从经筋论治Ⅲ型前列腺炎的临床研究
摘要
研究背景:美国国立卫生研究院目前已将慢性前列腺炎和心肌梗死、不稳定性心绞痛活动性Crohn病等一起列为影响居民生活质量最为严重的慢性疾病。如何提高疗效,成为目前中西医治疗的热点,而从经筋探讨和治疗慢性前列腺炎尤其是Ⅲ型前列腺炎有着坚实的理论基础和一定的临床依据,但尚未进行临床研究。
研究目的:证明从经筋论治Ⅲ型前列腺炎的临床疗效
研究方法:采用随机单盲对照试验方法,研究对象为广州中医药大学第一附属医院男科门诊Ⅲ型前列腺炎患者,把60例合格病例分为试验组(30例)和对照组(30例),试验组用桂枝茯苓胶囊+可多华(a-受体阻断剂)对照组用可多华治疗,疗程12周。观察治疗前后美国国立卫生院慢性前列腺炎症状评分(NIH—CPS1)、EPS的变化、尿流动力学指标。同时观察两组药物合用的安全性。统计方法使用SPSS11.0多元统计软件,计量资料用t检验;计数资料用R×C表x~2检验及四格表确切概率法。
研究结果:试验组有效率90.00%,对照组有效率83.33%,两组比较有显著性差异P<0.05。疼痛症状治疗后与对照组比较有极显著的差异,明显优于对照组,P<0.05。排尿症状比较试验组于治疗后症状积分较对照组有显著性改善,P<0.05。临床症状对生活质量影响比较试验组于治疗后积分较对照组有显著性改善,P<0.05。前列腺液WBC改善比较治疗后比较有显著性差异,P<0.05,明显优于对照组。前列腺液卵磷脂小体改善比较试验组在治疗后与对照组比较有显著性差异,明显优于对照组,P<0.05。尿流动力学变化比较试验组于治疗后最大尿流率显著升高,与对照组比较有显著性差异,明显优于对照组,P<0.05。
结论:从经筋论治Ⅲ型前列腺炎体现了中医的特色和优势,疗效确切。
Background: chronic pelvic pain syndromes (CPPS) do harm to the malesHealthy, and many methods have been used in the treatment. However, theefficacy is not satisfactory.How to improve the efficacy have become acritical task faced the world medical field including West Medicine andTraditional Chinese Medicine (TCM). The jingjin theory is a characteristicof TCM with the advantage of the strong basis and the clinical proof. Butit is not proved by a clinic study.Objective: To evaluate the efficacy of the jingjin theory in the treatmentof CNBP.Methods: The trial was conducted between March 2003 and November 2004.63patients who had been diagnosed were randomly divided into 2 groups:the trial group treated with guizhifuling capsule 3 pills three times aday and Doxazosin Mesylate (a-blocker) 4mg per night for 90 days and thecontrol group given only Doxazosin Mesylate 4mg per night in the same way.The efficacy was evaluated by the NIH chronic prostatitis symptomindex(NIH—CPSI), the microscopic findings of prostatic secretion andthe measurement of maximum uroflow rate (Qmax) before and after thetreatment.Result: 60 evaluable patients were stratified. Each group have 30 patients.The results were evaluated with T test or X2 test of Spss 11. 0. The totaleffective rates were 96.38% in trial group and 83.33% in controlgroup(P<0. 05). The INIH-CPSI scores were reduced both in trial group andin control group, and significant differences of reduction were foundbetween the two groups(P<0.05). The microscopic findings of prostaticsecretion and the measurement of maximum uroflow rate (Qmax) were improvedin trial group and had a significant difference from the control group(P<0.05).Conclusion: using the jingjin theory may be a useful method for thetreatment of chronic nonbacterial proctatitis.
