消瘀通列汤治疗慢性盆腔疼痛综合征临床研究

目的：观察“消瘀通列汤”治疗慢性疼痛综合征（CPPS）的疗效及NIH—CPSI评分。方法：据NIH前列腺炎综合征分类标准，选择CPPS病例186例，根据EPSRT分成Ⅲa和Ⅲb两组。给予“消瘀通列汤”治疗，治疗前及治疗后每月作EPSRT常规及NIH—CPSI评分进行疗效评价。结果：3个疗程后Ⅲa组显效率41．1％，总有效率82．2％；Ⅲb组显效率51．9％，总有效率86．1％。经统计分析，两组疗效差异有显著性意义（P〈0．05）。每个疗程结束后，两组NIH—CPSI各类得分均有明显改善（P〈0．001或P〈0．01）。Ⅲa组WBC计数评分，除第1、2疗程有明显减少外，第3疗程开始无明显变化。结论：“消瘀通列汤”能有效改善慢性盆腔疼痛综合征临床症状，提高生活质量。可能减轻盆腔内静脉充血。     

武警某部军人慢性前列腺炎样症状的调查研究

 目的 了解武警军人慢性前列腺炎样症状的发病情况并研究在部队特殊环境下的发病因素,为进一步探讨其发病机制与针对性治疗提供依据。方法 应用自制问卷和美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)对301名武警某部军人进行调查。结果 (1)慢性前列腺炎样症状阳性率为23.6%。(2)单因素分析结果,年龄、BMI、入伍前性行为、遗精、体能锻炼量、工作压力、喝水习惯等对阳性率无影响。(3)多因素分析结果:经常憋尿的比没有或偶尔憋尿的军人发生慢性前列腺炎样症状的概率高11.64倍;服役2~5年的比服役2年内的高1.31倍,服役5年以上比服役2年内的高4.68倍;城镇或城市来源的比农村来源的高1.01倍。是否经常熬夜和担负勤务(全训或执勤为主)对慢性前列腺炎样症状的发生均无显著性影响。结论 武警军人慢性前列腺炎样症状阳性率处于较高水平,经常憋尿、服役年限长、城镇或城市生长环境是其发生的独立危险因素。     

联合应用郁乐疏合剂治疗慢性前列腺炎的临床疗效评价

目的:探讨联合郁乐疏合剂治疗慢性前列腺炎的临床疗效。方法:将88例Ⅲ型慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者随机分为对照组和试验组,每组44例,对照组采用临床常规治疗,即口服抗生素、α受体阻滞剂、活血化瘀中成药及前列腺按摩;试验组44例,在接受临床常规治疗的同时口服郁乐疏合剂。治疗前后两组分别应用国际慢性前列腺炎症状评分(NIH-CPSI)测评症状严重程度,用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)测评患者焦虑、抑郁等情绪障碍状况,用国际勃起功能指数-5(IIEF-5)测评患者性功能状况,并对各项结果进行统计学分析。结果:治疗后两组患者前列腺炎症状均有明显改善,性功能障碍亦有改善,试验组改善程度明显优于对照组,其中对疼痛不适症状改善明显,试验组治疗后疼痛症状评分为(7.89±2.82)分,对照组为(10.41±2.55)分,两者比较有显著差异(P0.01)。对照组治疗前后HAMA、HAMD评分无显著性差异(P0.05);而试验组治疗前后HAMA、HAMD评分有显著性差异,试验组治疗前后HAMA评分分别为(24.30±5.07)分和(13.80±3.62)分(P0.01);试验组治疗前后HAMD评分分别为(23.81±5.01)分和(16.23±5.93)分(P0.01)。结论:郁乐疏合剂能缓解患者的焦虑、抑郁心理状态,改善慢性前列腺炎患者的症状,是治疗慢性前列腺炎的有效药物。     

药物与心理行为干预综合治疗慢性前列腺炎

目的探讨慢性前列腺炎的综合治疗方法。方法回顾性分析本院应用药物与心理行为干预联合治疗及单独应用药物治疗慢性前列腺炎疗效,选择2010年1～12月门诊患者58例。随机分为治疗组与对照组。治疗组32例,年龄17～46岁,平均26．6岁,病程3个月～3年,平均19．8个月;对照组26例,年龄19～49岁,平均28．1岁,病程3个月～4年,平均20．8个月。采用美国国立卫生研究院慢性前列腺炎症状评分（NIH—CPSI）进行评分,计数前列腺液常规中白细胞。结果治疗组的32例患者中,总有效率达93．8％。对照组26例患中．总有效率达76．9％。治疗组疗效明显优于对照组（P〈0．05）。结论慢性前列腺炎患者除了进行药物治疗外,辅以心理治疗使患者趋于稳定、镇静、乐观,症状明显改善或消失,可以达到事半功倍的效果,值得临床大力推广。     

