坦洛新联合前列安栓治疗Ⅲ型前列腺炎临床观察

目的 观察坦洛新联合前列安栓治疗Ⅲ型前列腺炎的临床疗效.方法 Ⅲ型前列腺炎患者90例,随机分为治疗组(n=45)和对照组(n=45),治疗组应用坦洛新和前列安栓,对照组应用特拉唑嗪和前列安栓,观察2组治疗前后的慢性前列腺炎症状积分指数(NIH-CPSI评分)和疗效变化,并进行统计学分析.结果 治疗组:临床痊愈12例,显效14例,有效16例,无效3例,总有效率93.3%;对照组:临床痊愈5例,显效9例,有效17例,无效12例,总有效率72.1%.治疗组优于对照组(P<0.05):治疗组在改善患者尿路症状、生活质量及总NIH-CPSI方面优于对照组(P<0.05);两者在改善疼痛症状上无明显差异(P>0.1).结论 坦洛新联用前列安栓是治疗Ⅲ型前列腺炎有效的药物组合.     

前列安栓治疗慢性前列腺炎综合征的疗效观察

目的 评估前列安栓在治疗慢性前列腺炎综合征中的临床疗效。方法 采用随机开放前瞻对照试验方法,将120例慢性前列腺炎患者随机分为两组:前列安栓治疗组(A组)和常规治疗对照组(B组),分别采用前列安栓联用氧氟沙星或单用氧氟沙星治疗。以前列腺按摩液(EPS)检查和NIH前列腺炎症状评分作为评估手段,对每个患者随访4周观察临床疗效。结果 本研究中共有6例患者未能完成第2周的随访而退出试验,其中A组2例在第1周末因腹痛、腹泻拒绝进一步治疗,B组2例失访,2例因对疗效不满意而退出,其余病例均完成了4周的随访。结果显示:前列安栓治疗组临床痊愈10例(17.2％),显效20例(34.5％),有效19例(32.6％),总显效率51.7％,总有效率83.3％,明显优于对照组(总显效率和总有效率分别为31.7％和66.7％),P<0.01。结论 前列安栓直肠给药联合口服抗生素对慢性前列腺炎综合征具有较好的疗效。前列安栓直肠给药是治疗慢性前列腺炎的新选择。     

前列安栓治疗慢性前列腺炎350例临床分析

目的:评估前列安栓治疗慢性前列腺炎的临床效果.方法:将350例慢性前列腺炎患者随机分成前列安栓组和抗生素对照组,前列安栓组每日一粒前列安栓于晚间便后塞入肛门3～5 cm ;抗生素组单用广谱抗生素或抗革兰阴性菌的药物.对两组疗效进行分析评估.结果:前列安栓组总有效率达81%,抗生素对照组有效率40%,差异有统计学意义.结论:前列安栓治疗慢性前列腺炎临床效果满意,是治疗慢性前列腺炎有效药物之一,值得在基层医疗机构推广.     

前列安栓治疗慢性前列腺炎综合征29例疗效观察

目的 :评估前列安栓治疗慢性前列腺炎 (CP)综合征各种疼痛和不适感等症状的有效性、安全性和治疗依从性。　方法 :采用持续 1个月的病例开放自身对照研究方法。根据美国国立卫生研究院 (NIH)前列腺炎症状评分表 ,对 2 9例前列腺按摩液 (EPS)进行检查 ,WBC≥ 10个 /HP、临床诊断为CP综合征的病人应用前列安栓进行治疗。并对每个病人接受前列安栓治疗前后的疗效进行观察。　结果 :本组病例治疗后与治疗前相比 ,其NIH前列腺炎症状评分、前列腺液的白细胞计数等均明显降低 ,其中显效 18例 ( 62 .1% ) ,有效 8例 ( 2 7.6% ) ,无效 3例( 10 .3 % )。　结论 :前列安栓治疗CP综合征安全、有效、使用方便 ,病人的依从性较好。     

