生物反馈联合药物治疗对慢性前列腺炎／慢性骨盆疼痛综合征患者前列腺液中干扰素γ及转化生长因子β1水平的影响

The effect of biofeedback combined with drugs therapy on interferon-γ and transforming growth factor-β1 in expressed prostatic secretions of patients with chronic prostatitis / chronic pelvic pain syndrome

目的探讨生物反馈联合药物治疗对慢性前列腺炎／慢性骨盆疼痛综合征（CP／CPPS）患者前列腺液中干扰素γ（INF-γ）及转化生长因子β1（TGF-β1）表达的影响。方法将55例CP／CPPS患者根据美国国立卫生研究院（NIH）前列腺炎分型标准分型后均接受生物反馈治疗20次、每次20min，同时给予常规药物治疗。治疗前后分别评价NIH慢性前列腺炎症状指数（NIH-CPSI）评分，并采用双抗体夹心酶联免疫吸附试验法测定16例健康男性及各型CP／CPPS患者治疗前后前列腺液中INF-γ、TGF-β1的表达水平。结果55例CP／CPPS患者NIH．CPSI总分治疗前后分别为（26．36±6．16）分和（10．24±5．18）分，症状程度评分治疗前后分别为（19．59±4．67）分和（7．35±3．46）分，治疗后均较治疗前改善，差异有统计学意义（P〈0．01）。CP／cPPsⅢA型及ⅢB型患者治疗前前列腺液中INF-γ、TGF-β1水平均明显高于健康男性[（14．89±7．43）、（13．51士5．88）ng／L比（7．56±1．52）．g／L，（8464．41±4604．49）、（7985．19±5068．07）ng／L比（2475．50±973．42）ng／L]，差异有统计学意义（P〈0．01）；治疗后前列腺液中INF-γ、TGF-β1水平[（8．63±1．86）、（8．23±1．75）ng／L和（2887．32±926．45）、（2576．50±955．38）ng／L]均较治疗前明显降低，差异有统计学意义（P〈0．01），与健康男性比较差异无统计学意义（P〉0．05）。结论生物反馈联合药物治疗CP／CPSS安全、有效，可显著降低其前列腺液中INF-γ及TGF-β1表达。

Objective To study the effect of biofeedback combined with drugs therapy on interferon- γ （INF）- γ , and transforming growth factor- β1 （TGF- β1） in expressed prostatic secretions of patients with chronic prostatitis/chronic pelvic pain syndrome（CP/CPPS）. Methods Fifty-five patients who had been diagnosed as CP/CPPS were classified according to U.S. National Institutes of Health （NIH） classification system for prostatitis and received the treatment of biofeedback therapy （20 times and 20 min every time） in addition to the general drugs. The efficacy was evaluated by the NIH chronic prostatitis symptom index （NIH-CPSI） before and after treatment. INF-γ and TGF-β1 levels were measured in expressed prostatic secretions of 55 patients with CP/CPPS and 16 normal controls by double antibody enzyme-linked immune sandwich assay. Results The overall NIH-CPSI scores were （26.36 ± 6.16） scoresand （ 10.24 ± 5.18） scores, arid symptom degree scores were （ 19.59 ±4.67 ） scores and （7.35 ± 3.46） scores pre-and post-treatment in 55 patients with CP/CPPS, significant differences of reduces were found compared with pre-treatment （P 〈 0.01 ）. INF-γ and TGF-β1 levels in expressed prostatic secretions pre-treatment in CP/CPPS patients withⅢA type andⅢI B type were higher than those in normal controls [ （ 14.89 ±7.43）, （ 13.51 ±5.88） ng/L vs. （7.56 ± 1.52） ng/L, （8464.41 ± 4604.49）, （7985.19 ± 5068.07） ng/L vs. （2475.50 ± 973.42） ng/L], there were significant differences （P 〈 0.01 ） ; which post-treatment were lower than those pre-treatment [（8.63± 1.86）, （8.23 ± 1.75） ng/L and （2887.32± 926.45）, （2576.50 ±955.38） ng/L] ,and there were significant differences （P 〈 0.01 ）,but there was no significant difference compared with normal controls （P 〉 0.05）. Conclusion Biofeedback combined with drugs therapy in treatment of CP/CPPS is effective and safe. And the expression of INF-γ and TGF-β1 in expressed prostatic secretions can be significantly reduced by this therapy.