Long-term efficacy and safety of tamsulosin hydrochloride for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: data from China

Background  Tamsulosin hydrochloride can significantly improve benign prostatic hyperplasia (BPH) symptoms after the first dose and achieve long-term efficacy in European and American populations; however, the coresponding studies from China are rarely seen. The purpose of this study was to evaluate the long-term efficacy and safety of tamsulosin hydrochloride 0.2 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of BPH in China.

Methods  Chinese patients with LUTS suggestive of BPH were enrolled in a 4-week placebo run-in period and subsequent 60-week open-label study. Tamsulosin hydrochloride 0.2 mg was administered daily during the period of the study. The efficacy and safety parameters were evaluated at the end of treatment period I (0–12 weeks) and period II (13–60 weeks). The BPH patients were divided into tamsulosin monotherapy group and combination therapy group which received concomitant medication of finasteride 5 mg once daily after the evaluation at the end of treatment period I.

Results  A total of 113 patients were recruited to the study. Eighty-two patients received tamsulosin monotherapy and twenty-nine received combination therapy during the treatment period II. Tamsulosin hydrochloride produced a great improvement in mean maximum urinary flow rate (Q_max) (1.7 ml/s, 3 ml/s) and a significant decrease in mean international prostate symptom score (IPSS) (4.1, 6.4) after 12-week and 60-week treatments, respectively. At the end of treatment period II, there were significant improvement in IPSS, quality of life (QOL) score, Q_max and average flow rate (Q_ave) for combination therapy group compared with the treatment period I (all P <0.05). No serious adverse events (SAE) were recorded during the study.

Conclusion  Long-term tamsulosin hydrochloride therapy is a safe, effective and well-tolerated method for the treatment for LUTS suggestive of BPH in China.

     

Clinical curative effect of electroacupuncture combined with Zhizhukuanzhong Capsules for treating gastroesophageal reflux disease

OBJECTIVE:To study the clinical curative effect,safety and mechanism of action of electroacupuncture combined with Zhizhukuanzhong capsules(ZZKZC) in treating gastroesophageal reflux disease(GERD).METHODS:A total of 480 patients with confirmed GERD were randomly divided into four groups:the electroacupuncture group,the ZZKZC group,the combined therapy group,and the control group,with 120 cases in each group.Each case in the electroacupuncture group was treated with electroacupuncture on Zusanli(ST36),Zhongwan(CV12),Neiguan(PC6),Taichong(LR3)and Gongsun(SP 4)once daily for 6 weeks.Each case in the ZZKZC group was treated with oral administration of 1.29 g ZZKZC three times daily.The combined therapy group had electroacupuncture and ZZKZC.The control group was given oral administration of 5 mg mosapride three times and 20 mg pantoprazole twice daily.The 24-hour intraesophageal total number of reflux episodes with pH <4(or bilirubin absorbance ≥ 0.14),the number of long-term(≥5 min) reflux episodes,the percentage of upright time,the percentage of supine time,the percentage of total time of pH <4(or bilirubin absorbance ≥0.14),endoscopic grading score,symptom score,quality of life score,and adverse reactions were observed before treatment,at the end of treatment and 54 weeks after treatment in the four groups.RESULTS:The 24-hour intraesophageal pH and bile reflux,endoscopic grading score and symptom score were all significantly decreased at the end of treatment in every group,while the scores of 8 dimensions of quality of life were all increased compared with those before treatment(P<0.01).All of these indices were better in the combined therapy group than those in the other groups(P<0.05).These indices did not significantly deteriorate in the combined therapy group and electroacupuncture group 54 weeks after treatment compared with the end of treatment(P>0.05);however,these indices all significantly deteriorated in the ZZKZC and control groups(P>0.05).The short and long-term total efficacy rates in the combined therapy group showed significant superiority to those in the other groups(P<0.05 or P<0.01).No serious adverse reactions were found in the four groups.CONCLUSION:Electroacupuncture and ZZKZC play an important role in inhibiting intraesophageal acid and bile reflux,decreasing the endoscopic grading score,and alleviating the symptoms of gastroesophageal reflux to improve the quality of life.However,the effect of combined treatment is more effective,with better security and long-term efficacy,and therefore,this combination treatment is appropriate for clinicaluse.     

