高频热疗联合吲哚美辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征的研究

目的:评价高频热疗联合吲哚美辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征(CPPS)的方法和疗效。方法:采用高频热疗联合吲哚美辛治疗CPPS患者321例,并观察其治疗效果。结果:治疗1个月后,临床治愈163例,占50.78%;显效112例,占34.89%;有效27例,占8.41%;无效19例,占5.91%。结论:高频热疗联合吲哚美辛是一种治疗CPPS患者安全、有效的方法     

氯美扎酮联合α1受体阻滞剂治疗慢性非细菌性前列腺炎／慢性骨盆疼痛综合征的疗效观察

目的：评价氯美扎酮联合α1受体阻滞剂治疗慢性非细菌性前列腺炎，慢性骨盆疼痛综合征（CPPS-ⅢB）的疗效。方法：对符合CPPS-ⅢB诊断标准的62例患者随机分为治疗组及对照组．治疗组口服氯关扎酮（0．2g，每天3次，饭后服）及特拉唑嗪（2mg，每天1次，晚服），对照组仅口服特拉唑嗪（2mg，每天1次．晚服），疗程8周。评价指标包括症状评分、生活质量评分及最大尿流率等。结果：62例患暂均获随访，治疗组有效30例（93．8％），其中临床治愈9例（28．1％），无效2例（6．3％）；对照组有效24例（80％）．其中临床治愈4例（13．3％），无效6例（20％），两组相比差异有统计学意义（P〈0．05）。治疗过程中无严重不良反喧发牛。结论：氯美扎酮联合α1受体阻滞剂可作为CPPS-ⅢB的一种有效治疗手段。     

前列腺注药、按摩联合吲哚美辛栓治疗慢性前列腺炎的随机对照研究

目的 探讨慢性前列腺炎(chronic Prostatitis,CP)的有效治疗方法.方法 600例慢性前列腺炎患者随机分成A、B、C三组,A组:前列腺注药按摩联合吲哚美辛栓200例:B组:抗生素200例;C组:抗生素联合普适泰(商品名:舍尼通)200例,三种方法 各治疗2个月,随访1～3年,对比治疗前后三种疗法的疗效...     

特拉唑嗪联合氯美扎酮治疗慢性前列腺炎/慢性骨盆疼痛综合征的回顾性分析

目的:探讨α肾上腺素能受体(α-AR)阻滞剂特拉唑嗪联合氯美扎酮治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的疗效和安全性。方法:将168例CP/CPPS患者随机分成3组:特拉唑嗪组58例、氯美扎酮组38例和特拉唑嗪+氯美扎酮组72例,每组患者均接受药物治疗4周。采用美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分作为疗效指标,分别评价各组患者的疗效和药物不良反应。结果:159例完成了4周的治疗并接受最终评估,其中特拉唑嗪组55例、氯美扎酮组35例、特拉唑嗪+氯美扎酮组69例。3组患者的NIH-CPSI总分治疗前后平均分别下降7.90、5.92、8.92分,与治疗前相比均有显著性差异(P<0.05)。特拉唑嗪+氯美扎酮组较特拉唑嗪组和氯美扎酮组总分下降均有显著性差异(P<0.05)。药物不良反应包括体位性低血压(特拉唑嗪组17.1%,特拉唑嗪+氯美扎酮组15.4%)、射精障碍(仅特拉唑嗪组3.4%)和倦怠、疲乏和厌食等(氯美扎酮组18.5%,特拉唑嗪+氯美扎酮组12.6%)。因不良事件终止治疗的共9例,其中特拉唑嗪组3例(5.2%)、氯美扎酮组3例(7.9%)、特拉唑嗪+氯美扎酮组3例(4.2%)。结论:特拉唑嗪、氯美扎酮均能有效缓解CP/CPPS患者的症状,改善患者的生活质量,两者联合治疗疗效优于单一治疗。     

吲哚美辛治疗慢性非细菌性前列腺炎/骨盆疼痛综合征患者疼痛的研究

我们采用吲哚美辛治疗以疼痛为主诉的慢性非细菌性前列腺炎 /骨盆疼痛综合征 (CPPS)患者 ,效果较好 ,现报告如下。材料与方法　本组 180例。年龄18～ 4 9岁 ,平均 31岁。病史 3个月～ 4年。患者均以下腹部、会阴区、腰骶部、睾丸阴囊疼痛为主诉 ,分别伴有性功能减退、尿频等症状。均根据病史、症状和Meares Stamey“四杯法”诊断为CPPS ,并系统检查除外其他可能引起上述疼痛的疾病。 180例随机分为吲哚美辛组、左氧氟沙星组、特拉唑嗪组 3组 ,每组6 0例。吲哚美辛组肛塞吲哚美辛 10 0mg ,根据疼痛程度 1～ 2次 /d。左氧氟沙星组口服左氧…     

