非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征

目的探讨非介入式前列腺超声联合中西药治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床效果。方法收集临床诊断为CP/CPPS且符合研究标准的患者105例,随机分为3组,每组35例。A组采用非介入式前列腺超声联合中西药治疗方法;B组为中西药物治疗组;C组单用非介入式前列腺超声治疗。观察各组治疗前后前列腺炎症状指数(NIH-CPSI)疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分及各组治疗总有效率。结果 3组治疗前后NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异比较有统计学意义(P0.05)。治疗后,A组分别与B组、C组比较,NIH-CPSI疼痛或不适症状评分、排尿症状评分、生活质量评分、NIH-CPSI总评分差异均具有统计学意义(P0.05);B组与C组比较差异无统计学意义(P0.05)。治疗总有效率,A组为88.6%,B组为68.6%,C组为74.3%,A组总有效率最高,A组与B组C组比较差异均具统计学意义(P0.05)。结论非介入式前列腺超声与中西药在临床治疗CP/CPPS中具有协同作用,非介入式前列腺超声联合中西药治疗方法能明显改善CP/CPPS患者的NIH-CPSI疼痛或不适症状、排尿症状,提高生活质量。     

补锌在治疗Ⅱ型前列腺炎中的作用

根据美国国立卫生研究院 (NIH)前列腺炎分类方法[1] ,Ⅱ型前列腺炎为慢性细菌性前列腺炎。文献报道前列腺液中的抗菌活性蛋白的主要活性成分为锌 ,而Ⅱ型前列腺炎 (慢性细菌性前列腺炎 ,CBP)患者的前列腺液中的锌离子浓度往往降低。因此 ,有学者认为补充锌离子有助于Ⅱ型前列腺     

前列解毒胶囊联合芦氟沙星治疗慢性前列腺炎的随机双盲对照临床观察

目的:中成药治疗慢性前列腺炎的双盲对照试验报导不多,本文旨在用随机双盲的方法观察前列解毒胶囊治疗慢性前列腺炎的疗效。方法:将慢性前列腺炎患者80例随机分成2组,即前列解毒胶囊+芦氟沙星组(实验组)和安慰剂+芦氟沙星组(对照组),均服药4周。采用双盲对照,所有患者治疗前及治疗4周后均以NIH-CPSI评分、行EPS常规检查。结果:两组患者经治疗4周后,NIH-CPSI总分及疼痛症状评分、排尿症状评分及生活质量评分均比治疗前有显著降低(P<0.05),EPS中WBC计数也明显减少(P<0.05)。实验组治疗后在NIH-CPSI总分、疼痛症状评分、排尿症状评分和生活质量评分方面与对照组相比也有明显改善(P<0.05),但两组治疗后在WBC计数方面无显著性差异(P>0.05)。结论:前列解毒胶囊联合芦氟沙星治疗慢性前列腺炎4周能有效缓解患者疼痛和排尿症状,改善患者生活质量,较单独应用抗生素疗效好。     

独一味胶囊治疗ⅢB型前列腺炎疗效分析

目的:探讨独一味胶囊治疗ⅢB型前列腺炎的疗效。方法:选择ⅢB型前列腺炎患者225例,随机分为两组:治疗组125例,口服独一味胶囊,一次3粒,一日3次,疗程4周;对照组100例,口服盐酸坦索罗辛缓释胶囊,0.2 mg/次,一日1次,疗程4周。以NIH-CPSI评分为疗效评价指标,比较治疗前后、停药4周后两组的疗效。结果:治疗组完成治疗120例,结果示:(1)治疗组治疗后疼痛症状评分、生活质量评分和总评分均较治疗前显著下降(5.30±1.23 vs 14.68±1.51;6.46±0.93 vs 8.52±1.05;17.50±2.77 vs 27.99±2.98)(P0.05);而排尿症状评分治疗前后无明显改变(7.41±1.16 vs 7.16±1.04)(P0.05)。(2)治疗组治疗后疼痛症状评分、生活质量评分和总评分均较对照组治疗后评分低(5.30±1.23 vs 13.67±1.49;6.46±0.93 vs 7.47±0.88;17.50±2.77 vs 25.77±2.01)(P0.05);而排尿症状评分对照组较治疗组低(5.68±1.34 vs 7.16±1.04)(P0.05)。(3)停药4周后,治疗组疼痛症状评分、生活质量评分和总评分,比治疗前仍显著下降(7.23±1.03 vs 14.68±1.51;6.58±0.87 vss 8.52±1.05;22.18±2.03 vs 27.99±2.98)(P0.05);同时也明显低于对照组撤药后评分(7.23±1.03 vs 14.14±0.98;6.58±0.87 vs 8.12±0.72;22.18±2.03 vs 26.89±1.67)(P0.05)。(4)治疗组因为头晕不适退出治疗2例,失联3例,其余患者未见明显不良事件发生。结论:独一味胶囊在改善ⅢB型前列腺炎患者疼痛症状及生活质量上安全、有效,有临床应用价值。     

