α-受体阻滞剂和抗抑郁药联合治疗Ⅲ型前列腺炎

Combination therapy of α -blockers and antidepressive drug for treatment of CP/CPPS

目的研究α-受体阻滞剂和抗抑郁药联合治疗Ⅲ型前列腺炎的效果。方法本组48例被诊断为Ⅲ型前列腺炎（CP／CPPS）的患者，年龄20-50岁，平均30岁。均有会阴区域疼痛、尿频及紧张、焦虑等症状。病程3月。2年，平均18个月。均有抗生素治疗史，疗效不佳。采用α-受体阻滞剂（多沙唑嗪控释片4mg／d或坦索罗辛2mg／d口服）、抗抑郁药（舍曲林50mg／d或文拉法辛75mg／d口服）联合疗法，3个月为一疗程。在治疗前、治疗后4周、8周和12周对患者进行美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）评分并记录不良反应情况。疗效评定标准为：（1）显效：NIH-CPSI较治疗前下降〉15分：（2）有效：NIH-CPSI较治疗前下降〉5分：（3）无效：NIH-CPSI较治疗前下降〈5分或上升。总有效率为显效率与有效率之和。结果显效16例，有效25例，无效4例，总有效率91％（41／45）。2例患者因药物不良反应退出治疗。结论α-受体阻滞剂和抗抑郁药联合治疗方案安全有效，可以明显缓解Ⅲ型前列腺炎患者的临床症状。

Objective To investigate the effect of treatment with α-receptor inhibitor and antidepressive drug in patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. Methods A total of 48 patients with CP/CPPS were enrolled in this study. Whose age range is from 20 to 50 years old, （Mean age 30）. All patients had symptoms of pain in the region of perineum, urine frequency, mental stress and anxiety. All of them had been treated with antibiotics but with Ix）or effect. Mean course of disease was 10 （range from 3 to 24） months. All patients received 3-months-combination therapy of a-receptor inhibitor （doxazosin 4mg/d or tamsulosin 2mg/d） and antidepressive drug （sertraline 50mg/d or venlafzxine75-150mg/d）. And then they were evaluated at time pretreatment and 4, 8, 12 weeks posttreatment respectvely by the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and adverse events. Assessment criteria： （1）marked effective： decrease of NIH-CPSI score was more than 15; （2）effective： the decrease of NIH-CPSI score was more than 5; （3）no effective： decrease of NIH-CPSI score was less than 5. The total effective rate was the sum of marked effective rate and effective rate. Results There were 16 patients with marked effective, 25 patients with effective and 4 cases with no effect. Total effective rate was 91 percent （41/45）. Two patients withdrew the treatment due to adverse drug reaction in this study. Conclusion Combination therapy of α-receptor inhibitor and antidepressive drug is safe and effective in managing CP/CPPS patients.