慢性前列腺炎/慢性盆腔疼痛综合征治疗进展

慢性前列腺炎/慢性盆腔疼痛综合征(Chronic Pro-statitis/Chronic Pelvic Pain Syndrome,CP/CPPS)即美国国立卫生研究院(National Institutes of Health,NIH)分类系统中的Ⅲ型前列腺炎,是泌尿男科门诊最常见的疾病之一,该病在世界范围内发病率...     

前列安栓治疗慢性盆腔疼痛综合征疗效观察

目的:观察前列安栓治疗慢性盆腔疼痛综合征(CPPS)的疗效.方法:对180例EPS常规检查及细菌培养(Meares-stamey四杯法),后按NIH分类标准(1995年)确诊为CPPS.并随机分成治疗组90例应用前列安栓,对照组90例应用野菊花栓,单盲对照观察疗效.结果:治疗组痊愈12例( 13.3%),显效36例( 40.0%),有效30例( 33.4%),总显效率 53.3%,总有效率 86.7%,明显优于对照组( 63.3%),由于采用改进后的水溶性栓剂,治疗组仅有10例轻度肛门不适及排便感,2例出现腹泻,3例有轻度腹痛,均可耐受.结论:前列安栓治疗CPPS安全,疗效满意.     

吲哚美辛栓联合抗菌药治疗ⅢA型前列腺炎疗效观察

慢性前列腺炎是中青年男性的常见病，对患者的生活质量和生殖健康产生严重影响。目前临床治疗方法较多。我院于2003年1月～2005年5月对ⅢA型前列腺炎患者采用吲哚美辛栓和抗菌药联合治疗，临床疗效满意，现报告如下。     

吲哚美辛栓联合曲唑酮治疗Ⅲ型前列腺炎的临床研究

目的探讨慢性非细菌性前列腺炎/慢性盆底疼痛综合征(CAP/CPPS)的治疗方法。方法对60例诊断为CAP/CPPS的患者使用非甾体类抗炎药直肠栓剂吲哚美辛栓及三唑吡啶类抗抑郁药曲唑酮进行8周的联合治疗。在治疗前、治疗后4周及8周对所有患者进行NIH-CPSI症状评分和EPS-WBC计数,对其中伴精液参数异常和性功能下降的患者分别进行精液参数测定和性功能评价。观察疗效及不良反应情况。结果60例患者在治疗后4周及8周NIH-CPSI评分和EPS-WBC较治疗前明显降低(P<0.001);伴精液参数异常和性功能下降的患者的射精潜伏期及IIEF-5评分较治疗前有明显改善(P<0.01);不良反应发生率较低。结论吲哚美辛栓联合曲唑酮的治疗方案安全有效,可以明显缓解CAP/CPPS患者症状,对患者精液质量及性功能亦有明显改善。     

慢性前列腺炎/慢性盆腔疼痛综合征的物理治疗进展

慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)作为男性常见的泌尿生殖系统疾病,近年来在物理治疗领域取得了显著的进展。物理治疗以其非侵入性、副作用小、有效性明确、患者依从性高等特点,逐渐成为CP/CPPS治疗的重要手段之一。在慢性前列腺炎的物理治疗中,常用的方法主要包括前列腺按摩、生物反馈治疗、磁疗、超声波及冲击波治疗、热疗、针灸治疗以及电生理治疗等。这些方法通过不同的物理效应而最终达到缓解患者的疼痛和其他不适症状的目的。本文将对这些CP/CPPS的物理治疗方法的最新研究进展进行归纳总结,浅析其作用机制及各自优缺点,以供临床治疗时参考,同时也为研究人员提供新的理念与思路。     

