虎杖愈浊汤治疗慢性盆腔疼痛综合征湿热瘀证临床研究

Clinical study of Huzhang Yuzhuo Tang in treating chronic pelvic pain syndrome of damp-heat and blood-stasis syndrome

目的:评价虎杖愈浊汤治疗慢性盆腔疼痛综合征(CPPS)湿热瘀阻证的有效性,并探讨其治疗机制。方法:93例患者随机分为中药组48例,对照组45例。中药组口服虎杖愈浊汤,每日1剂,分2次服;对照组口服塞来昔布胶囊200mg,每日1次。疗程均为4周。治疗前后观察慢性前列腺炎症状评分(CPSI)及中医证候评分,ELISA法测定前列腺液(EPS)中IL-1β、PGE2含量,分析治疗前后的差异并进行组间比较。结果:治疗后中药组CPSI疼痛不适、排尿症状、生活质量的影响及总评分较治疗前分别下降了4.58分、2.98分、2.92分和9.75分,对照组分别下降了5.82分、2.87分、2.62分和11.51分,两组间差异均无统计学意义。中药组中医证候积分下降了9.94分,对照组下降了11.73分,总有效率分别为72.92%和86.67%,两组间差异无统计学意义。治疗后中药组IL-1β、PGE2分别降低了0.46ng/mL和471.31fg/L,对照组分别降低了0.55ng/mL和688.39fg/L,对照组均优于中药组(P<0.01)。结论:虎杖愈浊汤治疗CPPS湿热瘀阻证有效,其疗效机制与降低前列腺组织中IL-1β和PGE2含量有关。

Objectives： To evaluate the effect of Huzhang Yuzhuo Tang in treating chronic pelvic pain syndrome（CPPS） of damp-heat and blood-stasis syndrome and explore the mechanism of therapy.Methods： 93 patients were randomly divided into Chinese medicine group and control group to receive a 4-week oral course of either Huzhang Yuzhuo Tang twice daily or Celecoxib 200 mg once daily.The content of IL-1β and PGE2 in EPS were measured by ELISA,scores of NIH-CPSI and Chinese medicine syndrome were assessed.The differences were analyzed at baseline and 4 week after therapy completion in both groups.Results： After the treatment,items of NIH-CPSI of pain,urinary symptoms,quality of life and total score in Huzhang Yuzhuo Tang group decreased by 4.58,2.98,2.92 and 9.75 with the decrement of 5.82,2.87,2.62 and 11.51 in Celecoxib group respectively.No significant difference was found between the two groups.The decrement of Chinese medicine syndrome score and total effective rate in Huzhang Yuzhuo Tang group were 9.94,72.92% and 11.73,86.67% in Celecoxib group with no significant difference between the two groups.The decrement of IL-1β and PGE2 in Celecoxib group were 0.55ng/mL and 688.39fg/L,superior to 0.46ng/mL and 471.31fg/L in Huzhang Yuzhuo Tang group（P0.01）.Conclusions：Huzhang Yuzhuo Tang is effective in treating CPPS of damp-heat and blood-stasis syndrome and the mechanism of therapy was related to the decrement of IL-1β and PGE2.