阶梯式治疗慢性前列腺炎／慢性盆底疼痛综合征的疗效观察（附147例报告）

Study on treatment of chronic prostatitis / chronic pelvic pain syndrome using stepwise therapy （report of 147 cases）

目的探索慢性前列腺炎／慢性盆底疼痛综合征的阶梯式治疗手段的结果。方法全部147例病人使用慢性前列腺炎症状积分指数（NIH—CPSI）评分和SGA（全球主观症状评估）评分进行评估，治疗方法依次为：抗生素、抗炎药、α受体阻滞剂和抗焦虑抑郁药。结果患者平均年龄42岁，病程平均1．6年。根据尿与前列腺液的培养和常规检查，11.8％为Ⅱ型前列腺炎；另外88．2％是Ⅲ型前列腺炎，这其中42．4％属于Ⅲa，其余45．8％属于Ⅲb。这些病人（147例）的NIH—CPSI评分从最初的（23．2±5．6）下降到（12．5±8．7）（P〈0．001），根据SGA评分，其中82％为好转，12％无变化，6％恶化。结论阶梯式应用抗生素、抗炎药、CI受体阻滞剂和抗焦虑抑郁药可以成功地治愈绝大多数的慢性前列腺炎／慢性盆底疼痛综合症的病人。

Objective To evaluate the treatment of chronic prostatitis/chronic pelvic pain syndrome using stepwise therapy. Methods A total of 271 patients were assessed by the NIH-CPSI and SGA. The sequence modality therapy was as follow： antibiotics, anti-inflammatory phytotherapy, a -blockers and antianxiety ＆ antidepressant. Results Mean age of patients was 42 years old and median symptom history was 1.6 years. Based on results of bacterial culture and routine examination of urine and prostatic fluid, 11.8% of the cases were type II prostatitis, other 88.2% were type Ⅲ prostatitis including 42.4% type Ⅲ and 45.8% Ⅲb. The score on the NIH-CPSI were changed from （23.2±5.6） to （12.5±8.7） （P〈0.001）. Based on SGA score, 82% of the cases were better, 12% were the same and 6% were worse. Conclusion Stepwise modality therapy with antibiotics, anti-inflammatory phytotherapy, a -blockers and antianxiety ＆ antidepressant was effective for treatment of most patients with chronic prostatitis/chronic pelvic pain syndrome.