生物反馈和电刺激联合治疗慢性前列腺炎/慢性骨盆疼痛综合征

目的:通过临床试验的方法,探讨生物反馈和电刺激联合治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的效果。方法:收集湘雅医院门诊诊断为CP/CPPS符合研究标准患者140例。将患者随机分为对照组、生物反馈组、电刺激组和生物反馈加电刺激组;对照组20例,生物反馈组、电刺激组和生物反馈加电刺激组各40例。采用Laborie-Urostym生物反馈电刺激治疗仪,生物反馈组行生物反馈治疗,电刺激组行电刺激治疗,生物反馈加电刺激组行生物反馈电刺激治疗;每周5次,连续2周;对照组不予上述治疗,随诊1个月。治疗前后进行NIH-CPSI评分以及尿流率检查。结果:生物反馈组、电刺激组和生物反馈加电刺激组治疗后NIH-CPSI疼痛与不适评分、NIH-CPSI排尿症状评分、NIH-CPSI生活质量评分、NIH-CPSI总评分、最大尿流率较治疗前均有显著改善(P<0.05);治疗前各组积分及最大尿流率比较无显著差异(P>0.05);治疗后上述参数生物反馈组、电刺激组比较没有显著差异(P>0.05),生物反馈加电刺激组与生物反馈组、电刺激组比较有显著差异(P<0.05)。而对照组治疗前后的以上各组评分及最大尿流率比较无显著差异(P>0.05)。结论:生物反馈和电刺激治疗能明显改善CP/CPPS患者疼痛与不适症状,排尿症状,提高生活质量,以及提高最大尿流率。生物反馈和电刺激联合治疗CP/CPPS有协同作用。     

慢性前列腺炎/慢性盆腔疼痛综合征与勃起功能障碍的临床预测

目的应用临床指标,预测慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPSS）发生勃起功能障碍（ED）的可能性。方法以90例门诊确诊的慢性前列腺炎/慢性盆腔疼痛综合征患者为研究对象,分为发生ED组（A组）23例,未发生ED组（B组）67例,分别比较两组间在硫酸脱氢表雄酮（DHEAS）、24h尿香草扁桃体酸（VMA）、年龄等观察指标上的差异性,寻找其中能用于预测ED的临床指标。结果A组平均DHEAS值低于B组,VMA值高于B组,年龄方面两组差异无统计学意义。结论可通过DHEAS、VMA来预测慢性前列腺炎/慢性盆腔疼痛综合征患者ED的发生,有利于对慢性前列腺炎/慢性盆腔疼痛综合征发生ED患者的监控和治疗干预。     

A case-control study of chronic prostatitis/chronic pelvic pain syndrome and colorectal cancer

Study Type – Symptom prevalence (case control) Level of Evidence 2b What's known on the subject? and What does the study add? Associations are well established between intestinal infection/inflammation or inflammatory bowel diseases and colorectal cancer (CRC). Our study found an association between CRC and previously diagnosed chronic prostatitis/chronic pelvic pain syndrome. Patients with CRC had a 1.45‐fold higher risk of having a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome than controls. This phenomenon was found to be more prominent in subjects younger than 60 years.

OBJECTIVE

• ? To estimate the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and colorectal cancer (CRC) using a nationwide population‐based data set.

PATIENTS AND METHODS

• ? This case–control study used data sourced from the Taiwan Longitudinal Health Insurance Database.
• ? The cases comprised 2899 patients with CRC and 14 995 randomly selected subjects as controls.
• ? We used conditional logistic regression to examine the association between CRC and previous diagnosis of CP/CPPS.

RESULTS

• ? Of the sampled patients, 531(3.05%) had been diagnosed with CP/CPPS before the index date, with 123 (4.24% of the patients with CRC) coming from the cases and 408 individuals (2.81% of patients without CRC) coming from the controls.
• ? Conditional logistic regression analysis revealed that cases were more likely to have CP/CPPS than controls (odds ratio 1.45, 95% CI 1.17–1.79, P < 0.001) after adjusting for the monthly income, geographic location, urbanization level, hypertension, diabetes, renal disease, obesity and cystic kidney disease.
• ? In subgroup analysis, we found the magnitude of the association to be higher in subjects younger than 60 years (age 40–49, odds ratio 2.01; 95% CI 2.04–3.58 and aged 50–59, 2.40, 95% CI 1.48–3.87, both P < 0.001) than among other age groups.

CONCLUSION

• ? We conclude that CP/CPPS patients are at higher risk for CRC, especially in males under 60 years of age.

