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药物联合体外冲击波治疗ⅢA型前列腺炎的临床研究
作者:廖波  邓显忠  程树林  邬韬  李雨根  陈小彬 
单位:川北医学院附属医院 泌尿外科, 四川 南充 637000
关键词:慢性前列腺炎 体外冲击波治疗 药物治疗 慢性骨盆疼痛综合征 
分类号:R697.33
出版年·卷·期(页码):2019·47·第四期(398-402)
摘要:

目的:研究药物联合体外冲击波治疗ⅢA型前列腺炎的临床效果。方法:将96例确诊为ⅢA型前列腺炎的患者按患者意愿分为药物组32例、体外冲击波治疗(ESWT)组28例和联合组36例,分别予单独药物治疗、ESWT和联合治疗,共4周,记录患者治疗前后NIH-CPSI、IPSS、NRS-11量表评分结果和前列腺按摩液(EPS)内白细胞(WBC)数量,通过比较治疗前后各指标的变化和治愈率,评价3种治疗方案的治疗效果。结果:3组患者治疗4周后CPSI、IPSS、NRS-11量表评分及EPS内WBC数量较治疗前均明显下降,CPSI评分联合组较药物组和ESWT组明显降低(P<0.05),药物组与ESWT组差异无统计学意义;NRS-11评分ESWT组和联合组较药物组明显降低(P<0.05),ESWT组与联合组差异无统计学意义;治疗后EPS内WBC数量ESWT组明显高于药物组和联合组。以CPSI评分<9分作为治愈标准,联合组治愈率明显高于药物组和ESWT组。结论:药物联合ESWT治疗ⅢA型前列腺炎能更好地改善患者的前列腺炎相关症状,明显缓解患者盆腔区疼痛症状,减少EPS内WBC数量,较单独药物治疗或ESWT方案有更高的治愈率。

Objective:To study the clinical effect of drugs combined with extracorporeal shock wave in the treatment of type ⅢA prostatitis. Methods:We collected 96 patients who were diagnosed with type ⅢA prostatitis clinically, and these patients were randomly divided into three groups, i.e.,drug treatment group, ESWT group and combination therapy group. The three groups were treated with drugs,ESWT and drugs combined with ESWT respectively. The total treatment time was 4 weeks. The scores of NIH-CPSI, IPSS, NRS-11 and the numbers of white blood cells(WBC) in prostatic secretion(EPS) were recorded before and after treatment. The therapeutic effect was evaluated by comparing the changes of each index before and after the different treatments and the curative rate. Results:After 4 weeks of treatment, the scores of CPSI, IPSS, NRS-11 and numbers of WBC in EPS were significantly decreased in all the three groups compared with those before treatment. After treatment,the CPSI score in the combination therapy group was significantly lower than that in drug and ESWT groups(P<0.05), but there was no significant difference in CPSI score between the drug group and ESWT group. There were no significant differences between each group in IPSS score. The NRS-11 scores of the ESWT group and the combination therapy group were significantly lower than those in the drug group(P<0.05), but there was no significant difference between the ESWT group and the combination therapy group in NRS-11 score. The WBC in the EPS of the ESWT group was significantly higher than that in the drug group and combination therapy group. Patients with CPSI score <9 were recognized as curative standard, the curative rate was significantly different in the three groups. The curative rate of the combined group was 86.11%, which was significantly higher than that of the other two groups. Conclusion:The combination of drug treatment and ESWT can improve prostatitis-related symptoms obviously, relieve the pelvic area pain, and reduce the amount of WBC in EPS, which has a higher curative rate than that of drug therapy or ESWT approach alone.

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