前列安栓治疗慢性前列腺炎:多中心双盲随机安慰剂对照试验

目的　评估前列安栓治疗慢性前列腺炎各种疼痛和不适感等症状的有效性、安全性和依从性。　方法　安慰剂对照随机双盲试验。 72例慢性前列腺炎患者随机分为两组。治疗组 36例 ,每晚前列安栓 1粒纳肛 ,连续 1个月 ;对照组 36例 ,安慰剂治疗 1个月。根据前列腺按摩液 (EPS)和美国国立卫生院 (NIH)前列腺炎症状评分评估疗效。　结果　治疗组痊愈 1例 (2 .8% ) ,显效 7例(2 0 .0 % ) ,有效 16例 (45 .7% ) ,总显效率 2 2 .8% ,总有效率 6 8.6 %。对照组无痊愈病例 ,显效 2例(5 .7% ) ,有效 8例 (2 2 .8% ) ,总显效率 5 .7% ,总有效率 2 8.6 %。两组各有 1例在治疗 2周内退出试验。两组相比 ,总有效率和总显效率差别均有显著性意义 (P <0 .0 5 ) ;不良反应发生率差别无显著性意义 (P >0 .0 5 )。　结论　前列安栓治疗慢性前列腺炎安全、有效 ,患者依从性较好     

前列安栓治疗慢性前列腺炎的安全性和有效性:随机双盲安慰剂对照试验

目的　评价前列安栓治疗各型慢性前列腺炎的安全性、有效性和依从性。　方法　多中心随机双盲安慰剂对照研究。 12 5例慢性前列腺炎患者根据美国国立卫生院 (NIH)前列腺炎分型标准分型后随机分为治疗组和对照组 ,治疗组 (6 5例 )前列安栓 1粒 ,对照组 (6 0例 )安慰剂 1粒 ,肛内用药每晚 1次 ,疗程 1个月。以NIH慢性前列腺炎症状评分 (NIH CPSI)和前列腺按摩液 (EPS)白细胞计数为疗效评价指标。　结果　试验结束时 ,12 4例可评价病例中Ⅱ型 4 8例 (38.7% ) ,Ⅲa型 4 5例 (36 .3% ) ,Ⅲb型 31例 (2 5 .0 % )。治疗组NIH CPSI总分用药前后分别为 (2 5 .4 5± 5 .82 )和 (15 .0 8± 7.84 )分 ,平均降低 10 .37分 ,症状程度评分用药前后分别为 (16 .76± 4 .0 7)和 (9.4 2± 5 .38)分 ,平均降低 7.34分 ;对照组NIH CPSI总分用药前后分别为 (2 2 .87± 5 .79)和 (16 .2 2± 6 .2 3)分 ,平均降低 6 .6 5分 ,症状程度评分用药前后分别为 (15 .2 7± 3.86 )和 (10 .5 5± 4 .2 9)分 ,平均降低 4 .72分 ;治疗组NIH CPSI总分与症状程度评分的下降幅度均较对照组更明显 (P <0 .0 1)。治疗组总显效率2 8.1% (18/ 6 4 ) ,总有效率 71.9% (4 6 / 6 4 ) ,对照组总显效率 13.3% (8/ 6 0 ) ,总有效率 4 1.7% (2 5 / 6 0 )     

前列安栓治疗慢性前列腺炎(湿热瘀血壅阻证)的安全性和有效性的Ⅲ期临床试验

目的:评价前列安栓治疗慢性前列腺炎(湿热瘀血壅阻证)的安全性和有效性。方法:随机、单盲、平行对照、多中心临床试验,467例受试者分为试验组349例、对照组118例。试验组前列安栓1粒,对照组野菊花栓1粒,肛内用药每晚1次,疗程28 d。以中医证候、美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)、主要临床症状及前列腺按摩液白细胞(EPS-WBC)计数为疗效评价指标。结果:试验组治疗结束时中医证候疗效临床控制率为4.4%、总显效率为58.0%、总有效率为90.7%,明显优于对照组的0.9%、33.1%、70.4%(P<0.025)。试验组的NIH-CPSI总分、疼痛与不适、排尿情况、生存质量评分的下降程度均较对照组明显(P<0.025)。试验组对主要临床症状尿急、会阴部等局部坠胀和局部疼痛有明显缓解作用,疗效优于对照组(P<0.05)。试验组EPS-WBC计数改善率为55.2%,明显优于对照组的32.4%(P<0.05)。试验组和对照组均未发生严重不良事件,试验药和对照药不良反应发生率低,分别为0.56%(2/349)和0.83%(1/118)。结论:前列安栓治疗慢性前列腺炎(湿热瘀血壅阻证)疗效肯定,临床用药安全性良好。     

前列安通片治疗慢性前列腺炎多中心临床试验研究

目的:评价前列安通片治疗慢性前列腺炎的疗效及安全性。方法:采用多中心、自身对照、开放性的临床研究方法,共纳入280例受试者,口服前列安通片,5片/次,3次/d。分别于治疗前、治疗后2周和4周按美国国立卫生研究院(NIH)慢性前列腺炎症状评分(NIH-CPSI)进行评分,并记录EPS中白细胞数。结果:纳入统计受试者共273例,治疗4周后,显效96例(35.2%),有效130例(47.6%),无效47例(17.2%),总有效率为82.8%。治疗4周后,受试者NIH-CPSI总评分、疼痛评分、排尿评分、生活质量评分及EPS中WBC计数与治疗前相比,差异有统计学意义(P<0.01)。试验期间未发现与治疗相关的不良反应事件发生及实验室检查异常。结论:前列安通片治疗慢性前列腺炎疗效确切,安全性高,尤其适合伴有盆腔疼痛的慢性前列腺炎治疗。     

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.     

