α-受体阻滞剂和生物类黄酮治疗慢性非细菌性前列腺炎的随机对照临床试验

目的 比较盐酸酚苄明和盐酸黄酮哌酯改善慢性前列腺炎患者临床症状的效果。方法 采用随机对照临床试验方法,将60例慢性非细菌性前列腺炎(NIH-Ⅲa型)患者随机分为三组,分别给予安慰剂、竹林胺(盐酸酚苄明)和盐酸黄酮哌酯,连服1个月。在试验起始及结束时分别采用NIH慢性前列腺炎症状指数量表对每一例患者进行测定。结果 试验前三组中年龄、患病时间及NIH-CPSI评分均衡无差异。研究结束时,NIH-CPSI平均值安慰剂组从21.85降到19.55(差异无统计学意义);竹林胺组从21.95降到13.75(P<0.01);盐酸黄酮哌酯组从21.75降到16.95(P<0.05)。NIH-CPSI的降低均伴随有症状的显著改善。结论 在一定时间内竹林胺能被慢性非细菌性前列腺炎患者接受且能显著降低患者的主观症状,盐酸黄酮哌酯虽能改善主观症状,但效果较竹林胺差。

Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis (NIH-Ⅲa):a prospective,placebo-controlled trial

OBJECTIVE: The National Institutes of Health (NIH) category IIIa chronic prostatitis syndromes (non bacterial chronic prostatitis) were common disorders but with few effective therapies. Alpha-blockers and bioflavonoids had recently been reported in randomized controlled trials to improve the symptom of these disorders in a significant proportion of men. The aim of this study was to confirm these findings in a prospective randomized, placebo-controlled trial. METHODS: Forty-five men with category IIIa chronic non bacterial protatitis were randomized into three groups as follows: (1) placebo; (2) phenoxybenzamine-hydrochloride:10 mg two times a day for one month; (3) flavoxate HCI-neptumus: 200 mg three times a day for one month. The NIH chronic prostatitis symptom score was used to grade symptoms at the beginning and conclusion of the study. RESULTS: All the patients in three groups completed the study except three dropout patients in placebo group because of sever symptoms. The three groups were similar in age, duration of symptoms and initial symptom score. Patients taking placebo had a mean improvement in NIH-CPSI from 21.85 to 19.55 (not significant), while the phenoxybenzamine-hydrochloride group had a mean improvement from 21.95 to 13.75 (P < 0.01), and those taking flavoxate HCI-neptumus had a mean improvement from 21.75 to 16.95 (P < 0.05). The decrease in NIH-CPSI was associated with significant improvement in patients' clinical manifestations. CONCLUSION: Therapy with alpha-blockers was well tolerated with significant symptomatic improvement in most men having chronic non-bacterial chronic protatitis while the bioflavonoids group had no significant improvement. Mechanism of both medicines needs further study.