Synergistic effects of tetrandrine on the antifungal activity of topical ketoconazole cream in the treatment of dermatophytoses: A clinical trial

Objective:To evaluate the synergistic effects of tetrandrine(TET)on the antifungal activity of topical ketoconazole(KCZ)in the treatment of dermatophytoses.Methods:The minimum inhibitory concentrations(MICs)for KCZ and combined KCZ and TET were compared in vitro.A randomized,double-blind trial was conducted among 97 patients with dermatophytoses who were assigned to 3 groups and received: treatment with combination of 2%KZC and 2%TET cream(KCZ+TET group),or only 2%KZC cream(KCZ group),or 2%TET cream(TET group).Patients with tinea corporis and/or tinea cruris were treated for 2 weeks, separately.The patients with tinea pedis and/or tinea manuum were treated for 4 weeks.Results:Compared with KZC alone,combined use of KZC and TET showed lower MICs against clinical isolates of dermatophytes (P<0.05 for all).In the patients with tinea corporis and/or tinea cruris,the rates of overall cure(clinical cure plus mycologic clearance)were 81.25%vs.33.33%for combined treatment and KZC monotherapy,respectively, after 4 weeks.All clinical indices were significantly different between the combination therapy and only KCZ therapy groups(P<0.05).Among the patients with tinea pedis and/or tinea manuum after 4 weeks treatment,the overall cure rates in the KCZ + TET group and KCZ group were 75.00%vs.40.00%,respectively.In the KCZ + TET group,all the clinical indices were significantly better than those in the KCZ group and TET group(P<0.05). The rates of overall efficacy in the TET group were all zero.No local skin redness or itching was observed during TET treatment.No clinically significant changes were found in post-treatment routine blood,urine,or stool tests, ECG,or tests for liver and kidney function;no serious adverse events occurred.Conclusion:TET synergistically enhanced the clinical efficacy of topical KZC cream in the treatment of dermatophytoses.     

Effect of Longbishu Capsule (癃闭舒胶囊) plus Doxazosin on Benign Prostatic Hyperplasia: A Randomized Controlled Trial

Objective:To investigate the effect of Longbishu Capsule(癃闭舒胶囊,LBS),doxazosin,and combination therapy on benign prostatic hyperplasia(BPH).Methods:A randomized,double-blind,multi-center parallel trial was conducted involving 360 patients in hospitals in Beijing(108 cases),Heilongjiang(90 cases),Sichuan(90 cases),Shanghai(72 cases),China.They were randomly assigned with central randomization method to group A(LBS placebo plus doxazosin),group B(LBS plus doxazosin)or group C(LBS plus doxazosin placebo),120 cases for each group.The international prostate symptom score,maximum urinary flow rate,postvoid residual urine volume and prostate volume were measured for evaluating the efficacy of the three treatments.Results:At baseline,there was no significant difference in the measured variables among the three groups.After 12-month treatment,the three groups showed significant improvements in IPSS and maximum urinary flow rate from baseline(P0.01).Although postvoid residual urine volume was not significantly different from the baseline in group A(P0.05),it significantly decreased in group B and C(P0.05).The incidence of adverse events were similar among the three groups.Conclusions:The treatment of LBS alone or LBS plus doxazosin was able to significantly improve IPSS in patients with BPH.The treatments may reduce the increase in prostate volume and postvoid residual urine volume as well.     