血尿安胶囊联合左氧氟沙星治疗慢性细菌性前列腺炎的疗效观察

目的 探讨血尿安胶囊联合左氧氟沙星治疗慢性细菌性前列腺炎的临床疗效。方法 126例慢性细菌性前列腺炎患者随机分为对照组（60例）和治疗组（66例）。对照组为左氧氟沙星组，给予盐酸左氧氟沙星片（0.6 g/d）治疗；治疗组为联合用药组，给予血尿安胶囊（4.2 g/d）联合盐酸左氧氟沙星片（0.6 g/d）治疗。两组均连续治疗8周。观察两组的临床疗效，比较NIH-CPSI评分、前列腺液细菌培养转阴率、血清学指标及不良反应。结果 治疗后，对照组和治疗组的总有效率分别是66.67%、89.39%，两组比较差异具有统计学意义（P<0.05）。治疗后，对照组和治疗组慢性前列腺炎症状指数（NIH-CPSI）的疼痛症状评分（5.45±1.12）、排尿症状评分（3.31±0.70）、生活质量评分（3.08±0.55）均低于本组治疗前（P<0.05），且治疗组均低于对照组，差异具有统计学意义（P<0.05）。治疗后，对照组和治疗组的前列腺液细菌培养转阴率分别是71.67%、92.42%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、超敏C反应蛋白（hs-CRP）水平均较治疗前显著降低（P<0.05），而治疗组炎症因子水平均低于对照组（P<0.05）。结论 血尿安胶囊联合左氧氟沙星治疗慢性细菌性前列腺炎疗效确切，可以有效缓解患者的临床症状、提高前列腺液细菌培养转阴率，并降低患者的血清炎症因子水平，具有一定的临床推广应用价值。     

泉宁方治疗非细菌性前列腺炎的临床观察

为观察泉宁方治疗非细菌性前列腺炎的临床疗效 ,将 12 0例患者分为泉宁方治疗组 6 0例和舍尼通对照组 6 0例 ,观察治疗前后NIH CPSI评分及EPS、B超等指标变化情况。结果 :治疗组和对照组临床总有效率分别为91 7%和 78 3% ,治疗组在改善主观症状与客观指标方面的疗效均显著优于对照组 (P <0 0 1)。     

"Nanobacterium sanguineum"--is it a new life-form in search of human ailment or commensal: overview of its transmissibility and chemical means of intervention

Morphological, cultural, and immuno-histochemical characteristics of "Nanobacterium sanguineum" (NB) described in the literature are reviewed. NB is reported to be a motile, Gram negative organism that divides by binary fission within a calcium-coated slimy shell; this yeast-like shell replicates by budding. It measures between 20 and 200 nm with a unique structure containing 16S ribosomal RNA. NB has been observed by electron microscopy in coronary artery plaques (CAD) and in kidney stones (KS) found in renal diseases. On the basis of supportive literature, we suggest that NB is not only present in the human body but also has auxiliary association with human ailments without a specific etiological role; anti-NB antibody has been detected in subjects with calcified lesions and inflammation in diverse ailments including choriodecidual inflammation in pregnancy, ovarian cancers, arthritis and even Alzheimer's disease. More recent report on the detection and vertical transmission of NB antigen and anti-NB antibody in HIV-infected mothers supports the view that NB might be an important opportunistic infective agent contributing to HIV pathology; we note that the presence of viable and transmitting NB was not studied and suggest further studies to establish vertical transmission of NB in HIV-infected persons. On the basis of the foregoing we suggest that NB possibly exacerbates human ailments and raise the question: Is NB a new life-form in search of human ailment or a commensal organism? Recognizing the presence of NB in the human body, we discuss clinical trials, reported in the literature relevant to its eradication, with a rectal suppository containing very high amounts of disodium EDTA and tetracycline. We suggest that tetracycline in this formulation acted in combination with EDTA, more as a chelating agent than an antibiotic; oxytetracycline- a non-chelating form of tetracycline-does not inhibit or kill NB. Evaluation of anti-NB effect of orally administrable and potentially safer as well as therapeutically more acceptable chelating agent -ascorbic acid, acting alone or in combination with antibiotics-that eradicates another slime forming bacterium - Pseudomonas aeruginosa - in children with cystic fibrosis, is suggested.     

