前列腺内直接注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征

目的 :评价经会阴注射川参通治疗慢性非细菌性前列腺炎 /慢性骨盆疼痛综合征 (CAP/CPPS)的有效性和安全性。　方法 :安慰剂对照双盲试验 ,将 38例诊断为CAP/CPPS的患者随机分为 2组。治疗组 2 4例 ,运用川参通及利多卡因注射液 6ml,经会阴注射至前列腺 ,每日 1次 ,共 6次 ;对照组 14例 ,安慰剂治疗 6次。采用美国国立卫生研究院 (NIH)制定的前列腺炎症状评分 (CPSI)标准判定疗效 ,比较治疗组治疗前后精液的主要参数。　结果 :观察 6周 ,两组各有 1例在治疗中退出试验。治疗组痊愈 13例 ( 5 6 .5 % ) ,显效 5例 ( 2 1.7% ) ,有效 4例 ( 17.4 % )。对照组无痊愈病例 ( 0 % ) ,显效 2例 ( 15 .4 % ) ,有效 3例 ( 2 3% )。治疗组痊愈率、显效率及有效率显著高于对照组 (P <0 .0 5 )。川参通治疗前后 ,CPSI疼痛评分、排尿症状评分、生活质量评分及总分均有显著改善 ( 95 %可信区间分别为 :9.83至 12 .70 ,3.15至 4 .94 ,3.95至 6 .4 8,17.97至 2 3.0 8)。对精液主要参数无显著性影响 (P >0 .0 5 )。　结论 :经会阴注射川参通治疗CAP/CPPS有效、安全。     

川参通直接注入前列腺治疗慢性非细菌性前列腺炎/慢性盆腔疼痛综合征

目的:观察川参通直接注入前列腺治疗慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(CABP/CPPS)的疗效与安全性。方法:用川参通及利多卡因注射液5 m l,经会阴注射至前列腺,每日1次,共6次,治疗98例CABP/CPPS患者。采用美国国立卫生研究院(NIH)制定的前列腺炎症状评分(CPSI)标准判定疗效。结果:观察12周,治愈53例(54.08%),显效17例(17.35%),有效23例(23.47%),总显效率71.43%,总有效率94.90%。川参通治疗前后,CPSI疼痛评分、排尿症状评分、生活质量评分及总分均有显著改善(95%可信区间分别为:6.83~9.41,2.16~3.94,2.95~5.43,12.85~17.91)。结论:经会阴前列腺内注射川参通治疗CABP/CPPS有效、安全。     

川参通前列腺注射疗法161例临床应用

慢性非细菌性前列腺炎、慢性盆腔疼痛综合征(chronic abacterial prostatitis、chronic pelvic pain syndrome,CABP、CPPS)是男性常见的泌尿生殖系统疾病,近50%的男性在一生中曾经出现过前列腺炎的症状.由于病因尚不明确,目前国内外尚无特效治疗方法.我院2003年4月-2003年12月对161例病人行经会阴注射川参通治疗,取得了良好的疗效,现报告如下.     

经会阴前列腺药物注射治疗慢性前列腺炎147例疗效分析

自１９９２年１月以来，我院随机采用两组药物经会阴前列腺直接注射治疗慢性前列腺炎１４７例，Ａ组：曲安缩松＋敏感抗生素＋利多卡因，Ｂ组：敏感抗生素＋利多卡因。并对两组进行疗效比较，提示：Ａ组疗效较好。现报告如下。临床资料本组慢性前列腺炎患者１４７例，年龄...     