前列安栓治疗慢性前列腺炎疗效评价

目的：评价前列安栓治疗慢性前列腺炎的有效性、安全性和依从性。方法：临床对照随机试验。282例慢性前列腺炎，分型后各型均随机等分为两组，分别以前列腺安栓和抗菌药治疗。根据治疗前后前列腺按摩液(EPS)中白细胞数和美国国立卫生研究院慢性前列腺炎症状指数表(NIH—CPSI)评分评价疗效。结果：Ⅱ型和ⅢA型治疗后，EPS白细胞个数明显较对照组减少，差异有显著性意义。症状程度改善显著，差异有显著性意义。ⅢB型治疗后，两组差异无显著性意义。不良反应发生率无差异。结论：前列安栓治疗慢性前列腺炎安全、有效、方便、患者依从性较好。     

A randomized placebo-controlled multicentre study to evaluate the safety and efficacy of finasteride for male chronic pelvic pain syndrome (category IIIA chronic nonbacterial prostatitis)

OBJECTIVE: To determine if finasteride can reduce symptoms in men with a clinical diagnosis of chronic nonbacterial prostatitis (National Institutes of Health, NIH, category IIIA chronic pelvic pain syndrome, CPPS) compared with placebo. PATIENTS AND METHODS: Men (76) with category IIIA CPPS enrolled in four North American prostatitis research centres were randomized after a 2-week placebo run-in to finasteride or placebo for 6 months. The primary efficacy variable was a subjective overall assessment (SOA); the secondary efficacy variables included the NIH chronic prostatitis symptom index (NIH-CPSI) and safety data. Patients were assessed at screening, baseline (after the 2-week placebo run-in), 3 and 6 months. RESULTS: Sixty-four patients had at least one assessment on medication (31 placebo, 33 finasteride); 75% of the finasteride and 54% of the placebo group had at least a mild improvement (defined as > 25% improvement in SOA), and 44% and 27%, respectively, a moderate or marked improvement (>50% improvement in SOA). The trend was similar in the NIH-CPSI scores. Five patients in the finasteride and seven in the placebo group reported medication-related adverse events. CONCLUSION: This randomized placebo-controlled pilot study suggests that finasteride was of benefit for some men with category IIIA CPPS, but the results do not justify recommending finasteride as monotherapy, except for men who also have benign prostatic hyperplasia. A larger, properly powered study, possibly evaluating combination with other therapies or specifically in men with prostatitis and benign prostatic hyperplasia, is required to confirm any clinical benefit.     

Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial

Objectives. The National Institutes of Health (NIH) category III chronic prostatitis syndromes (nonbacterial chronic prostatitis and prostatodynia) are common disorders with few effective therapies. Bioflavonoids have recently been shown in an open-label study to improve the symptoms of these disorders in a significant proportion of men. The aim of this study was to confirm these findings in a prospective randomized, double-blind, placebo-controlled trial.Methods. Thirty men with category IIIa and IIIb chronic pelvic pain syndrome were randomized in a double-blind fashion to receive either placebo or the bioflavonoid quercetin 500 mg twice daily for 1 month. The NIH chronic prostatitis symptom score was used to grade symptoms and the quality-of-life impact at the start and conclusion of the study. In a follow-up unblind, open-label study, 17 additional men received 1 month of a supplement containing quercetin, as well as bromelain and papain (Prosta-Q), which enhance bioflavonoid absorption.Results. Two patients in the placebo group refused to complete the study because of worsening symptoms, leaving 13 placebo and 15 bioflavonoid patients for evaluation in the blind study. Both the quercetin and placebo groups were similar in age, symptom duration, and initial symptom score. Patients taking placebo had a mean improvement in NIH symptom score from 20.2 to 18.8 (not significant), while those taking the bioflavonoid had a mean improvement from 21.0 to 13.1 (P = 0.003). Twenty percent of patients taking placebo and 67% of patients taking the bioflavonoid had an improvement of symptoms of at least 25%. In the 17 patients who received Prosta-Q in the open-label study, 82% had at least a 25% improvement in symptom score.Conclusions. Therapy with the bioflavonoid quercetin is well tolerated and provides significant symptomatic improvement in most men with chronic pelvic pain syndrome.     

Terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome: a randomized,placebo controlled trial

PURPOSE: We evaluate terazosin therapy for chronic prostatitis/chronic pelvic pain syndrome. MATERIALS AND METHODS: The study included 100, 20 to-50-year-old subjects who met the consensus criteria for chronic prostatitis/chronic pelvic pain syndrome and had not received previous alpha-blockers. Subjects were randomized to receive terazosin with dose escalation from 1 to 5 mg. daily or placebo for 14 weeks. The primary criterion for response was scoring 2 or less ("delighted-to-mostly satisfied") on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) quality of life item. The secondary criterion for response was greater than 50% reduction in NIH-CPSI pain score at 14 weeks. Other outcomes included total and NIH-CPSI domain scores, International Prostate Symptom Score, peak urinary flow rate, post-void residual urine and adverse effects. RESULTS: Using the primary criterion 24 of 43 evaluable subjects (56%) responded in the terazosin group compared to 14 of 43 (36%) in the placebo group (p = 0.03). Using the secondary criterion 26 of 43 subjects (60%) responded in the terazosin group compared to 16 of 43 (37%) in the placebo group (p = 0.03). The terazosin group had greater reductions (p <0.05) in NIH-CPSI total score, individual domain scores and International Prostate Symptom Score than the placebo group. There was no difference in peak urinary flow rate or post-void residual. In the terazosin group 18 patients (42%) had side effects compared to 9 (21%) in the placebo group (p = 0.04). CONCLUSIONS: Terazosin proved superior to placebo for patients with chronic prostatitis/chronic pelvic pain syndrome who had not received alpha-blockers previously.     

Use of prostatic massage in combination with antibiotics in the treatment of chronic prostatitis

Chronic prostatitis is often refractory to antibiotics, however biopsy and molecular data indicate persistent symptoms may be due to occult infection. Combining antibiotic therapy with regular prostatic massage has been suggested as an effective therapy for some of these men. From November 1996 to December 1998, 73 men with chronic pelvic pain syndromes were treated with antibiotics and prostatic massage. Antibiotic selection was based on culture and sensitivity of prostatic fluid or empirically if cultures were negative. Prostatic massage was done 1 to 3 times per week and fluid examined for WBCs and cultured for bacteria. The average age of the group was 43.5 y (range 23-72) and average duration of symptoms 6.7 y (median 3 y, range 3 months-30 y). Prostatic cultures were negative in 19, grew uropathogens in 2, and Gram positive bacteria in 52 patients. Overall 29 patients (40%) had complete resolution of symptoms, 14 (19%) had complete resolution followed by a recurrence, 15 (21%) had some improvement and 15 (21%) had no improvement. All positive cultures were sterilized during treatment. Combination prostatic massage and culture specific antibiotics can be an effective treatment in a proportion of men with long standing refractory chronic prostatitis.     

宁泌泰胶囊联合左氧氟沙星治疗慢性前列腺炎的疗效观察

目的:探讨宁泌泰胶囊联合左氧氟沙星对慢性前列腺炎患者炎症细胞的影响和临床症状改善的效果。方法:选取诊断为慢性前列腺炎的患者共160例,随机分为观察组和对照组各80例。对照组予以左氧氟沙星治疗,观察组予以宁泌泰胶囊联合左氧氟沙星治疗。比较两组治疗前后前列腺液中白细胞、和卵磷脂小体水平、NIH-CPSI评分和中医症候评分,评价两种用药方法对慢性前列腺炎患者的疗效。结果:两组治疗后前列腺液中白细胞计数和卵磷脂小体水平有显著改善,而NIH-CPSI各项评分和中医症候评分均比治疗前由显著下降(P0.05),且观察组均显著低于对照组(P0.05)。接受30 d治疗后,观察组总有效率为77.50%,对照组为51.25%(P0.05)。结论:与单一使用左氧氟沙星相比,采用宁泌泰胶囊联合左氧氟沙星治疗慢性前列腺炎,能够有效降低前列腺液炎症细胞水平,改善临床症状,提高治疗有效率。     

A randomized,placebo controlled,multicenter study to evaluate the safety and efficacy of rofecoxib in the treatment of chronic nonbacterial prostatitis