Ⅲ型和Ⅳ型前列腺炎患者前列腺按摩液中锌离子浓度检测和临床价值

目的:探讨前列腺按摩液(EPS)中锌离子浓度对Ⅲ型和Ⅳ型前列腺炎诊疗的意义和参考价值。方法:根据NIH前列腺炎分型标准,将入选的173例研究对象分为ⅢA型(n=65)、ⅢB型(n=69)、Ⅳ型(n=39)前列腺炎,并以35例门诊健康体检、无前列腺炎症状者为对照组,检测4组EPS中锌离子浓度,并分析其与慢性前列腺炎症状评分(CPSI),年龄,EPS中白细胞计数、p H值等指标的相关性。结果:ⅢA型及ⅢB型前列腺炎患者EPS中锌离子浓度[(162.2±10.8)、(171.2±12.0)μg/ml]显著低于Ⅳ型及对照组[(234.6±17.9)、(259.5±14.6)μg/ml),P均0.05]。EPS中锌离子浓度与疼痛评分、生活质量(QOL)评分、症状严重评分以及CPSI总评分均呈显著负相关(r分别为-0.284、-0.232、-0.270、-0.281,P均0.01),与排尿症状评分无相关。EPS中锌离子浓度与白细胞计数、年龄无明确相关,与p H值呈负相关(r=-0.208,P0.01)。结论:Ⅲ型和Ⅳ型前列腺炎患者EPS中锌离子浓度低下可能与疼痛等前列腺炎相关症状有关,EPS中锌离子浓度检测对Ⅲ型和Ⅳ型前列腺炎的诊疗具有潜在参考价值。     

体外冲击波治疗ⅢB型慢性前列腺炎的临床研究

目的 探讨体外冲击波治疗ⅢB型慢性前列腺炎的临床疗效.方法 将32例ⅢB型慢性前列腺炎患者随机分为治疗组(20例)及对照组(12例),治疗组患者给予低能量级别冲击波治疗.对照组给予体外电场热疗.两组均每周治疗1次,连续治疗4次,4次为一疗程,两组患者分别于治疗前、治疗后4周进行NIH-CPSI评分,并对两组患者疗效进行比较.结果 治疗前2组患者的疼痛/不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分组间均无统计学差异(P＞0.05).两组治疗后疼痛/不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分较治疗前差异有统计学意义(P＜0.05).治疗组治疗后的疼痛/不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分下降幅度明显高于对照组治疗后下降幅度(P＜0.05).治疗组在治疗后的总有效率明显高于对照组(均P＜0.05).结论 体外冲击波治疗慢性前列腺炎(ⅢB)有较好的近期疗效,但其远期疗效有待进一步追踪观察.     

宁泌泰胶囊治疗Ⅲ型前列腺炎疗效评价

目的:探讨宁泌泰胶囊治疗Ⅲ型前列腺炎的疗效。方法:选取符合Ⅲ型前列腺炎诊断标准的50例患者,给予口服宁泌泰胶囊(4粒/次,3次/d)治疗1个月,观察治疗前后NIH-CPSI评分和精浆弹性蛋白酶浓度的变化,评价疗效。结果:受试者NIH-CPSI总分显著降低,由(21.34±3.44)分降至(16.30±4.08)分,且疼痛或不适症状评分、排尿症状评分以及生活质量评分较治疗前均有明显的降低(P0.05)。精浆蛋白酶浓度由治疗前的1666.42 ng/mL下降到920.25 ng/mL(P0.05)。结论:宁泌泰胶囊能有效缓解Ⅲ型前列腺炎的症状,是治疗Ⅲ型前列腺炎的有效药物。     