前列腺穿刺注射治疗慢性细菌性前列腺炎580例疗效分析

目的 观察应用前列腺穿刺注射治疗慢性细菌性前列腺炎的效果。方法 对580例患经会阴部前列腺穿刺注射敏感抗菌素等药物进行治疗。结果 580例中临床治愈482例．占83．1‰；好转43例．占7．4％；无效55例．占9．5％；有效率90．5％。临床治愈随访6个月，仅8例复发。结论 应用前列腺穿刺注射治疗慢性细菌性前列腺炎具有简便、安全、疗效好及副作用少等优点，是治疗慢性细菌性前列腺炎可供选择的有效方法之一。     

药物前列腺内注射治疗顽固性淋菌性前列腺炎（附48例报告）

报告采用药物前列腺内注射治疗顽固性淋菌性前列腺炎48例,治愈率85.4％,总有效率95.8％。表明此疗法可显著提高前列腺内药物浓度,延长药物有效作用时间,从而达到最佳杀菌效果,并具有见效快、治愈率高、用药量少、毒副作用少、操作简便、痛苦小、患者易于接受等优点,值得临床应用。     

前列腺汤治疗慢性前列腺炎30例

前列腺汤是中国中医研究院北京广安门医院、我国著名中西医结合泌尿科专家刘猷枋教授在 2 0世纪 6 0年代研制的治疗慢性前列腺炎的有效方剂。目前已作为基本方药在国内广为应用。笔者运用本方治疗慢性前列腺炎 30例 ,取得满意疗效。1　一般资料本组病例年龄 18～ 5 0岁 ,其中 2 1～ 40岁者 2 6例 ,占96 7%。病程半年～ 10年以上不等。均于外院长期接受各种治疗无效。诱因多为嗜酒、辛辣食物及长途骑车 ,驾驶汽车 ;性生活不正常 ,频繁手淫等。轻型 5例 ,病程不长 ,前列腺触诊尚正常 ,前列腺液白细胞 10～ 2 0 /ＨＰ ,卵磷脂小体减少 ;重型 1…     

前列腺汤辅助治疗慢性前列腺炎临床观察

2001~2003年,笔者运用抗生素加用北京广安门医院泌尿科经验方“前列腺汤”[1]辅助治疗前列腺炎 54 例,并以口服前列康治疗30例作为对照组,临床疗效满意,报道如下。1　资料与方法1.1　临床资料　全部病例来源均符合下列诊断要点:①尿道口滴白可有可无;②排尿不适、排尿不尽,或有尿频、尿急、尿痛;③会阴部或直肠坠痛,常放射到耻骨上、睾丸、腹股沟等处;④直肠指检前列腺正常或稍大,有压痛:⑤前列腺镜检:白细胞≥10 个/HP,卵磷脂小体显著减少或消失;⑥可伴有性功能障碍,如阳痿、早泄、性欲减低等。共 84 例,年龄 19 ~56岁,平均 38. 4 岁,…     

慢性前列腺炎与前列腺结石的相关性

目的:探讨慢性前列腺炎(CP)与前列腺结石(PC)的相关性。方法:对500例健康志愿者和491例CP患者经会阴B超检测PC,将其分成无PC组与有PC组,并进行NIH-CPSI评分、症状持续时间及前列腺按摩液(EPS)中白细胞计数的统计分析。结果:健康组和CP组PC的检出率分别为19.8%、42.2%,差异有显著性(P<0.01);健康组各年龄段(20～30,31～40,41～50,51～60和61～70岁组)PC的检出率分别为5%(5/100)、12%(12/100)、19%(19/100)、27%(27/100)、36%(36/100),CP组各年龄段PC的检出率分别为15.8%(12/76)、32.1%(69/215)、55.7%(59/109)、66.2%(43/65)、82.8%(24/29),两组各年龄段间PC的检出率差异有显著性(P<0.01);无PC组与有PC组NIH-CPSI评分差异无显著性(P>0.05),症状持续时间及EPS中白细胞计数差异有显著性(P<0.01)。结论:CP中PC的检出率明显增多,PC与感染、年龄及症状持续时间有关,与NIH-CPSI评分无关。     

