谢建平(深圳市龙岗中心医院中医全科，深圳 龙岗　514800)



加味知柏汤与α受体阻断剂联合治疗慢性前列腺炎的疗效观察

谢建平*(深圳市龙岗中心医院中医全科，深圳 龙岗514800)

DOI10.14009/j.issn.1672-2124.2016.02.010

摘要探讨加味知柏汤与α受体阻断剂联合治疗慢性前列腺炎的临床疗效。方法：选取深圳市龙岗中心医院2013年2月—2014年10月收治的慢性前列腺炎患者114例,按随机数字表法分成2组各57例。对照组患者给予α受体阻断剂治疗，观察组患者在此基础上联合加味知柏汤治疗。比较2组患者治疗前、后慢性前列腺炎症状评分(NIH-CPSI)的差异，记录最大尿流率、平均尿流率及肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)变化情况。结果：观察组患者NIH-CPSI评分由治疗前的(23.7±2.7)分降低为治疗后的(13.4±2.2)分，对照组由治疗前的(23.9±2.6)分降低为治疗后的(16.9±2.4)分，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。观察患者最大尿流率由治疗前的(15.8±5.5)V/(ml·s)升高为治疗后的(21.0±2.2)V/(ml·s)，对照组由治疗前的(15.9±5.3)V/(ml·s)升高为治疗后的(18.9±2.0)V/(ml·s)，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。观察组患者平均尿流率由治疗前的(8.5±3.3)V/(ml·s)升高为治疗后的(12.3±1.9)V/(ml·s)，对照组由治疗前的(8.7±3.1)V/(ml·s)升高为治疗后的(10.5±1.7)V/(ml·s)，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。观察组患者TNF-α、IL-6、IL-8指标由治疗前的(92.7±33.0) pg/ml、(1.7±0.2) μg/ml、(12.6±2.5) μg/ml降低为治疗后的(63.7±15.1) pg/ml、(1.1±0.2) μg/ml、(7.4±1.0) μg/ml，对照组由治疗前的(92.5±33.1) pg/ml、(1.7±0.3) μg/ml、(12.7±2.3) μg/ml降低为治疗后的(79.9±14.7) pg/ml、(1.5±0.2) μg/ml、(9.3±1.3) μg/ml，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。结论：加味知柏汤与α受体阻断剂联合治疗慢性前列腺炎疗效确切，可有效缓解其炎症反应、改善患者前列腺功能，值得临床推广。

关键词加味知柏汤； α受体阻断剂； 慢性前列腺炎

Observation on Efficacy of Modified Zhibai Decoction Combined with α-retardant in Treatment of Chronic Prostatitis

XIE Jianping (Dept.of Traditional Chinese Medicine, Shenzhen Longgang Central Hospital, Shenzhen Longgang 514800, China)

ABSTRACTOBJECTIVE：To investigate the clinical efficacy of modified zhibai decoction combined with α-retardant in treatment of chronic prostatitis. METHODS: 114 cases with chronic prostatitis admitted into Shenzhen Longgang Central Hospital from Feb. 2013 to Oct. 2014 were selected to be divided into two groups via the random number table, with 57 cases in each. The control group were treated with α-retardant therapy, while the observation group additionally received modified zhibai decoction based on the control group. Differences in chronic prostatitis symptom scores (NIH-CPSI) were compared between two groups before and after treatment, changes of maximal urinary flow rate, average urinary flow rate, TNF-α, IL-6 and IL-8 were recorded. RESULTS: After treatment, NIH-CPSI scores in observation group decreased from (23.7±2.7) to (13.4±2.2), and in control group decreased from (23.9±2.6) to (16.9±2.4), the data in two groups were significantly lower than those before treatment (P<0.05), the decline in observation group was greater than that in control group, with statistically significant difference(P<0.05). The maximal urinary flow rate in observation group increased from (15.8±5.5) V/(ml·s) to (21.0±2.2) V/(ml·s), and in control group, it decreased from (15.9±5.3) V/(ml·s) to ( 18.9±2.0)V/(ml·s), the data in two groups were significantly lower than those before treatment (P<0.05), the decline in observation group was greater than that in control group, with statistically significant difference(P<0.05). The average urinary flow rate in observation group increased from (8.5±3.3) V/(ml·s) to (12.3±1.9) V/(ml·s), and in control group, it decreased from (8.7±3.1) V/(ml·s) to ( 10.5±1.7)V/(ml·s), the data in two groups were significantly lower than those before treatment (P<0.05), the decline in observation group was greater than that in control group, with statistically significant difference(P<0.05). TNF-α, IL-6 and IL-8 of observation group all had a significant decrease from (92.7±33.0) pg/ml,(1.7±0.2) μg/ml and (12.6±2.5) μg/m to (63.7±15.1) pg/ml,(1.1±0.2) μg/ml,(7.4±1.0) μg/m; of control group, the data decreased from (92.5±33.1) pg/ml, (1.7±0.3) μg/ml and (12.7±2.3) μg/ml to (79.9±14.7) pg/ml,(1.5±0.2) μg/ml and (9.3±1.3) μg/ml, the decline in observation group was greater than that in control group, with statistically significant difference(P<0.05). CONCLUSIONS: The efficacy of modified zhibai decoction combined with α-retardant therapy in treatment of chronic prostatitis is significantly effective, which can relieve the inflammatory reactions, improve the prostate function of patients and is worthy of the clinical promotion.

KEYWORDSModified Zhibai decoction; α-retardant; Chronic prostatitis

据不完全资料统计，我国的前列腺炎患者9成以上确诊为ⅢA型[1]，且患病人数呈逐年递增趋势，严重影响患者健康安全及生活质量，如何选择最佳疗法以全面提升患者临床疗效、改善其预后水平也成为各学者探究的热点话题。由于慢性前列腺炎具有病程长、临床症状多变等特点，现代医学仍未就其病机予以准确定论[2]，为治疗工作的顺利开展增加了难度。故部分研究者将重点由单纯西医治疗逐渐向中西医结合方向过渡，试图利用西医抗炎速度快、中医标本兼治的优势促进患者病情转归。……