临床联合药物治疗慢性前列腺炎疗效观察（附328例报告）

目的探讨慢性前列腺炎联合药物治疗的临床疗效。方法选择中、重度慢性前列腺炎328例,其中细菌性前列腺炎36例,非细菌性前列腺炎292例,按照美国国立卫生研究所（NIH）制定的前列腺症状评分标准（CPSI）和前列腺按摩液（EPS）标准变化及细菌学检查结果评估疗效。应用敏感抗生素,α1受体阻滞剂,选择性COX-2抑制剂,中成药等联合治疗1.5～3个月,对比分析疗效。结果 328例平均随访11.8个月,行两次CPSI,平均15.4分,与治疗前平均33.6分比较差异有统计学意义（P〈0.05）。依据CPSI进行疗效判定,治愈16.7%,显效50.4%,有效19.8%,无效14%,总有效率86.9%;治疗后平均WBC11.6个/HP与治疗前（32.4个/HP）比较差异有统计学意义（P〈0.05）。36例慢性前列腺炎患者治疗后,两杯判定试验（PPMT）法行细菌培养,26例转为阴性,转阴率72.2%。结论两杯判定实验对慢性前列腺炎分类简单易行,CPSI是一种较好疗效评价方法,合适的抗生素,α1受体阻滞剂,选择性COX-2抑制剂和中药等联合应用对慢性列腺炎有较好疗效。

A clinical survey of combined use of different drugs in the treatment of chronic prostatitis(report of 328 cases)

Objective To study the efficacy of consecutive drugs in the treatment of chronic prostatitis.Methods 328 cases of moderate serious chronic prostatitis were treated with consecutive drugs with sensitive antibiotics,α1-blocker,inhibitor of cox-2 and traditional Chinese herb,36 cases being chronic bacterial and 292 nonbacterial.They were classified and evaluated according to the CPSI EPS examinations as analyzed by T test.Results All cases were followed up for an average of 11.8 months（8～18months）.The average CPSI score was 33.6（32.7±5.3） before treatment and 15.4（12.8±7.3） after treatment（P0.05）.Based on the study of CPSI,the curative rate was 16.7%,the remarkable effective rate 50.4%,and the improving rate was 19.8%,the total effective rate being 86.9%,whereas the no effective rate was 14%.The average WBC count in EPS after treatment was 11.6（11.6±10.9）and 32.4（32.4±29.7） before treatment（P0.05）.36 cases of chronic bacterial prostatitis had posiaive bacterial culture of EPS,26 of which turned negative after treatment and the negative rate being 72.2%.Conclusion PPMT is a reliable method to diagnose prostatitis,and easy to carry out.NIH-CPSI is a reliable method to evaluate the drug therapy.The consecutive drugs treatment,including the proper antibiotics,α1-blocker,the inhibitor of COX-2 and traditional Chinese herb can be an effective therapy for chronic prostatitis.