Relationship between lower urinary tract symptoms and objective measures of benign prostatic hyperplasia: a Chinese survey

Background The enlarged prostate leads to obstruction and lower urinary tract symptoms （LUTS）, which comprise frequency, urgency, weak stream, straining and nocturia. This study was conducted in a large series of patients to evaluate the relationship between LUTS as stipulated in the International Prostate Symptom Score （IPSS） and the objective parameters related to benign prostatic hyperplasia （BPH）.
Methods We enrolled 1295 BPH patients from seven centers. The patients were either at first diagnosis of BPH or had discontinued medical treatment for at least 3 months. Those with several other diseases that may be potential risk factors affecting urinary symptoms were excluded from the study. Age, IPSS, prostate volume, peak flow rate, urine volume and post-voiding residual urine volume were measured. The relationship between IPSS and objective parameters were quantified by means of Spearman correlation coefficients. The differences in these parameters between the groups with mild, moderate or severe symptoms were also evaluated.
Results Statistically significant correlations were found between IPSS and objective parameters by means of Spearman correlation coefficients. When the patients were divided into three groups with different severities of symptoms, there were significant differences in peak flow rate, urine volume, prostate volume, residue urine volume and quality of life, whereas average age and prostate-specific antigen levels were similar. However, there was evident overlap of these parameters between the groups. The same results were found when the irritative or obstructive subscore of IPSS was considered.
Conclusions The correlation between objective parameters of BPH and LUTS is significant. However, it is hard to predict the severity of symptoms by these parameters.     

Acupuncture Treatment for 15 Cases of Post-traumatic Coma

In order to observe the effects of acupuncture combined with point-injection therapy on post-traumatic coma, 30 such cases were randomly divided into the following two groups. The patients in the control group were simply treated with the basic neural medical treatment; while patients in the treatment group were treated by acupuncture and point-injection therapy in addition to the above treatment. Comparisons were made between the two groups in the therapeutic effects by GCS evaluations as well as in the changes of main symptoms. The results showed that the GCS value in the treatment group was higher than that of the control group, but with no statistical significance （P〉0.05）. However, the main symptoms of the patients in treatment group, such as aphasia, hemiplegia, and injuries of cranial nerves （including injuries of the facial, oculomotor and abducent nerves） were obviously improved, showing significant differences as compared with the control group （P〈0.05）. Conclusion can be made that acupuncture combined with point-injection has the consciousness-inducing effect for post-traumatic coma, and shows good effects for the cranial nerve iniuries and aohasia.     

Two-year Observation of the Clinical Efficacy in Treating Chronic Hepatitis B Patients with Ganxian Recipe(肝纤方) and Lamivudinene

Objective:To evaluate the clinical efficacy of Ganxian recipe (肝纤方, GXR) and lamivudine (LVD) in a two-year treatment of chronic hepatitis B (CHB). Methods: One hundred and twenty patients with CHB were randomly divided into the combinedly treated group (combined group) of 40 CHB patients who were treated with GXR combined with LVD. Another 40 CHB patients were treated with LVD alone (WM group), and still another 40 CHB patients were treated with GXR alone (TCM group). All these cases were randomly controlled and observed for two years. Results: Comprehensive efficacy: Total effective rate of the combined group (complete response and partial response) was 92. 5 %, while that of the WM group was 67.5 % and TCM group 57.5 %, respectively, with the difference between them was significant (P＜0.01);after treatment, the hepatic functions (AST, ALT, SB) of the three groups were all reduced, and the reduction in the combined group was particularly significant in comparison with the WM group or TCM group, P＜0.05 or P＜0.01 respectively, suggesting that the effect in the combined group was better than that in the other two groups; the rate of tyrosine-methionine-aspartate-aspartate (YMDD) virus mutation: it was 7.5%in the combined group, 40.0% in the WM group, and 5.0% in the TCM group; liver fibrosis improvement parameter: after treatment, the results in the combined group got better than those in the other two groups.Conclusion: GXR could inhibit the appearance of YMDD after long-term application of LVD, and combined use has marked synergism.     

