三种中医治则治疗慢性前列腺炎/慢性盆腔疼痛综合征临床观察

Clinical Study on Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome by Three Different TCM Principles

目的评价三种不同中医治则治疗慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者的疗效。方法218例CP/CPPS患者随机分成4组,分别用疏肝理气的艾可汤剂(A组)、清热利湿的八正散汤剂(B组)、活血化瘀的前列腺炎汤剂(C组)和安慰剂(D组)盲法给药治疗。于治疗前、治疗2周和4周时测定慢性前列腺炎症状指数(NIH-CPSI)、临床症状(包括疼痛、尿路症状、生活质量)和中医证候量化积分。结果治疗2周时A组NIH-CPSI总分、各项临床症状及中医证候量化积分改善优于其他3组(P<0.05);治疗4周后A组NIH-CPSI总积分及疼痛积分、生活质量积分改善优于其他3组(P<0.05),而尿路症状积分及中医证候量化积分A组优于B组及D组,与C组比较差异无统计学意义。A组及D组未发生不良反应,而B组、C组均出现不良反应。结论疏肝理气治疗CP/CPPS疗效好、起效快、安全性高,是中医治疗CP/CPPS重要法则。

Objective To assess the efficacy of various therapeutic principles of TCM in treating patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods Adopting blinded controlled trial method, 218 patients with CP/CPPS were randomly assigned to 4 groups： Group A treated with Aike Decoction for smoothing Gan-qi; Group B with Bazhengsan Decoction for clearing heat and removing dampness; Group C with Qianliexianyan Decoction for promoting blood circulation to remove stasis; and Group D with placebo. The scores of N IH chronic prostatitis symptom index （NIH-CPSI）, clinical symptoms, including pain, symptoms of urinary tract and quality of life （QOL）, and TCM syndrome integral were estimated at the beginning, the end of the 2nd and 4th week in the study. Results Compared with the others, Group A showed a superiority in im- proving NIH-CPSI, scores of various clinical symptoms and TCM syndrome integral at the 2nd week, and im- proving NIH-CPSI, scores of pain and QOL at the 4th week （all P〈0.05）, while the improvement on urinary tract symptoms and TCM syndrome integral in Group A at the 4th week were better than those in Group B and D, but insignificantly different to those in Group C, respectively. No adverse reaction occurred in Group A and D, but it did occur in the other two groups. Conclusion TCM therapy for smoothing Gan-qi shows good effica- cy with quick initiating and high safety, it is an important principle for the treatment of CP/CPPS.