研究目的:证明从经筋论治Ⅲ型前列腺炎的临床疗效
研究方法:采用随机单盲对照试验方法,研究对象为广州中医药大学第一附属医院男科门诊Ⅲ型前列腺炎患者,把60例合格病例分为试验组(30例)和对照组(30例),试验组用桂枝茯苓胶囊+可多华(a-受体阻断剂)对照组用可多华治疗,疗程12周。观察治疗前后美国国立卫生院慢性前列腺炎症状评分(NIH—CPS1)、EPS的变化、尿流动力学指标。同时观察两组药物合用的安全性。统计方法使用SPSS11.0多元统计软件,计量资料用t检验;计数资料用R×C表x~2检验及四格表确切概率法。
研究结果:试验组有效率90.00%,对照组有效率83.33%,两组比较有显著性差异P<0.05。疼痛症状治疗后与对照组比较有极显著的差异,明显优于对照组,P<0.05。排尿症状比较试验组于治疗后症状积分较对照组有显著性改善,P<0.05。临床症状对生活质量影响比较试验组于治疗后积分较对照组有显著性改善,P<0.05。前列腺液WBC改善比较治疗后比较有显著性差异,P<0.05,明显优于对照组。前列腺液卵磷脂小体改善比较试验组在治疗后与对照组比较有显著性差异,明显优于对照组,P<0.05。尿流动力学变化比较试验组于治疗后最大尿流率显著升高,与对照组比较有显著性差异,明显优于对照组,P<0.05。
结论:从经筋论治Ⅲ型前列腺炎体现了中医的特色和优势,疗效确切。
Background: chronic pelvic pain syndromes (CPPS) do harm to the malesHealthy, and many methods have been used in the treatment. However, theefficacy is not satisfactory.How to improve the efficacy have become acritical task faced the world medical field including West Medicine andTraditional Chinese Medicine (TCM). The jingjin theory is a characteristicof TCM with the advantage of the strong basis and the clinical proof. Butit is not proved by a clinic study.Objective: To evaluate the efficacy of the jingjin theory in the treatmentof CNBP.Methods: The trial was conducted between March 2003 and November 2004.63patients who had been diagnosed were randomly divided into 2 groups:the trial group treated with guizhifuling capsule 3 pills three times aday and Doxazosin Mesylate (a-blocker) 4mg per night for 90 days and thecontrol group given only Doxazosin Mesylate 4mg per night in the same way.The efficacy was evaluated by the NIH chronic prostatitis symptomindex(NIH—CPSI), the microscopic findings of prostatic secretion andthe measurement of maximum uroflow rate (Qmax) before and after thetreatment.Result: 60 evaluable patients were stratified. Each group have 30 patients.The results were evaluated with T test or X2 test of Spss 11. 0. The totaleffective rates were 96.38% in trial group and 83.33% in controlgroup(P<0. 05). The INIH-CPSI scores were reduced both in trial group andin control group, and significant differences of reduction were foundbetween the two groups(P<0.05). The microscopic findings of prostaticsecretion and the measurement of maximum uroflow rate (Qmax) were improvedin trial group and had a significant difference from the control group(P<0.05).Conclusion: using the jingjin theory may be a useful method for thetreatment of chronic nonbacterial proctatitis.
引文
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[7] 郑翔,章真如.治疗前列腺疾病的经验[J].北京中医杂志,1994;1:10—11
[8] 姜生坤.前列腺疾病从肝论治[J].陕西中医,1993;14(5):217—218
[9] 郭弢.前列腺炎从肝论治经验介绍[J].实用中医内科杂志,1994;3(3):27—28
[10] 戴西湖.中药治疗慢性前列腺炎浅析[J].河北中医,1997;19(1):27—28
[11] 刘春英.施汉章治疗慢性前列腺炎经验[J].中医杂志,1992;33(10):21
[12] 韩万锋.补肾利尿法治疗非细菌性前列腺炎48例[J].吉林中医药,1996;1:19—20
[13] 潘学柱.慢性前列腺炎治从肝阳不足初探[J].陕西中医,1995;16(10):453—454
[14] 李波.疏润任脉法治疗非细菌性前列腺炎临床观察[J].中国中西医结合杂志,2003;23卷(1):70-71
[2] 何乐业.前列腺炎综合症[J].中华泌尿外科杂志,2000;21(11):697
[3] 李曰庆.中医药治疗前列腺炎临床研究述评[J],北京中医药大学学报,20(5):2-5
[4] 王祖贤.慢性前列腺炎治疗重在活血化瘀[J].湖北中医杂志,1995;2:49
[5] 徐东浩.慢性前列腺炎从瘀论治五法[J].新疆中医药,1996;4:8—9
[6] 吴少刚.王琦治疗慢性前列腺炎的临床思维[J].山东中医杂志,1994;13(10):438—439
[7] 郑翔,章真如.治疗前列腺疾病的经验[J].北京中医杂志,1994;1:10—11
[8] 姜生坤.前列腺疾病从肝论治[J].陕西中医,1993;14(5):217—218
[9] 郭弢.前列腺炎从肝论治经验介绍[J].实用中医内科杂志,1994;3(3):27—28
[10] 戴西湖.中药治疗慢性前列腺炎浅析[J].河北中医,1997;19(1):27—28
[11] 刘春英.施汉章治疗慢性前列腺炎经验[J].中医杂志,1992;33(10):21
[12] 韩万锋.补肾利尿法治疗非细菌性前列腺炎48例[J].吉林中医药,1996;1:19—20
[13] 潘学柱.慢性前列腺炎治从肝阳不足初探[J].陕西中医,1995;16(10):453—454
[14] 李波.疏润任脉法治疗非细菌性前列腺炎临床观察[J].中国中西医结合杂志,2003;23卷(1):70-71