肾气汤加味治疗BPH的临床疗效分析
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摘要
目的:评估经尿道前列腺钬激光剜除术(HoLEP)联合济生肾气汤加味治疗BPH的临床效果。方法:选择2017年8月至2018年4月住院治疗的BPH患者110例作为研究对象,根据随机数字表法将其分为对照组和治疗组,每组各55例。对照组仅行HoLEP,治疗组在对照组的基础上联合济生肾气汤加味治疗,对比分析两组手术前后IPSS、生活质量(QOL)评分、前列腺体积、残余尿量(PVR)、最大尿流率(Qmax)、平均尿流率(Qavg)、血清T、E2、T/E2,以及术后并发症发生率。结果:治疗组患者术后IPS及QOL评分均显著低于对照组(P<0.05);治疗组患者术后前列腺体积及膀胱PVR均明显较对照组低,而Qmax和Qavg均显著高于对照组(P<0.05);治疗组术后T水平显著高于对照组,而T/E2显著低于对照组(P<0.05);两组术后E2水平差异无显著性(P>0.05);对照组和治疗组并发症发生率无统计学差异(29.09%vs 21.82%,P>0.05)。结论:济生肾气汤加味联合HoLEP可明显改善BPH患者下尿路症状,提高术后生活质量,提升膀胱及尿道功能。
Objective: To assess the clinical effects of transurethral holmium laser enucleation of the prostate(HoLEP) combined with Jisheng Shenqi Decoction(HoLEP + JSSD) on BPH. Methods: This study included 110 BPH patients treated in our hospital from August 2017 to April 2018, who were randomly assigned to receive HoLEP(n = 55) or HoLEP + JSSD(n = 55). We compared the pre-and post-operative IPSS, quality of life(QOL) score, prostate volume, postvoid residual urine volume(PVR), maximum urinary flow rate(Qmax), average urinary flow rate(Qavg) and levels of serum T, E2 and T/E2 as well as postoperative complications between the two groups of patients. Results: After treatment, both IPSS and QOL score were significantly lower in the HoLEP + JSSD than in the HoLEP group(P < 0.05), and so were the prostate volume and PVR(P < 0.05). The Qmax, Qavg and serum T level were significantly higher(P < 0.05) while T/E2 markedly lower in the former than in the latter group(P < 0.05). There were no statistically significant differences between the HoLEP + JSSD and HoLEP groups in the E2 level(P > 0.05) or the total incidence rate of complications postoperatively(21.82% vs 29.09%, P > 0.05). Conclusion: HoLEP + JSSD can significantly alleviate the lower urinary tract symptoms as well as improve the QOL and bladder and urinary tract functions of BPH patients. Natl J Androl, 2019, 25(4): 351-355
Objective: To assess the clinical effects of transurethral holmium laser enucleation of the prostate(HoLEP) combined with Jisheng Shenqi Decoction(HoLEP + JSSD) on BPH. Methods: This study included 110 BPH patients treated in our hospital from August 2017 to April 2018, who were randomly assigned to receive HoLEP(n = 55) or HoLEP + JSSD(n = 55). We compared the pre-and post-operative IPSS, quality of life(QOL) score, prostate volume, postvoid residual urine volume(PVR), maximum urinary flow rate(Qmax), average urinary flow rate(Qavg) and levels of serum T, E2 and T/E2 as well as postoperative complications between the two groups of patients. Results: After treatment, both IPSS and QOL score were significantly lower in the HoLEP + JSSD than in the HoLEP group(P < 0.05), and so were the prostate volume and PVR(P < 0.05). The Qmax, Qavg and serum T level were significantly higher(P < 0.05) while T/E2 markedly lower in the former than in the latter group(P < 0.05). There were no statistically significant differences between the HoLEP + JSSD and HoLEP groups in the E2 level(P > 0.05) or the total incidence rate of complications postoperatively(21.82% vs 29.09%, P > 0.05). Conclusion: HoLEP + JSSD can significantly alleviate the lower urinary tract symptoms as well as improve the QOL and bladder and urinary tract functions of BPH patients. Natl J Androl, 2019, 25(4): 351-355
引文
[1] 卢一平,梁嘉宇.良性前列腺增生微创治疗新进展.中华男科学杂志,2016,22(5):387-392.
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[5] 宋伟强.济生肾气丸联合非那雄胺对肾虚血瘀证前列腺增生的临床效果分析.中医药导报,2016,22(22):77-79.
[6] 李春耕,李淑娟.济生肾气汤加味治疗老年男性术后排尿困难50例.河南中医,2014,34(10):2046-2047.
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[9] Arai Y,Ishitoya S,Okubo K,et al.Transurethral interstitial laser coagulation for benign prostatic hyperplasia:Treatment outcome and quality of life.BJU Int,2015,78(1):93-98.