经会阴前列腺包膜下穿刺治疗慢性前列腺炎

目的 :探讨经会阴前列腺包膜下穿刺注射药物治疗慢性前列腺炎的效果。　方法 :对 4 0例难治性慢性前列腺炎患者的前列腺液进行细菌培养和药敏试验 ,选择一种敏感抗生素 ,加入地塞米松和利多卡因的混合液中行经会阴前列腺包膜下注射 ,隔 7d注射 1次 ,4次为 1个疗程 ,治疗后 1个月评价其疗效并随访 6个月。　结果 :4 0例慢性前列腺炎患者中治愈 2 1例 (5 2 .5 % ) ,有效 16例 (40 % ) ,无效 3例 (7.5 % ) ,总有效率达 92 .5 %。 2 8例获 6个月随访 ,无 1例复发。　结论 :经会阴前列腺包膜下穿刺注射药物治疗慢性前列腺炎是一种安全有效、治愈率较高的治疗方法。     

良性前列腺增生合并慢性前列腺炎的临床特点分析

目的:探讨良性前列腺增生(BPH)合并慢性前列腺炎(CP)患者的临床特点。方法:将行经尿道前列腺电切术(transurethral resection of the prostate,TURP),术后病理诊断证实为BPH的患者120例,按是否合并CP分为单纯BPH组(简称单纯组,75例)和BPH合并CP组(简称合并组,45例)。结合术前经直肠超声检查及f-PSA、t-PSA、f-PSA/t-PSA检测结果,并根据公式计算出前列腺总体积(TPV)、PSA密度(PSAD),进行统计和分析。结果:单纯组患者,随着年龄或前列腺体积的增加,f-PSA及t-PSA均呈上升趋势,差异有统计学意义(P<0.05),但f-PSA/t-PSA值及PSAD差异无统计学意义(P>0.05)。合并组患者,随着年龄的增加,f-PSA及t-PSA各组间比较差异有统计学意义(P<0.05),随着前列腺体积的增加,f-PSA及t-PSA各组间比较差异有统计学意义(P<0.05),均呈上升趋势,但f-PSA/t-PSA值及PSAD各组间比较差异无统计学意义(P>0.05)。合并组患者较单纯组患者的f-PSA、t-PSA及PSAD有所上升,差异有统计学意义(P<0.05),但f-PSA/t-PSA值变化不大,差异无统计学意义(P>0.05)。通过对各项指标做ROC工作曲线分析发现,f-PSA、t-PSA、PSAD 3项指标的曲线下面积分别为0.644、0.628、0.624,均介于0.5至0.7之间。结论:BPH患者常合并CP,临床中f-PSA、t-PSA升高,同时伴PSAD升高的BPH患者,应考虑合并前列腺炎的可能性大,上述3个指标作为诊断BPH伴CP的依据有一定的意义,但并不是十分可靠。     

保列治治疗合并慢性前列腺炎的良性前列腺增生症疗效观察

目的 观察保列治治疗合并慢性前列腺炎的良性前列腺增生症的临床疗效。方法 选择经临床确诊的合并慢性前列腺炎的良性前列腺增生症患者40例,口服保列治5 mg,1次/d,共3个月,分别于治疗前,治疗3个月后行国际前列腺症状评分(IPSS)、尿流率、残余尿量、前列腺体积及前列腺液常规等指标测定。结果 用药3个月后IPSS平均降低31.6％,最大尿流率平均升高38.3％,残余尿量平均减少38.6％。前列腺体积平均缩小18.1％。前列腺液白细胞计数平均减少39.8％。前列腺液检查好转率50％。前列腺体积≥40 mL组及<40 mL组的前列腺液检查好转率分别为66.7％及31.6％,两者比较P<0.05。结论 保列治治疗合并慢性前列腺炎的良性前列腺增生症,对慢性前列腺炎及良性前列腺增生症均效果良好。对慢性前列腺炎伴前列腺体积较大者效果尤佳。     

Correlation of inflammatory mediators in prostatic secretion with chronic prostatitis and chronic pelvic pain syndrome

