自制痔宁丸治疗湿热下注型内痔55例疗效观察

目的:评价自制痔宁丸口服治疗湿热下注型内痔的临床疗效。方法:将2020年11月至2021年6月,本院治疗的110例湿热下注型内痔患者,按随机数字表法分为观察组和对照组,各55例。观察组采用口服痔宁丸治疗,对照组采用口服槐角丸治疗。观察比较2组疗效及不良反应情况。结果:观察组总有效率为90.0%,高于对照组的76.3%(P<0.05)。2组用药后不良反应发生率比较差异无统计学意义(P>0.05)。结论:自制痔宁丸口服治疗湿热下注型内痔,临床疗效显著,且无明显不良反应。     

舍尼通治疗慢性非细菌性前列腺炎的临床研究

目的 评价舍尼通(Prostat)治疗慢性非细菌性前列腺炎(CNP)的有效性及安全性。方法 采用多中心开放临床试验方法，对115例慢性非细菌性前列腺炎患者进行为期8周的观察。口服舍尼通每天2次，每次1片(含70mg水溶性提取物P5及4mg脂溶性提取物EAl0)。结果 治疗后4周和8周，患者国际慢性前列腺炎症状评分(NIH-CPSI)总分分别较治疗前平均降低7．1(29．5％)和11．9(49．4％)，症状尺度评分分别较治疗前平均降低5．0(32．1％)和8．2(52．5％)，生活质量评分分别较治疗前平均降低2．1(24．6％)和3．7(43．9％)，前列腺液中WBC计数分别较治疗前平均降低8．8个／HP(39．3％)和13．9个／HP(61．9％)。治疗8周后总有效率82．1％。全组病例观察过程中未发现任何与药物有关的不良反应。结论 舍尼通可明显改善慢性非细菌性前列腺炎患者的疼痛不适症状和排尿症状，改善生活质量，减少前列腺液中的WBC计数，治疗效果确切，耐受性良好。     

淋必清汤治疗性病后慢性前列腺炎的临床研究

目的: 观察淋必清汤治疗性病后慢性前列腺炎(CPFSTD)的疗效。　方法: 通过对 36例CPFSTD患者口服淋必清汤治疗前后临床症状与客观指标的测定,总结其疗效。　结果: CPFSTD患者口服淋必清汤治疗 4~8周后,总有效率为72. 22%,NIH CPSI评分显著下降(P<0. 05 )。　结论: 淋必清汤对CPFSTD有明显的临床疗效,可以作为一种有效的治疗手段。     

消炎方系列治疗慢性非细菌性前列腺炎的临床研究

目的 :观察消炎方系列治疗慢性非细菌性前列腺炎 (CNP)的疗效。　方法 :共有 16 0例符合条件的病人参与本研究 ,随机分为A(单纯消炎冲剂 )、B(消炎冲剂 +保留灌肠 )、C(消炎冲剂 +直肠给药 )、D(消炎冲剂 +直肠给药+坐浴熏洗 ) 4组 ,单盲对照 ,持续 8周的临床观察。　结果 :A、B、C、D组治愈率分别为 37.5 %、5 7.5 %、5 2 .5 %、82 .5 % ;总有效率分别为 4 2 .5 %、82 .5 %、77.5 %、92 .5 %。D组与A、B、C组比较 ,治愈率差异有显著性 (P <0 .0 5 ) ;D组与B组比较 ,有效率差异无显著性 (P >0 .0 5 ) ;D组与A、C组比较 ,差异有显著性 (P <0 .0 5 )。　结论 :综合疗法能显著提高CNP的疗效 ,具有清热解毒、活血通瘀之功效 ,消炎方系列制剂是治疗CNP的有效中药。     