体外冲击波治疗难治性IIIB型慢性前列腺炎的临床研究

目的 探讨体外冲击波治疗IIIB型慢性前列腺炎的临床疗效。方法 将32例ⅢВ型慢性前列腺炎患者随机分为治疗组（20例）及对照组（12例）,治疗组患者给予低能量级别冲击波治疗。对照组给予体外电场热疗。两组均每周治疗１次,连续治疗4次,4次为一疗程,两组患者分别于治疗前、治疗后4周进行NIH—CPSI评分,并对两组患者疗效进行比较。结果　治疗前2组患者的疼痛／不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分组间均无统计学差异（P＞0.05）。两组治疗后疼痛／不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分较治疗前差异有统计学意义（P＜0.05）。治疗组治疗后的疼痛／不适评分、排尿评分、生活质量影响评分及NIH-CPSI总分下降幅度明显高于对照组治疗后下降幅度（P＜0.05）。治疗组在治疗后的总有效率明显高于对照组（均P＜0.05）。结论　体外冲击波治疗慢性前列腺炎（IIIB）有较好的近期疗效,但其远期疗效有待进一步追踪观察。     

前列腺炎Ⅱ型与Ⅲ型之间症状、前列腺液白细胞和卵磷脂小体计数比较

目的 探讨前列腺炎Ⅱ型与Ⅲ型之间症状严重程度、前列腺液白细胞和卵磷脂小体计数的区别.方法 以NIH-CPSI评价症状,参照"二杯法", 初段尿、前列腺液常规镜检,中段尿、前列腺液(或前列腺按摩后尿)行细菌培养.对患者的症状严重程度、前列腺液白细胞和卵磷脂小体计数进行统计分析.结果 164例中,Ⅱ型22例(13.4%),Ⅲ型142例(86.6%).Ⅱ型与Ⅲ型之间CPSI中疼痛不适、排尿症状、生活质量、总评分以及EPS中白细胞、卵磷脂小体计数的差异均无统计学意义(P均>0.05).EPS中自细胞和卵磷脂小体计数与患者CPSI中疼痛不适、排尿症状、生活质量及总评分均无显著相关性(P均>0.05).结论 Ⅱ型与Ⅲ型之间患者症状严重程度、前列腺液白细胞和卵磷脂小体计数无显著差异,白细胞和卵磷脂小体计数与症状严重程度无显著相关性.     

坦索罗辛联合多塞平治疗顽固性ⅢB型前列腺炎

目的：探讨坦索罗辛联合多塞平治疗顽固性ⅢB型前列腺炎的疗效和机制。方法：将106例ⅢB型前列腺炎患者随机分为坦索罗辛单剂治疗组（n=51）和坦索罗辛＋多塞平联合治疗组（n＝55）,治疗时间为6周。治疗前、后分别采用美国国立卫生研究院慢性前列腺炎症状指数评分（NIH—CPSI）对症状进行评测和比较,并记录不良反应。结果：两组患者经过治疗后,在疼痛或不适症状评分、排尿症状评分、生活质量评分及总分4项上均有明显改善;联合治疗组疗效（78．8％）较单剂治疗组（64．7％）显著,联合治疗组中有2例因药物不良反应退出实验,1例失访。结论：坦索罗辛联合多塞平治疗ⅢB型前列腺炎安全有效。     

锌硒宝辅助治疗慢性细菌性前列腺炎

目的 :探讨锌硒宝口服片辅助治疗慢性细菌性前列腺炎的效果。　方法 :对 38例慢性细菌性前列腺炎患者联合应用锌硒宝片剂和敏感抗生素 (A组 ) ,4 3例慢性细菌性前列腺炎患者单用敏感抗生素 (B组 ) ,对两组的疗效进行对比研究。　结果 :A组的疗效明显高于B组。　结论 :锌硒宝片剂是一种能有效治疗慢性细菌性前列腺炎、改善其症状的药物。     

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.     