PURPOSE: We determine the effects of treatment with rofecoxib and placebo in patients with chronic prostatitis. MATERIALS AND METHODS: Patients diagnosed with chronic nonbacterial prostatitis were randomized to 6 weeks of 25 or 50 mg., rofecoxib or placebo in a double-blind multicenter study with a 1-week run in of placebo. End points included the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) (average pain score item 4 primary end point), and patient global assessment questions of pain, disease activity and response to therapy. RESULTS: A total of 161 patients were randomized in the study. The NIH-CPSI total, domain and pain scores significantly decreased from baseline in all groups and, although the mean scores numerically favored the rofecoxib groups, the difference was not significantly different among groups. There was a trend for the percentage of patients with a 25% (or 6 point) improvement in total score being superior on rofecoxib versus placebo with the difference being significantly different (p <0.05) for the 50 mg. rofecoxib group. Patient global assessment of pain, response to therapy and disease activity also favored rofecoxib over placebo (p <0.05, p = 0.07, p = 0.06, respectively). Of the patients 79% on 50 mg. rofecoxib versus 59% on placebo reported no or mild pain, and 56% of patients on 50 mg. rofecoxib versus 27% on placebo experienced significant improvement in quality of life (p <0.005). Rofecoxib was generally well tolerated. CONCLUSIONS: To our knowledge this study is the first to evaluate rofecoxib versus placebo in patients with prostatitis and the first large multicenter treatment study to use the NIH-CPSI. Subjective assessment with patient global questions may be more sensitive to change than the NIH-CPSI and, therefore, may be a better tool to use in future therapeutic trials. Although 6 weeks of rofecoxib treatment appear to benefit many men diagnosed with chronic prostatitis/chronic pelvic pain syndrome further studies are needed.     

Terazosin in the Treatment of Premature Ejaculation: A Short-term Follow-up

Aim: The aim of the present study was to evaluate the efficacy of terazosine in patients with premature ejaculation and lower urinary tract symptoms (LUTS), after excluding other sexual disorders and chronic prostatitis. Methods: A total of 90 patients with premature ejaculation and LUTS were enrolled to the study after excluding sexual disorders, prostatitis and benign prostatic hyperplasia. The patients were divided into two groups. Sixty patients in group 1 were treated with terazosine 5 mg daily for a month. Patients were followed monthly and questioned for their ejaculation problem. The results were classified as cure, improvement and ineffective. If patients showed improvement and ineffectiveness, the treatment was continued with 10 mg daily for the following month. Group 2 was included 30 patients, and placebo was applied for a month. At the end of this period, in patients who did not show any improvement, terazosine 10 mg was started. Results: In the treatment group, at the 1st month follow-up, 21 patients (35%) were cured, 20 (33.3%) showed improvement. In 19 (31.7%) patients, the treatment was ineffective. In group 2, 9 (30%) patients showed improvement and the rest had no-changes after one-month follow up. There was statistically significant difference between two groups (Pearson χ² test=0.000). Later, terazosine 10 mg was given to the patients in group 2 and to the patients who showed improvement or unsuccessful result with terazosine 5 mg. With terazosine 10 mg, 10 (14.5%) patients were cured, 29 (42.2%) patients were improved. Finally, terazosine treatment in patients with premature ejaculation was found to be effective in 60 patients (66.7%).Conclusion: Alpha blockers seem to be physiological medical agents in the treatment of premature ejaculation since ejaculation is under sympathetic control. Moreover, these agents are effective in lower urinary tract and they should be used in patients with premature ejaculation and lower urinary tract symptoms.     

慢性前列腺炎相关的性功能障碍及心理治疗

目的:了解慢性前列腺炎和性功能障碍的关系及心理行为干预治疗的效果。方法:对346例伴有性功能障碍的慢性前列腺炎患者进行随机对照研究。对照组(173例)给予常规的药物治疗(抗生素,吲哚美辛,α1受体阻滞剂和中药),治疗组(173例)除上述治疗外,同时给予心理和行为干预治疗。治疗前后采用国际前列腺炎症状评分指数表(NIH-CPSI)和勃起功能国际指数问卷5(IIEF-5)评分进行疗效比较。结果:慢性前列腺炎伴性功能障碍的程度和前列腺炎症状的严重程度不相关;治疗后两组患者前列腺炎症状和性功能障碍均有明显改善,但治疗组改善程度明显优于对照组(P<0.01)。结论:心理因素在慢性前列腺炎所致的性功能障碍中起重要作用。心理治疗不但对慢性前列腺炎相关的性功能障碍有明显的疗效,而且可明显改善前列腺炎的症状。