西沙必利治疗慢性前列腺炎的临床研究

慢性前列腺炎是男性常见的疾病,症状反复,难于治愈。由于慢性非细菌性前列腺炎和前列腺痛临床表现相同,难于区分,因而人们常将二者归为一类,称慢性前列腺炎或慢性前列腺炎类综合征。我们选用西沙必利治疗慢性前列腺炎,探讨其治疗效果及应用前景。材料与方法　病人选择标准：（１）具有前列腺炎的临床症状,包括会阴部、肛周、睾丸及下腹部疼痛或不适,腹股沟区、腰部及阴茎疼痛、尿道不适、射精疼痛等,病人具备２个以上症状。（２）病史１年以上、反复发作,抗生素治疗无效。（３）前列腺液细菌培养阴性,白细胞＜２０个／ＨＰ。（４…     

通淋汤治疗湿热下注型慢性前列腺炎的临床研究

目的:探讨通淋汤治疗湿热下注型慢性前列腺炎的临床疗效。方法:选取湿热下注型慢性前列腺炎患者50例,采用随机分组方法分为治疗组(通淋汤组)和对照组(左氧氟沙星胶囊组)各25例,治疗4周后对其疗效进行判断。结果:治疗组临床显效17例,有效7例,无效1例,总有效率96%;对照组临床显效7例,有效11例,无效7例,总有效率72%。两组在中医症状评分、疼痛、排尿症状等方面均有改善,NIH-CPSI评分方面与对照组相比有统计学差异(P0.05)。治疗组2例在服用中药时出现腹泻,中药减量后症状缓解;对照组1例出现胃肠道不适,减半剂量后症状缓解。临床随访1年,治疗组临床复发6例,复发率为24%,对照组临床复发12例,复发率为48%。结论:通淋汤治疗湿热下注型慢性前列腺炎有较好疗效,能改善患者的临床症状,有明显改善排尿症状作用,可减少临床复发率。     

清康灌肠液治疗湿热瘀阻证慢性前列腺炎的疗效观察

目的:观察清康灌肠液保留灌肠治疗慢性前列腺炎湿热瘀阻证的疗效.方法:随机将180例患者分为中药灌肠组(治疗组)和口服药组(对照组),每组各90例.治疗组给予清康灌肠液保留灌肠,对照组服用龙金通淋胶囊.治疗4周后分析NIH-CPSI评分和中医证侯评分,比较两组疗效.结果:治疗4周后,NIH-CPSI评分、疼痛、排尿症状及生活质量评分、中医证侯评分等方面,治疗组显效17例,有效45例,无效23例;对照组显效3例,有效26例,无效57例,治疗组优对照组(P<0.05).结论:清康灌肠液保留灌肠治疗慢性前列腺炎湿热瘀阻证较龙金通淋胶囊口服效果好.     

中西医结合治疗湿热下注型臁疮的临床观察研究

目的：观察银黄洗剂溻渍复合地奥司明片口服对湿热下注型臁疮疮面的疗效。方法：将 50 例湿热下注型臁疮患者随机分为治疗组及对照组各 25 例。对照组予以常规治疗,治疗组在常规治疗的基础上予以银黄洗剂溻渍,疗程均为 30 天, 观察临床疗效,比较其临床症状及体征（疼痛程度、疮面的色泽、气味、渗出及大小）评分,炎症相关指标（白细胞计数、超敏 C 反应蛋白值）的变化情况。结果：治疗组临床治愈率和总有效率为 52%、96%,对照组分别为 24%、76%（P<0.05）。治疗组和对照组疮面明显缩小、颜色气味及渗出均较治疗前明显改善,疼痛明显减轻（P<0.05）。治疗组及对照组较治疗前白细胞计数及超敏 C 反应蛋白值明显降低（P<0.05）,且治疗组较对照组降低更为明显（P<0.05）。结论：银黄洗剂溻渍联合地奥司明片口服,对湿热下注型臁疮有明显疗效,可明显改善患者的临床症状及体征,明显降低白细胞计数及超敏C 反应蛋白值。     

