慢性前列腺炎辨证分型与尿流曲线变化相关性的研究

Relativity between syndrome type based on syndrome differentiation and urine flow curve in patients with prostatitis

目的探讨慢性前列腺炎辨证分型与尿流曲线变化的相关性。方法选择符合慢性前列腺炎诊断标准的患者102例,按中医辨证分为湿热型、血瘀型、湿热瘀滞型、肾虚湿热型、肾虚血瘀型5组,并以正常人20例作为对照组,测试全部人员尿流曲线图,通过检测结果的分析研究,得出慢性前列腺炎不同证型尿流曲线特点、同一证型尿流曲线变化的规律性。结果①对照组尿流曲线呈"钟"型,或称高尖型、高丘型、丘状型;湿热证、肾虚湿热证尿流曲线呈低平型、低丘型或不规则起伏型;血瘀证、肾虚血瘀证和湿热瘀滞证尿流曲线呈重度低平型、长斜坡型、不规则起伏型、间断丘状型。②以上各证的最大尿流率、平均尿流率和2 s时的尿流率均小于正常对照组,达峰时间大于正常对照组,均有显著差异。③湿热证、肾虚湿热证与血瘀证、湿热瘀滞证、肾虚血瘀证相比,最大尿流率、平均尿流率均大于后三组,达峰时间小于后三组,具有显著性差异。湿热证、肾虚湿热证可见各指标无明显差异;血瘀证、湿热瘀滞证、肾虚血瘀证各组间亦无明显差异。结论慢性前列腺炎综合征患者存在后尿道梗阻现象,后尿道功能性梗阻导致前列腺内尿液返流是其重要发病机制之一。慢性前列腺炎综合征辨证分型中有瘀滞存在的其后尿道梗阻现象愈明显。

Objective To investigate the relativity between the syndrome type based on syndrome differentiation and theurine flow curve in patients with chronic prostatitis（CPS）, Method 102 patients who fitted the clinical diagnostic criteria for chronic prostatitis were divided into five groups,“damp-heat syndrome” group,“blood stasis syndrome” group,“damp-heat and blood stasis syndrome” group,“damp- heat and kidney-deficiency syndrome” group and “kidney-deficiency and blood stasis syndrome” group, with 20 normal persons as control, The urine flow charts of all cases were measured. Then the data were collected and analyzed statistically to find out the characteristics of urine flow curve in different syndrome types and the change regularity of urine flow curve in the same symptom type of chronic prostatitis. Results 1. In the control group the urine flow curve showed clock shape, while in the “damp-heat syndrome” group and “damp-heat and kidney-deficiency syndrome” group the urine flow curve showed low hillock shape or irregular fluctuation, and in the “blood stasis syndrome” group ,“damp-heat and blood stasis syndrome” group and “kidney-deficiency and blood stasis syndrome” group the urine flow curve showed severe low hillock shape, long slope shape and interrupted hillock shape. 2. The maximaland average urine flow rates and the urine flow rates after two seconds in the five groups were lower than those in the control group, with significant differences. 3. Compared with the “damp-heat syndrome” group and the “damp-heat and kidney-deficiency syndrome” group, the maximal and average urine rates were lower and the peak reaching times were higher in the “blood stasis syndrome” group,“damp-heat and blood stasis syndrome” group and “kidney-deficiency and blood stasis syndrome” group, with significant differences. There were not significant differences in the maximal and average urine rates and peak reaching times between the “damp-heat syndrome syndrome” group and the “damp-heat and kidney-deficiency syndrome” group and between the “blood stasis syndrome” group,“damp-heat and blood stasis syndrome” group and “kidney-deficiency and blood stasis syndrome”group. Conclusion The patients with chronic prostatitis have obstruction of posterior urethra. It is one of the significant pathological mechanisms that the functional obstruction of posterior urethra leads to urine back flow to prostate. It is more obvious in the syndrome types of CPS patients with stasis.