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common clinical syndrome, and the mechanisms underlying the relationship between CP/CPPS and ED are still unclear. This study aimed to investigate the differential expression of 40 inflammatory mediators in patients with CP/CPPS and to demonstrate whether these mediators related to the severity of erectile function. Eighty cases of patients with CP/CPPS were selected, including 40 cases of IIIA and 40 cases of IIIB, with 20 cases of healthy men as controls. After collecting their expressed prostatic secretion, cytokines levels in EPS were determined by ELISA using ELISA kits. The IIEF‐5 questionnaire was used to evaluate erectile function. IIEF‐5 scores were significantly lower in the IIIA and IIIB groups than those in the control group. The expression of IL‐8, IL‐1β and ICAM‐1 was markedly higher in the IIIA and IIIB groups than in the control group. The expression of IL‐8, IL‐1β and ICAM‐1 in the IIIA group was higher than that in the IIIB group. The expression of IL‐8, IL‐1β and ICAM‐1 was negatively correlated with IIEF‐5 scores in both IIIA and IIIB patients. In conclusion, IL‐8, IL‐1β and ICAM‐1 are possible indicators for the clinical diagnosis of CP/CPPS and evaluation of erectile function on patients with CP/CPPS.     

单纯良性前列腺增生与合并慢性前列腺炎患者临床特点分析

目的:探讨单纯良性前列腺增生(BPH)与合并慢性前列腺炎(CP)患者的临床特点及其意义。方法:回顾性分析2011年10月~2013年06月我院泌尿外科行经尿道前列腺等离子电切术(TURP)治疗BPH的患者236例,按照病理诊断分为单纯BPH(35例)和合并CP(201例)两组,采用SPSS 17.0软件进行统计学分析,比较两组患者在年龄、前列腺体积、最大尿流率(Qmax)、剩余尿量(RUV)、国际前列腺症状评分(IPSS)(术前及术后3个月)、生活质量评分(QOL)、是否发生急性尿潴留(AUR)、前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)等指标上是否存在差异。结果:合并CP组患者在前列腺体积、RUV、IPSS、QOL、AUR发生率等方面指标高于单纯BPH组患者,Qmax低于单纯BPH组,差异有统计学意义。而在年龄及PSA、PSAD等方面指标差异无统计学意义。手术治疗后3个月两组IPSS评分均较术前明显降低,且合并CP组较单纯组评分高,差异均有统计学意义。结论:CP可能是BPH临床进展的重要因素之一,同时也可能是导致BPH患者下尿路症状(LUTS)的重要原因之一。     

Endotoxins in the prostatic secretions of chronic prostatitis patients

AIM: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. METHODS: The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate. RESULTS: Patients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 +/- 32.83 EU/L vs. 4.77 +/- 4.14 EU/L (P <0.05)]. The levels of endotoxins in CP type II, type IIIa and type IIIb were 68.62 +/- 34.78 EU/L, 45.30 +/- 23.33 EU/L and 15.83 +/- 5.31 EU/L, respectively [type II vs. type IIIa (P >0.05), type IIIb vs. normal controls (P <0.05), type II/type IIIa vs. normal controls P >0.05)]. CONCLUSION: CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.     

Prostatic calculi influence the antimicrobial efficacy in men with chronic bacterial prostatitis

We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis (CBP) patients with or without prostatic calculi. This study included 101 patients (21–62 years old) who met the consensus criteria for CBP (National Institutes of Health category II). According to the results of transrectal ultrasonography (TRUS), all patients were divided into two groups: Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months (range: 3–8 months). In addition to expressed prostatic secretions (EPS) and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the subjective global assessment (SGA). The microbiological eradication rate at the end of treatment were 32/39 (82.1%) and 54/62 (87.1%), while the rates for continued eradication at the end of study were 17/39 (43.6%) and 45/62 (72.6%) in Group 1 and Group 2 (P<0.01), respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group 1 and from 24 to 11 in Group 2. The pain subscore (P<0.01), urinary sunscore (P<0.05) and quality of life (QoL; P<0.05) as well as the total NIH-CPSI score (P<0.01) were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NIH-CPSI total score by at least 50%, was seen in Group 1 versus Group 2 in 38.5% and 58.1% (P<0.01), respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP. There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.     