Effect of treatment based on syndrome differentiation by Chinese medicine on post-traumatic elbow arthritis

Objective：To compare the clinical efficacy of treatment based on syndrome differentiation of Chinese medicine and modern conservative therapeutic program on post-traumatic elbow arthritis（PTEA） in order to provide the guidance in clinical practice.Methods：Seventy-six patients with PTEA requesting the conservative therapy were equally assigned to two groups randomly.The 38 patients in the treated group were administered with Chinese herbal medicines according to their syndrome typing for oral intake and external washing; while the other 38 patients in the control group were treated orally with glucosamine hydrochloride and Celecoxib,combined with intra-articular injection of sodium hyaluronate and peri-articular pain spot blocking with Triamcinolone Acetonaide Acetate injection.All were followed-up for six months with the therapeutic efficacy assessed by Japanese Orthopaedic Association（JOA）and the Hospital for Special Surgery（HSS）Scale scoring.Results：All the 76 patients completed the trial.The JOA and HSS scores in the two groups were not significantly different before treatment（P〉0.05）,but they did show significant difference after treatment in terms of total score,joint pain,range of motion,and daily activity（P〈0.05）.However,there was no difference between the two groups in the improvement of joint stability and deformity（P〉0.05）.Conclusion：Both the Chinese drug therapy according to syndrome differentiation and modern conservative therapy are effective in treating PTEA, but the former shows more superiority,and so it is worthy of clinical spreading.     

Correlation between distribution of Helicobacter pylori in oral cavity and chronic stomach conditions

In this study,the colonization and distribution of Helicobacter pylori(Hp) in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases.Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp.Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques,gargles and dorsal mucosa were tested for Hp.The 96 patients were treated by bismuth triple therapy and among them,52 subjects were additionally given periodontal initial therapy.The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment.The results showed that the detection rates of oral specimens were in the order of dental plaques(82.3%),gargles(51.1%) and scrapings of dorsal mucosa of tongue(37.5%).One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment,the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone(62.8% vs.32.4%,P<0.05).Moreover,the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy.We are led to conclude that Hp is present at various parts of oral cavity,oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.     

Effect of Jin-3-needling therapy on plasma corticosteroid, adrenocorticotrophic hormone and platelet 5-HT levels in patients with generalized anxiety disorder

Objective:To observe the therapeutic efficacy of Jin-3-needling therapy(J3N)on generalized anxiety disorder(GAD)through clinical global impression scale(CGI), and to explore the mechanism by measuring the plasma levels of corticosteroid(CS),adrenocorticotrophic hormone (ACTH),and platelet 5-hydroxytryptamine(5-HT)before and after treatment.Methods:Eighty- six GAD patients with the diagnosis agreeing with the inclusion criteria were assigned,according to the sequence of visiting time,to three groups.The 29 patients in the Western medicine group were treated mainly with fluoxetine or paroxetine,Alprazolam might be given additionally in severe conditions if necessary;the 29 patients in the needling group received J3N therapy with Sishenzhen, Dingshenzhen,Neiguan(PC6),Shenmen(HT7)and Sanyinjiao(SP6)as the chief acupoints selected;and the 28 patients in the combined treatment group were treated with both drugs and needling in the same way as applied in the above two groups.The therapeutic course for all was 6 weeks.Conditions of patients were evaluated before and after treatment with CGI,and levels of CS, ACTH as well as 5-HT were measured by high performance liquid chromatography-electrochemistry. Results:By CGI scoring,the scores of severity index and the general index were not different significantly in the three groups,but the efficacy index proved to be the highest in the needling group, the second in the combined trentment group,and the lowest in the drug group.Plasma level of ACTH and platelet content of 5-HT were lowered in all the three groups after treatment,showing statistical significance(P<0.05),but no significant change was found in CS level(P>0.05).Conclusion:The therapeutic efficacy of J3N in treating GAD is equivalent to,but with the efficacy index significantly higher than,that of conventional treatment.Moreover,when combined with drugs,needling might effectively prevent the side effect of the routinely used Western drugs.The regulatory action of needling on platelet 5-HT and plasma ACTH is probably one of the acting pathways for J3N treatment on GAD.     