     

Cryotherapy alleviates symptoms in chronic prostatitis/chronic pelvic pain syndrome: The first results

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is an intractable disease. This study aimed to assess the efficacy of cryotherapy in the therapy of CP/CPPS. One hundred and seventy-two patients with CP/CPPS were randomised to receive cryotherapy or sham cryotherapy. The follow-up assessments were done at weeks 4, 12 and 24 using Visual Analogue Scale (VAS), International Prostate Symptom Score (IPSS) and National Institutes of Health-developed Chronic Prostatitis Symptom Index. The per-protocol analysis was performed. Eighty-two patients in the cryotherapy group and 76 patients in the sham group completed the treatment. The most obvious improvement (67%) of the VAS was observed in the cryotherapy group after 4 weeks, and although the improvement slightly weakened by 24 weeks (62.6%), a significant improvement from the treatment remained apparent. IPSS improved by 75% after 4 weeks and remained stable after 24 weeks. The response rates were 78.0%, 73.2% and 70.1% at weeks 4, 12 and 24 in the cryotherapy group, which were higher than 17.1%, 13.2% and 10.5% in the sham group (each p < .001). These results indicated that cryotherapy could alleviate voiding symptoms, ameliorate pain and improve the quality of life in people with CP/CPPS. It holds promise as a novel strategy to treat CP/CPPS.     

Seminal fluid analysis in chronic prostatitis/chronic pelvic pain syndrome

Prostatitis is a common cause of morbidity among adult men. There are more than 2,000,000 doctor visits per year in the United States, approximately half to urologists (Collins et al., 1998, J Urol 159:1224; Roberts et al., 1998, Urology 51:578; Krieger et al., 2003, Urology). The problem is that very few patients have obvious infections, or functional or structural abnormalities. The aim of this study is to examine our experience with seminal fluid analysis in this patient population, and to outline the potential utility of this examination in patient evaluation.     

Phenotypic approach to the management of the chronic prostatitis/chronic pelvic pain syndrome

? Our traditional approach to managing the chronic prostatitis (CP) syndromes has not been very successful for many of our patients. ? Our developing understanding of CP/chronic pelvic pain syndrome (CP/CPPS) as a heterogeneous syndrome rather than a homogenous disease has allowed us to develop treatment strategies based on individual patient characteristics. ? By considering each patient as a unique individual and tailoring treatments to a specific patient's clinical 'phenotype' we improve our therapeutic outcomes.     

番茄红素联合槲皮素、姜黄素对大鼠慢性前列腺炎/慢性骨盆疼痛综合征的治疗作用以及机制的初步探讨

目的:观察番茄红素联合槲皮素、姜黄素对大鼠慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的治疗作用,并对其机制进行初步探讨.方法:选取6周龄SD雄性大鼠33只,随机分成正常对照组(n=3)、模型组(n =6)、槲皮素组(n =6)、姜黄素组(n =6)、番茄红素组(n =6)、三素组(n =6),用完全弗氏佐剂诱导...     

IL-6在慢性前列腺炎患者精浆中的表达及其临床意义

目的探讨慢性前列腺炎/慢性骨盆疼痛综合症(CP/CPPS)患者精浆中IL-6的表达及临床意义。方法采用电化学发光免疫分析法(ECLIA)对52例炎症型慢性骨盆疼痛综合征(ⅢA型)、38例非炎症型慢性骨盆疼痛综合征(ⅢB型)患者及36例健康志愿者精浆中IL-6含量进行测定分析,并将ⅢA、ⅢB型IL-6的表达与其NIH-CPSI评分进行相关性分析。结果 CP/CPPS患者ⅢA[(27.46±5.29)ng/mL]、ⅢB型[(9.83±2.09)ng/mL]精浆中IL-6含量均明显高于健康对照组[(4.94±1.55)ng/mL](P0.01)。在CP/CPPSⅢA、CP/CPPSⅢB型患者精浆中IL-6的含量有明显差异(P0.01)。CP/CPPS患者ⅢA型精浆中IL-6的含量与NIH-CPSI总评分呈正相关(r=0.590,P0.01),与疼痛评分呈正相关(r=0.436,P0.01),与排尿评分呈正相关(r=0.557,P0.01),与生活质量评分正相关(r=0.321,P0.01)。CP/CPPS患者ⅢB型精浆中IL-6的含量与NIH-CPSI总评分呈正相关(r=0.404,P0.05),与疼痛评分呈正相关(r=0.597,P0.01),与排尿评分无相关性(r=-0.262,P=0.226),与生活质量评分无相关性(r=0.290,P=0.179)。结论精浆中IL-6含量可能作为CP/CPPS分型诊断指标,精浆中IL-6含量有望作为评价CP/CPPS病情程度的分子生物学指标。