Diagnosis of chronic prostatitis by noninvasive methods in elderly patients with benign prostatic hyperplasia in China

Chronic prostatitis is hard to be identified in BPH patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods. BPH patients who received transurethral resection of prostate from January 2014 to July 2015 were enrolled in current study. Patients were received examinations of PSA, sex hormones, inflammatory cytokines, metabolic panel and transrectal ultrasonography. According to histological results, patients were divided into two group of BPH with/without prostatitis. Logistic regression was used to find risk factors of chronic prostatitis. As a result, 181 men with an average age of 72.15 ± 8.41 years were enrolled in this study, including 116 patients with prostatitis and 65 patients without prostatitis. The storage sub-score, PSA and IL-2R were significantly higher in patients with prostatitis than those without prostatitis. Based on logistic regression analysis, the above three parameters were also the risk factors of BPH with prostatitis. The diagnostic model was calculated as: 0.317 × storage sub-score + 0.092 × PSA + 0.003 × IL-2R − 4.296. The AUC was 0.725. Histological prostatitis in BPH patients can be diagnosed by the combination of serum IL-2R, PSA and storage sub-score. Identification of chronic prostatitis in BPH patients could more efficiently alleviate urinary symptoms and reduce the risk of disease progression.     

慢性前列腺炎患者前列腺液中尿酸测定及意义

目的探讨前列腺液(EPS)中尿酸(UA)水平与慢性前列腺炎(CP)的关系以及降低尿酸在前列腺炎治疗中意义。方法按国际慢性前列腺炎诊断标准确诊的126例CP患者为研究组,另将15例未患CP的正常人设为对照组,分别进行国际前列腺炎评分(CPSI-P),EPS中白细胞(WBC)和UA浓度测定,治疗4周后研究组再行CPSI-P、EPS中WBC、UA测定。结果①CP患者的EPS中UA水平与正常对照组差异有显著性意义(p0.05)。②慢性前列腺炎患者治疗前后CPSI-P,EPS中UA对比有显著性差异(p0.05),而EPS中WBC在治疗前后差异无显著性意义(p>0.05)。结论EPS中UA水平可能与CP发病有关,EPS中UA测定可能是CP诊断及其疗效监测的有用指标之一。     

Resveratrol could attenuate prostatic inflammation in rats with Oestradiol-induced chronic prostatitis

To evaluate the effect of resveratrol in rats with chronic prostatitis, 24 rats were randomly divided into the negative control, vehicle-treated and resveratrol groups. The rats in the vehicle-treated group and the resveratrol group were injected subcutaneously with 17-β-oestradiol (0.25 mg/kg) daily for 6 weeks while the rats in the control group were injected with equivalent normal saline. From the 45th day, the rats in the resveratrol group were given resveratrol (10 mg/kg) by gavage per day while the rest rats were given normal saline. After 55 days, all the rats were sacrificed and the prostatic tissue was removed. Morphological changes were examined by light microscope after H&E staining. The expressions of IL-6, IL-8 and TNF-α were determined through ELISA and immunohistochemical staining. As a result, significant inflammatory cell infiltration and fibroblastic hyperplasia were observed in prostatic stroma in the vehicle-treated group compared with the negative control group, as well as the high expression of IL-6, IL-8 and TNF-α. After resveratrol treatment, inflammatory cell infiltration and fibroblastic hyperplasia were shown prominently reduced. Meanwhile, the expression of IL-6, IL-8 and TNF-α was significantly suppressed. For conclusion, resveratrol could attenuate the prostatic inflammation and downregulate the expression of IL-6, IL-8 and TNF-α in rat with oestradiol-induced chronic prostatitis.