M-受体与α-受体阻滞剂联合用药治疗良性前列腺增生及下尿路症状的临床观察

目的 评价M-受体阻滞剂与α-受体阻滞剂联合用药治疗良性前列腺增生（BPH）下尿路症状（LUT）的有效性及安全性。方法 选择经1周特拉唑嗪治疗后,梗阻症状缓解,但刺激症状仍明显的BPH／LUT患者69例,主要的排除标准为最大尿流率（Qmax）〈10ml／s、残余尿〉50ml、前列腺体积〉50ml。随机分成两组,特拉唑嗪组给予特拉唑嗪治疗,联合用药组给予托特罗定与特拉唑嗪联合治疗。用药时间6周,评估内容包括总症状评分（IPSS）及梗阻症状评分及刺激症状评分、尿流率和残余尿量等,并登记不良事件。结果 两组间基础临床指标比较差异无统计学意义。用药6周后联合用药组IPSS评分由19．1±2．9降低到14．0±4．2,P〈0．001。刺激症状评分由13．2±3．2降至9．2±2．9,P〈0．001。特拉唑嗪组IPSS评分由18．5±3．2降低到17．3±4．1,P=0．033。刺激症状评分由12．7±3．1降至11．7±3．0,P=0．001。治疗后两组间比较显示：（1）联合用药组IPSS评分的改善优于特拉唑嗪组（-5．09 vs-1．19,P〈0．001）,联合用药组刺激评分的改善优于特拉唑嗪组（-4 vs-1,P〈0．001）,而梗阻症状评分的改善两组间差异无统计学意义（-1．09 vs-0．2,P〈0．168）。（2）治疗6周后两组间Qmax、残余尿差异无统计学意义。联合用药组无急性尿潴留和其他严重并发症发生。结论 托特罗定与α-受体阻滞剂联合应用于前列腺轻中度肥大、轻中度肥大的患者,可不同程度降低患者IPSS评分,其中以刺激症状评分的改善更明显。未见严重不良反应和急性尿潴留出现。     

特拉唑嗪与托特罗定联合治疗良性前列腺增生的疗效评估

目的评价特拉唑嗪与托特罗定联合应用治疗良性前列腺增生的疗效。方法选择未经治疗的无严重梗阻症状的良性前列腺增生患者74例,随机分为特拉唑嗪组(单独使用特拉唑嗪,n=31)和联合用药组(特拉唑嗪+托特罗定,n=43),两组分别在治疗前后测定国际前列腺症状评分、储尿期刺激症状评分、最大尿流率、24 h平均尿量、残余尿量、24 h排尿次数、24 h尿失禁次数和夜尿次数,并记录出现的不良事件。结果用药12周后,特拉唑嗪组国际前列腺症状评分、储尿期刺激症状评分、残余尿量、24 h排尿次数、尿失禁次数及夜尿均次较治疗前均明显下降(P<0.05);最大尿流率和平均尿量较治疗前均明显上升(P<0.05);治疗后,联合用药组国际前列腺症状评分、储尿期刺激症状评分、尿失禁次数和夜尿次数与特拉唑嗪组相比均有明显改善,差异有统计学意义(P<0.05)。结论特拉唑嗪与托特罗定联合应用于无严重梗阻症状的良性前列腺增生患者,可以更全面地缓解症状,改善患者的生活质量。     