[10] Allen S,Aghajanyan I.Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology.Aging Male,2016,20(1):28-32.
[11] Kwon SY,Ryu JW,Dai HC,et al.Clinical significance of the resistive index of prostatic blood flow according to prostate size in benign prostatic hyperplasia.Int Neurourol J,2016,20(1):75-80.
[12] 徐浩,杨华,孙根喜,等.经尿道等离子前列腺汽化剜除术与前列腺电切术对良性前列腺增生患者性功能影响的对比研究.中国性科学,2016,25(3):20-23.
[13] Chen Y,Xu H,Gu M,et al.Comparison of plasmakinetic enucleation of the prostate with holmium laser enucleation of the prostate in the treatment of benign prostate hyperplasia.Int J Clin Exp Med,2016,9(4):7328-7333.
[14] 高玉杰,高玉翠,马江伟,等.前列腺钬激光剜除术与汽化电切术对患者血PSA的影响.中国煤炭工业医学杂志,2016,19(2):211-213.
[15] 郑文通,李志勇,彭明健.济生肾气汤加味治疗肾气亏虚型前列腺增生症的临床研究.光明中医,2012,27(8):1556-1557.
[16] Chen Z,Gong D,Na F,et al.Meta-analysis of metabolic syndrome and benign prostatic hyperplasia in Chinese patients.World J Urol,2016,34(2):281-289.
[17] 张永顺.110例良性前列腺增生患者前列腺体积与血清雌二醇及睾酮水平的相关性分析.贵州医药,2014,38(10):928-930.
[2] Aaron L,Franco OE,Hayward SW.Review of prostate anatomy and embryology and the etiology of benign prostatic hyperplasia.Urol Clin North Am,2016,43(3):279-288.
[3] Lubrano C,Petrangeli E,Catizone A,et al.Epidermal growth factor binding and steroid receptor content in human benign prostatic hyperplasia.J Steroid Biochem,2016,34(1):499-504.
[4] Jaeger CD,Mitchell CR,Mynderse LA,et al.Holmium laser enucleation and photoselective vaporization of the prostate for patients with benign prostatic hyperplasia and chronic urinary retention.BJU Int,2015,115(2):295-299.
[5] 宋伟强.济生肾气丸联合非那雄胺对肾虚血瘀证前列腺增生的临床效果分析.中医药导报,2016,22(22):77-79.
[6] 李春耕,李淑娟.济生肾气汤加味治疗老年男性术后排尿困难50例.河南中医,2014,34(10):2046-2047.
[7] Gregg EW,Engelgau MM,Narayan V.Complications of diabetes in elderly people.BMJ,2002,325(7370):916-917.
[8] Palorini F,Rancati T,Cozzarini C,et al.Multi-variable models of large International Prostate Symptom Score worsening at the end of therapy in prostate cancer radiotherapy.Radiother Oncol,2016,118(1):92-98.
[9] Arai Y,Ishitoya S,Okubo K,et al.Transurethral interstitial laser coagulation for benign prostatic hyperplasia:Treatment outcome and quality of life.BJU Int,2015,78(1):93-98.
[10] Allen S,Aghajanyan I.Use of thermobalancing therapy in ageing male with benign prostatic hyperplasia with a focus on etiology and pathophysiology.Aging Male,2016,20(1):28-32.
[11] Kwon SY,Ryu JW,Dai HC,et al.Clinical significance of the resistive index of prostatic blood flow according to prostate size in benign prostatic hyperplasia.Int Neurourol J,2016,20(1):75-80.
[12] 徐浩,杨华,孙根喜,等.经尿道等离子前列腺汽化剜除术与前列腺电切术对良性前列腺增生患者性功能影响的对比研究.中国性科学,2016,25(3):20-23.
[13] Chen Y,Xu H,Gu M,et al.Comparison of plasmakinetic enucleation of the prostate with holmium laser enucleation of the prostate in the treatment of benign prostate hyperplasia.Int J Clin Exp Med,2016,9(4):7328-7333.
[14] 高玉杰,高玉翠,马江伟,等.前列腺钬激光剜除术与汽化电切术对患者血PSA的影响.中国煤炭工业医学杂志,2016,19(2):211-213.
[15] 郑文通,李志勇,彭明健.济生肾气汤加味治疗肾气亏虚型前列腺增生症的临床研究.光明中医,2012,27(8):1556-1557.
[16] Chen Z,Gong D,Na F,et al.Meta-analysis of metabolic syndrome and benign prostatic hyperplasia in Chinese patients.World J Urol,2016,34(2):281-289.
[17] 张永顺.110例良性前列腺增生患者前列腺体积与血清雌二醇及睾酮水平的相关性分析.贵州医药,2014,38(10):928-930.