针刺联合西药治疗慢性前列腺炎/慢性骨盆疼痛综合征:随机对照研究

Acupuncture combined with western medicine for CP/CPPS:a randomized controlled trial

目的:比较针刺联合西药与分别单独运用针刺、西药治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床疗效差异。方法:将90例患者随机分为针药组、针刺组和西药组,每组30例。针药组予以针刺联合西药治疗,针刺头穴取神庭、囟会、前顶、百会、承光、通天等,体穴取中极、关元、膀胱俞、次髎等,每天1次,每次30min;西药口服左氧氟沙星0.2g、每天2次,盐酸坦索罗辛0.2mg、每天1次。针刺组、西药组分别予以和针药组相同的针刺、西药单独使用治疗。12d为一疗程,共观察2个疗程。比较3组治疗后的临床疗效,及治疗前后美国国立卫生研究院慢性前列腺炎症状积分(NIH-CPSI)总评分及疼痛症状积分、焦虑自评量表(SAS)评分与抑郁自评量表(SDS)评分。结果:研究过程中脱落2例,最后针药组30例、西药组29例、针刺组29例纳入统计。治疗后针药组痊愈21例、显效6例、有效2例、无效1例,针刺组分别为12、10、5、2例,西药组分别为11、12、4、2例,针药组优于其他两组(均P<0.05);各组治疗后各项评分均得到改善(均P<0.01);针药组改善NIH-CPSI总评分及SAS、SDS评分优于针刺组与西药组(P<0.05,P<0.01);针药组、针刺组改善NIH-CPSI疼痛症状评分优于西药组(P<0.05,P<0.01),而针药组与针刺组差异无统计学意义(P>0.05)。结论:针刺联合西药治疗CP/CPPS疗效优于单独使用针刺或西药治疗,且能够缓解患者前列腺炎症状以及焦虑、抑郁状态。

Objective To compare the clinical efficacy differences among acupuncture combined with western medicine, acupuncture alone and western medicine alone for chronic prostatitis/chronic pelvic pain syndrome （CP/ CPPS）. Methods Ninety patients were randomly assigned into a needle-medicine group, an acupuncture group and a western medicine group, 30 patients in each group. The patients in the needle-medicine group were treated with acupuncture combined with western medicine; the scalp points included Shenting （GV 24）, Xinhui （GV 22）, Qianding （GV 21）, Baihui （GV 20）, Chengguang （BL 6）, Tongtian （BL 7）, etc. The body points were Zhongji （CV 3） , Guanyuan （CV 4）, Pangguangshu （BL 28）, Ciliao （BL 32）, etc. The acupuncture was given 30 min per treatment, once a day, Besides, oral administration of 0.2g levofloxacin （twice per day） and 0.2 mg tamsulosin （once a day） was applied. The patients in the acupuncture group and western medicine group were treated by acupuncture and western medicine respectively. 12-d treatment was taken as one session, and totally 2 sessions were given. The clinical efficacy of the three groups after treatment was compared as well as the National Institutes of Health-Chronic Prostatitis Symptom Index （NIH-CPSI） total score and pain score, self-rating anxiety scale （SAS） and self-rating depression scale （SDS） before and after treatment. Results During the trial two patients dropped out, as a result, 30 patients in the needle-medicine group, 29 patients in the acupuncture group and 29 patients in the western medicine group were included in the analysis. After treatment, 21 patients were cured, 6 patients were markedly effective, 2 patients were effective and 1 patient failed in the needle-medicine group;12 patients were cured, 10 patients were markedly effective, 5 patients were effective and 2 patients failed in the acupuncture group; 11 patients were cured, 12 patients were markedly effective, 4 patients were effective and 2 patients failed in the medicine group; the efficacy in the needle-medicine group was superior to those in the acu- puncture group and medicine group （both P〈0.05）. Each score was improved after treatment in each group （all P〈0.01） ; the total score of NIH-CPSI as well as SAS and SDS scores in the needle-medicine group were superior to those in the acupuncture group and medicine group （P〈0.05, P〈0.01）; the pain scores of NIH-CPSI in needle- medicine group and acupuncture group were superior to that in the medicine group （P〈0.05, P〈0.01）, but the difference between the needle-medicine group and acupuncture group was not significant （P〉0.05）. Conclusion The efficacy of acupuncture combined with western medicine for CP/CPPS is superior to that of acupuncture alone and western medicine alone, which could improve the symptom of prostatitis as well as status of anxiety and depression.