前列舒通胶囊联合多沙唑嗪治疗良性前列腺增生临床观察

目的初步探讨中成药前列舒通胶囊联合多沙唑嗪治疗良性前列腺增生的临床疗效。方法40例BPH患者,随机分为两组,联合治疗组给予前列舒通胶囊,3次／d,3粒／次,多沙唑嗪4mg 1次/d,对照组单独服用多沙唑嗪治疗。用药3月,评估治疗前后国际前列腺症状评分（IPSS）、前列腺体积、最大尿流率（Qmax）、残余尿量,并记录不良事件。结果治疗3月后,两组间比较,联合用药组IPSS评分、前列腺体积变化较对照组明显,组间差异有统计学意义（P〈0．01）,治疗3月后两组间Qmax、残余尿量差异无统计学意义（P〉0．05）。结论前列舒通胶囊与α-受体阻滞剂联合用药能改善BPH症状,缩小前列腺体积,提高最大尿流率;联合用药优于单独使用α-受体阻滞剂。     

α受体阻滞剂治疗良性前列腺增生症的疗效比较

目的评价坦索罗新与特拉唑嗪治疗前列腺增生的效果和对血压影响的差异。方法将我院门诊治疗的前列腺增生患者随机分为2组,分别接受坦索罗新（每日0.4mg）和特拉唑嗪（每日4mg）治疗,评价治疗1个月后2组患者IPSS评分、血压和副作用发生率的差异。结果治疗1个月后特拉唑嗪组IPSS评分要显著优于坦索罗新组（42.50%vs34.29%,P〈0.05）,但特拉唑嗪组有2例患者出现头晕、恶心等不适。结论不同α受体阻滞剂对前列腺增生症的效果存在差异,特拉唑嗪的治疗效果更好,坦索罗新对血压的影响更小,相对更安全。     

多沙唑嗪控释片和特拉唑嗪治疗前列腺增生症的对照研究

目的　评价多沙唑嗪控释片和特拉唑嗪片治疗良性前列腺增生症 (BPH)的临床有效性和安全性。方法　对入选的119名BPH患者进行了前瞻性的随机、双盲和平行对照试验 ,过程分 3个阶段 :第 1阶段为 2周的清洗期 ,第 2阶段为 2周的单盲安慰剂导入期 ,第 3阶段为 12周的双盲药物治疗期。多沙唑嗪控释片和特拉唑嗪片的起始剂量分别为 4mg/d和 1mg/d ,如果治疗 4周后最大尿流率 (Qmax)增加 <3ml/s,国际前列腺症状评分 (IPSS)下降 <30 % ,则将 2种药物按不同方式加量至8mg/d。主要评价指标为从基线到最后 1次随访的IPSS和Qmax的变化值 ,以及治疗中常见不良事件的发生率。结果　多沙唑嗪控释片和特拉唑嗪片均能显著减轻BPH的下尿路梗阻症状 ,增加Qmax(P <0 .0 0 1) ,降低IPSS(P <0 .0 1) ,两组间比较的差异无显著性意义 (P >0 .0 5 )。多沙唑嗪控释片组没有因为与治疗相关的不良事件而退出试验的患者 ,并且在总不良事件的发生率和头晕、恶心、体位性低血压等主要不良事件的发生率与特拉唑嗪片组比较 ,差异有显著性意义 (P <0 .0 5 )。结论　多沙唑嗪控释片和特拉唑嗪片能同样有效缓解BPH的症状 ,但是前者的安全性和耐受性显著提高。     

通癃启闭汤联合坦索罗辛治疗前列腺增生症的临床观察

目的观察通癃启闭汤联合坦索罗辛治疗良性前列腺增生（BPH）引起下尿路症状及伴膀胱活动过度的临床疗效和安全性。方法将77例BPH患者随机分为对照组和治疗组。对照组33例,口服盐酸坦索罗辛缓释胶囊0．2mg,每晚1次;治疗组44例,在对照组治疗基础上,加服自拟中药方通癃启闭汤,每天1剂,分早晚2次服。观察两组分别在治疗前和治疗12周后行国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、膀胱残余尿量（PRV）、前列腺体积（PV）及血清总前列腺特异性抗原（t—PSA）的变化,并对出现的不良反应进行记录。结果治疗组总有效率为93．18％,对照组为75．76％,两组比较,差异有统计学意义（P〈0．05）;且治疗组在减轻患者的IPSS、改善QOL、提高Qmax和减少PRV等方面,疗效均明显优于对照组（P〈0．05）;治疗组PV和t—PSA下降幅度大于对照组,但差异无统计学意义（P〉0．05）。结论通癃启闭汤联合坦索罗辛治疗BPH可以显著改善患者主观症状及客观指标,且作用安全、有效。     