The Estonian version of the National Institutes of Health chronic prostatitis symptom index

Our aim was to establish the Estonian version of the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and to examine its validity and applicability in chronic prostatitis patients as well as in community-based study. The questionnaire was tested in 54 category III prostatitis patients. In addition, 452 men were enrolled into a community-based study that resulted in 83 completed questionnaires. The discriminatory power, psychometric properties and internal correlations of the questionnaire were tested. The questionnaire demonstrated good internal consistency, with Cronbach's alpha coefficient 0.82. The pain and quality of life domains demonstrated high correlations with each other and with the entire questionnaire. The total score and the scores of pain and quality of life domains of the Estonian NIH-CPSI differed significantly between the chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients and the men without CP/CPPS, and so the index proved a good discriminant validity. We can conclude that the Estonian NIH-CPSI is easily understood and reflects accurately the clinical symptoms and the quality of life in patients with chronic prostatitis. The similarity of the psychometric properties of the English and Estonian versions of the NIH-CPSI supports their measurement equivalence.     

西地那非对慢性非细菌性前列腺炎合并勃起功能障碍的作用

目的观察西地那非在治疗慢性非细菌性前列腺炎(CNP)合并勃起功能障碍(ED)时的作用。方法CNP合并ED患者52例,随机分为西地那非组(A组)和对照组(B组)。A组34例,NIH-CPSI评分27.4±9.5,IIEF-5评分10.7±2.8,用α1-受体阻断剂及消炎痛栓治疗4周后加用西地那非治疗6周。B组18例,NIH-CPSI评分27.3±9.6,IIEF-5评分10.9±2.7,持续使用α1-受体阻断剂及消炎痛栓治疗10周。治疗4、10周末行NIH-CPSI和IIEF-5评分并观察疗效。结果4周末,A、B组NIH-CPSI评分分别为13.2±4.7、12.5±4.5,较治疗前均显著下降(P<0.01),2组间比较差异无统计学意义(P>0.05);A、B组IIEF-5评分分别为14.1±4.3、14.8±4.6,较治疗前均显著上升(P<0.01),2组间比较差异无统计学意义(P>0.05)。NIH-CPSI评分改变值与自身IIEF-5评分改变值无明显相关性。10周末,A组NIH-CPSI评分9.4±3.6,IIEF-5评分19.1±4.0,与4周末比较差异均有统计学意义(P<0.01);B组NIH-CPSI评分12.9±5.1,IIEF-5评分14.8±5.0,与4周末比较差异均无统计学意义(P>0.05);2组间NIH-CPSI与IIEF-5评分比较差异均有统计学意义(P<0.01)。A组IIEF-5评分改变值与NIH-CPSI评分改变值呈负相关(r=-0.95,P=0.00)。结论对CNP合并ED患者,西地那非在有效治疗ED的同时,还能降低NIH-CPSI评分,促使CNP恢复。     

龙金通淋胶囊联合左氧氟沙星治疗Ⅲ型前列腺炎的疗效观察

目的研究龙金通淋胶囊联合左氧氟沙星治疗Ⅲ型前列腺炎的疗效,为临床上Ⅲ型前列腺炎的药物治疗提供依据。方法选择2013年10月—2015年6月天津中医药大学第一附属医院泌尿外科收治的Ⅲ型前列腺炎患者80例,随机分为对照组和治疗组,每组各40例。对照组患者口服盐酸左氧氟沙星片,0.2 g/次,2次/d。治疗组在对照组治疗基础上口服龙金通淋胶囊,3粒/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,同时比较两组慢性前列腺炎症状指数(NIH-CPSI)评分、前列腺液白细胞数的变化情况。结果治疗后,对照组和治疗组的总有效率分别为62.5%、87.5%,两组比较差异有统计学意义(P0.05)。治疗后,两组前列腺液白细胞数、疼痛评分、排尿症状评分、生活质量影响评分和NIH-CPSI总评分均较治疗前显著降低,同组治疗前后差异具有统计学意义(P0.05);且治疗后,治疗组这些观察指标显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论龙金通淋胶囊联合左氧氟沙星治疗Ⅲ型前列腺炎具有较好的临床疗效,可改善患者的NIH-CPSI评分,降低前列腺液白细胞数目,具有一定的临床推广应用价值。