芒针治疗慢性前列腺炎的临床研究

慢性前列腺炎（chronicprostatis）是感染细菌或病毒等或虽无感染但前列腺长期慢性充血所造成的前列腺慢性炎症,属中医的"精浊"、"白浊"、"白淫"或"淋证"等范畴。临床以发病缓慢、症状复杂、病程迁延、顽固难愈、容易复发为特征,部分病人可影响其生育能力。据统计,35岁以上的男子有35％～40％患有本病,约占泌尿科门诊的30％左右,也有报道达到或超过50％者[1]。本病大致可分为细菌性前列腺炎和充血性或非细菌性前列腺炎两类。Mearcs认为后者发病率较前者为高,国内统计资料表明,二者发病率相差甚微（49．4：50．6）[2]。近些年来,采…     

慢性前列腺炎患者抑郁症状相关因素分析

目的:研究影响慢性前列腺炎(CP)患者抑郁症状的相关因素。方法:选择国际慢性前列腺炎症状指数表(NIH-CPSI)及IIEF-5评价CP患者的临床症状,抑郁自评量表(SDS)、90项症状清单(SCL-90)抑郁子量表评定抑郁症状,特质应对方式问卷(TCSQ)评价特质应对方式,疾病感知问卷(IPQ)中文修订版(CIPQ-R)进行CP患者疾病感知特点评价。对CP患者的抑郁症状与临床症状进行相关分析,对影响CP患者抑郁症状的因素进行多元逐步回归分析。结果:抑郁症状与NIH中疼痛或不适、排尿症状、症状严重程度、NIH总分呈显著正相关,与勃起功能呈显著负相关(r=0.32,0.31,0.35,0.38,-0.36,P均<0.05)。消极特质应对、IPQ致病因素可解释CP抑郁症状的43.4%(R2=0.434,调整后R2=0.456,F=14.853,P<0.001)。结论:CP患者抑郁症状与临床症状密切相关,消极应对特质和过度的疾病归因是CP患者抑郁症状的重要预测因素。     

Presence of leucocytes in prostatic secretions correlates with the severity of lower urinary tract symptoms

We investigated the correlation between the presence of leucocytes in expressed prostatic secretion and the lower urinary tract symptom severity by retrospectively reviewing 699 men with lower urinary tract symptoms. The patients were evaluated by the International Prostate Symptoms Score and the Overactive Bladder Symptoms Score and underwent expressed prostatic secretion testing. Patients were classified into groups 1 and 2 based on the expressed prostatic secretion leucocyte count. The mean total and storage score of the International Prostate Symptoms Score, and mean total Overactive Bladder Symptoms Score were higher in group 1. Urine flow metrics showed that voided volume and maximum flow rate were lower in group 1. The scores for International Prostate Symptoms Score questions 4, 6 and 7 and Overactive Bladder Symptoms Score question 2 were higher in group 1 and showed a weak positive correlation with expressed prostatic secretion. Voided volume and maximum flow rate showed the strongest correlation, although International Prostate Symptoms Score question 7 and Overactive Bladder Symptoms Score question 2 were the only independent predictors of expressed prostatic secretion. Therefore, leucocytes in expressed prostatic secretion are associated with the lower urinary tract symptom severity, particularly nocturnal urination symptoms.     

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。     

氯美扎酮联合吲哚美辛栓治疗慢性非细菌性前列腺炎／慢性盆腔疼痛综合征的研究

目的评价氯美扎酮联合吲哚美辛栓治疗以疼痛为主诉的慢性非细菌性前列腺炎／慢性盆腔疼痛综合征（CP／CPPS）的疗效。方法对符合CP／CPPS标准的180例患者随机分为吲哚美辛栓组、氯美扎酮联合吲哚美辛栓组及特拉唑嗪组,疗程4周。在治疗结束时进行疗效判定,疗效评价标准采用视觉模拟评分方法。结果中途退出7例,173例患者进行了疗效评价,联合治疗组症状改善总有效率与吲哚美辛栓组（x^2=3．87,P〈0．05）和特拉唑嗪组（x^2=6．82,P〈0．01）相比疗效差异有统计学意义。治疗过程中无严重不良反应发生。结论氯美扎酮联合吲哚美辛栓可作为CP／CPPS疼痛患者的一种有效治疗手段。     

alpha-Blockers improve chronic ischaemia of the lower urinary tract in patients with lower urinary tract symptoms

OBJECTIVE

To investigate whether a mechanism of action of α‐blockers on lower urinary tract symptoms (LUTS) involves improved perfusion of the LUT.