Alpha-blockers impact stent-related symptoms: a randomized, double-blind, placebo-controlled trial

Abstract Background and Purpose: Ureteral stents are indispensable tools in endourology, although they often are associated with bothersome lower urinary tract symptoms. This study was conducted to evaluate the effect of alfuzosin on urinary symptoms, quality of life, and pain in patients after Double-J ureteral stent placement in a randomized, placebo-controlled trial. Patients and Methods: This study was conducted from July 2008 to May 2009. A total of 130 patients underwent placement of a Double-J stent after retrograde semirigid ureteroscopy for ureteral stones. They were randomized in two groups. Group 1 (n=65) received alfuzosin 10?mg once daily and group 2 (n=65) received placebo for 1 week. Both groups also received standardized analgesia. The stent symptoms were measured and recorded 1 week after the procedure. Statistical analyses were performed using the chi-square test and Student t test with P<0.05 considered significant. Results: The demographic profile including patient and stone-related parameters were comparable. Group 1 had significantly less urinary symptoms (P<0.05). The quality-of-life assessment was better in the alfuzosin arm than in the placebo arm (P<0.001). The mean pain score was 1.15 in group 1 and 3.89 in the placebo group (P<0.001). None of the patients in either of the arms withdrew from treatment; there were minimal adverse effects in the treatment arm. The limitation of the current work includes relatively smaller sample size and use of single type of stent. Conclusions: Alfuzosin 10?mg once daily in patients with a Double-J stent significantly decreases the bothersome urinary symptoms, besides decreasing significantly the pain associated with the stent.     

术中射频治疗在剖胸探查晚期非小细胞肺癌治疗中的作用和意义

目的探讨术中射频治疗在剖胸探查晚期非小细胞肺癌治疗中的作用和意义。方法2002年1月至2004年12月23例剖胸探查无法手术切除的晚期非小细胞肺癌患者行术中射频治疗为治疗组(n=23,A组),同期无法手术切除的晚期非小细胞肺癌30例给予化疗为对照组(n=30,B组),观察术后疗效、疼痛缓解程度、ECOG评分、术后生活质量。结果A组的治疗、疼痛缓解程度、ECOG评分及治疗后生活质量的好转率分别为65.22%、65.22%、60.86%、65.21%;B组为36.67%,33.33%,33.33%,30.00%。射频治疗组优于化疗组。(P<0.05)结论术中射频治疗可有效地提高不可切除的晚期非小细胞肺癌的术后疗效和生存质量,对于晚期非小细胞肺癌提供了新的治疗途径。     

门诊森田心理辅助疗法对ⅢB型前列腺炎的疗效探讨(附136例报告)

目的:了解门诊森田疗法对ⅢB型前列腺炎的辅助疗效。方法:将136例确诊为ⅢB型前列腺炎且伴有不同程度心理障碍的患者随机分为:A组,常规治疗+森田疗法组(n=68);B组,常规治疗组(n=68)。分析2组间症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分变化和前列腺痛症状缓解情况。结果:治疗8周后,A组的SCL-90、SAS、SDS自测表评分分别为(70.5±22.3)、(18.7±8.5)、(21.4±9.0)分,均较治疗前下降,并低于B组,差异有显著性(P<0.05),A组的前列腺痛症状缓解有效率和显效率分别为100%、72.1%,均优于B组(P<0.05)。结论:门诊森田疗法有助于改善ⅢB型前列腺炎患者的心理障碍,提高治疗效果。     

点阵CO2激光治疗女性轻中度压力性尿失禁的临床疗效分析

目的探究经阴道点阵CO₂激光治疗女性轻、中度压力性尿失禁(SUI)的临床疗效。方法回顾性研究本院2017年1月至2020年12月收治的轻中度SUI女性患者。激光治疗组41例,进行点阵CO₂激光联合盆底肌训练治疗,每月治疗1次,共治疗3次;生物反馈治疗组20例,采用生物反馈电刺激联合盆底肌训练。比较两组患者治疗后临床疗效、国际尿失禁委员会尿失禁问卷简表(ICI-Q-SF)、尿失禁生活质量问卷(I-QOL)及女性性功能量表(FSFI)评分。结果治疗后,激光治疗组总有效率为92.68%,疗效强于生物反馈组(P<0.05);治疗后ICI-Q-SF、I-QOL、FSFI评分均得到改善(P<0.01);与生物反馈治疗组比较,激光治疗组I-QOL、FSFI增加更显著(P<0.05),ICI-Q-SF评分明显降低(P<0.01)。3例患者治疗时述阴道烧灼感,休息后好转,5例患者出现一过性的尿急,部分患者阴道分泌物增多后自行恢复,整个治疗过程无其他不良事件发生。结论点阵CO₂激光治疗能够有效改善轻、中度SUI患者的...     