前列腺增生症患者勃起功能障碍及其影响因素分析

目的探讨老年男性在前列腺增生症（BPH）患者病史、年龄、IPSS、前列腺体积、最大尿流率及血清PSA与勃起功能障碍（ED）的相关性。方法采用SPSSl0.0软件总结并分析142例前列腺增生症患者病史、年龄、临床症状参数、前列腺体积、最大尿流率、血清PSA与勃起功能国际评分（ILEF-5）、性欲之间的关系。结果 BPH患者142例,年龄50~75岁。115例有ED（80.99%）,72例有性欲低下（50.70%）。研究显示年龄与性功能关系密切。IPSS评分在IIEF-5正常组与轻、中、重度ED组间比较,差异均有统计学意义（P〈0.05）。结论年龄是性功能障碍的主要因素,BPH患者中ED的发生率较高,ED的程度与下尿路症状（LUTS）的严重程度有相关性。     

合并前列腺炎的良性前列腺增生症的临床分析

目的：分析前列腺炎与前列腺增生症（BPH）的关系,探讨前列腺炎在BPH病程中可能起的作用。方法：对2003年7月至2009年2月间的466例良性BPH患者的资料进行回顾性分析。所收集临床资料包括年龄、病史、国际前列腺症状评分（IPSS）、生活质量评分（QOL）、前列腺体积、前列腺特异性抗原（PSA）相关值、最大尿流率（Qmax）,及是否出现急性尿潴留和接受相关手术治疗。结果：合并前列腺炎的患者423例（90.77%,PS/BPH组）,单纯BPH患者43例（9.23%,BPH组）。与BPH组比较,PS/BPH组患者病史延长,IPSS和QOL评分明显增加,前列腺体积和移行带体积显著增大,最大尿流率减小,发生急性尿潴留的概率增高,接受外科治疗的比例也较大。但是,年龄和PSA相关值（总PSA、游离PSA、游离与总PSA的比值、PSA的密度）2组之间差异无统计学意义。结论：前列腺炎可能是BPH的病因之一,同时炎症可能会加重BPH患者的下尿路症状,增加急性尿潴留和相关手术的风险     

双氯芬酸钠栓联合坦索罗辛治疗前列腺增生夜尿增多的疗效评估

目的评价双氯芬酸钠栓和坦索罗辛联合治疗前列腺增生患者夜尿增多的有效性和安全性。方法选择有明显夜尿增多症状的前列腺增生患者54例,随机分为两组,每组27例。对照组单服坦索罗辛（0．2mg,每天1次）,联合治疗组使用双氯芬酸钠栓（25mg,每天1次,睡前1h塞人直肠内）和坦索罗辛（0．2mg,每天1次）,疗程均为4周,评估内容包括国际前列腺症状评分（IPSS评分）、生活质量评估（QOL）及夜尿次数,并登记不良事件,每2周评估1次。结果治疗4周后,两组IPSS评分和QOL均较治疗前有明显改善（P〈0．05）。但对于夜尿状况,只有联合治疗组有明显疗效（P〈0．05）。两组比较,联合治疗组IPSS评分下降优于对照组（P〈0．05）,减少夜尿次数和改善生活质量优于对照组（P〈0．05）。两组无明显不良事件发生。结论双氯芬酸钠栓和坦索罗辛联合治疗前列腺患者夜尿增多。较单用坦索罗辛更为有效,且安全,无明显不良反应。