PATIENTS, SUBJECTS AND METHODS

The accuracy of perfusion measurements using transrectal colour Doppler ultrasound (TRCDUS) and colour pixel density (CPD) was initially confirmed in a porcine model. Following this confirmation, measurements were taken from four healthy male volunteers and 19 patients with LUTS. The urinary bladder was filled slowly (50 mL/min) with 0.2 m KCl, which resembles the osmolarity of concentrated urine, and evaluated by cystometry. In parallel, TRCDUS and measurement of the CPD of the LUT were performed. The patients with LUTS were then treated with daily α‐blocker (0.4 mg tamsulosin) for 5 weeks and urodynamic variables as well as perfusion were evaluated again.

RESULTS

In the healthy men, perfusion of the LUT increased considerably (157%) during filling of the bladder to a mean (sd ) maximum cystometric capacity (C_max) of 481 (28.9) mL. All the patients with LUTS had a reduced mean C_max during filling with KCl at 322.4 (58.5) mL. The mean CPD in the urinary bladder and the prostate were only increased by 58.4% during filling with KCl. After α‐blocker therapy the mean C_max during filling with KCl rose to 382.5 (42.9) mL; furthermore, perfusion of the LUT measured by CPD was significantly increased (132.8%).

CONCLUSIONS

The present data strongly suggest that LUTS are associated with chronic ischaemia of the prostate and urinary bladder. α‐blockers increase perfusion in the LUT and C_max. These results might explain the therapeutic effects of α‐blockers on LUTS.     

Characterisation of the bacterial community in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome and infertile men: a preliminary investigation

The expressed prostatic secretions (EPSs) of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), infertile men and normal men were subjected to microbiological study. EPSs were collected from the subjects, which included 26 normal men, 11 infertile patients and 51 CP/CPPS patients. DNA was extracted from each specimen, and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers. The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men, but without any difference among the three patient groups. The denaturing gradient gel electrophoresis (DGGE) method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues. Principal component analysis (PCA) and partial least squares (PLS) analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups. Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients (P<0.05). Two bands were identified as priority factors in the discrepancy of category IIIA and category IIIB prostatitis patients (P<0.05). According to this research, the ecological balance of the prostate and low urethra tract, when considered as a microenvironment, might play an important role in the maintenance of a healthy male reproductive tract.     

复方玄驹胶囊对慢性前列腺炎合并勃起功能障碍的疗效观察

目的:观察复方玄驹胶囊对慢性前列腺炎合并勃起功能障碍(ED)的治疗效果及安全性。方法:132例慢性前列腺炎伴发ED患者,治疗前行NIH慢性前列腺炎症状评分(NIH-CPSI)及国际勃起功能指数问卷5(IIEF-5)评分。根据治疗方式不同,将患者分为对照组(70例)及治疗组(62例)。对照组使用左氧氟沙星0.2 g,口服,2/d,连续服用4～6周,及特拉唑嗪2 mg,口服,1/晚,连续服用2个月。治疗组在上述治疗的基础上,同时使用复方玄驹胶囊2粒,口服,3/d,连续服用2个月。结果:所有患者均无严重不良反应出现,能坚持服药。治疗后2个月重新评分,对照组NIH-CPSI平均(16.5±5.9)分,较治疗前(25.1±5.5)分显著改善(P<0.05),IIEF-5平均(13.1±5.2)分,较治疗前(11.3±4.5)分有所增加,但差异无显著性(P>0.05);治疗组NIH-CPSI平均(13.4±5.7)分,IIEF-5平均(17.5±6.5)分,与治疗前比较,均改善显著(P<0.05)。对照组ED总有效率为20%,治疗组ED总有效率为74.2%,其差异有显著性(P<0.05)。结论:复方玄驹胶囊治疗慢性前列腺炎伴发ED,既可明显改善慢性前列腺炎症状,同时,对伴发的ED也有较好的疗效,无严重不良反应,值得推广使用。