Quality of life assessment before and after transurethral resection of the prostate in patients with lower urinary tract symptoms

Objectives: The aim of this study was to determine the effects of surgical treatment of lower urinary tract symptoms (LUTS) in a Malaysian population by evaluating the quality of life before and after treatment. Patients and methods: The study group comprised 111 LUTS patients (age 69.56 ± 7.94 years, mean ± SD ) who were assessed 1 week before and at 3, 6 and 12 months after treatment using the health-related quality of life (HRQOL-20) questionnaire, a visual analogue scale (VAS), the present pain intensity (PPI) scale and the international prostate symptom score (I-PSS). Results: Preoperatively the patients suffered more pain, severe prostatic symptoms, impaired disease-specific quality of life and a reduction in health-related quality of life. Postoperatively the patients showed a significant reduction and improvement in pain, prostatic symptoms, and disease-specific and health-related quality of life. Conclusions: The results showed that the operative procedure significantly improved the overall quality of life of patients with LUTS.     

Clinical studies on recurrence of acute uncomplicated cystitis

Recurrence rate and symptoms after chemotherapy against acute uncomplicated cystitis (AUC) were studied. Upon completion of a 7-day treatment with two regimens, one of CEX alone (Group C) and the other of a combination of CEX with Lysozyme (Neuzym) (Group L), at a dose of 1 g CEX daily, efficacy of the drugs was assessed according to the criteria established by the UTI Study Group. The forty one cases in Group C and 38 cases in Group L showing an excellent response were evaluated for recurrence. The rates of recurrence were 12.2% in Group C and 21.1% in Group L during the first 7 days after treatment. In recurrent cases, bacteriuria was seen in 84.6% (11/13), pyuria in 53.8% (7/13) and miction pain in 30.8% (4/13). Thus, bacteriuria and pyuria should be the items of the criteria for AUC recurrence.     

内镜早期治疗急性胆源性胰腺炎60例临床研究

目的：探讨内镜早期治疗急性胆源性胰腺炎（ABP）的临床疗效。方法：ABP患者120例,根据治疗方法的不同随机分为早期内镜治疗重症ABP组（Ⅰ组）、早期内镜治疗轻症ABP组（Ⅱ组）、保守治疗重症ABP组（Ⅲ组）以及保守治疗轻症ABP组（Ⅳ组）,每组30例,评价各组的临床疗效。结果：Ⅰ组及Ⅱ组恶心、呕吐、发热、腹痛等症状和体征以及TNF-α、C反应蛋白（CRP）、IL-6、IL-8、血淀粉酶、尿淀粉酶、直接胆红素、谷氨酰转肽酶、碱性磷酸酶等实验室检查指标,在治疗前后的改善情况显著优于其他2组,病程缓解时间也短（P〈0.05）;Ⅰ组和Ⅱ组的治疗总有效率为93.3%和90.0%,明显优于Ⅲ组的70.0%和Ⅳ组的76.7%（P〈0.05）。结论：对ABP患者采用内镜早期治疗,相比保守治疗更能有效改善患者的临床症状和体征,值得临床推广。     

Epididymectomy is an effective treatment for scrotal pain after vasectomy

OBJECTIVE: To investigate the efficacy of epididymectomy in patients with significant scrotal pain after vasectomy. PATIENT AND METHODS: Sixteen patients were identified retrospectively to have undergone epididymectomy for pain after vasectomy; 19 epididymectomies were performed (three bilateral and 13 unilateral). Details from the preoperative investigations, histological examination and follow-up of symptoms were analysed and correlated. Outcomes were initially assessed at the routine outpatient clinic review 3 months after surgery and the long-term outcomes were assessed by a telephone interview 3-8 years after epididymectomy (mean 5.5 years). RESULTS: Of the 16 patients, 14 had excellent initial symptomatic benefit from epididymectomy. At 3-8 years afterward, nine of 10 patients interviewed had a sustained improvement of their scrotal pain. The following were indicators of a poor outcome: atypical symptoms including testicular or groin pain; erectile dysfunction and normal appearance of the epididymis on ultrasonography. Patients with bilateral scrotal pain can have a good outcome after epididymectomy. CONCLUSION: Epididymectomy in well-selected patients is a reliable and effective treatment for pain after vasectomy.