体外冲击波治疗ⅢB型慢性前列腺炎患者的疗效及机制

Effect and mechanism of extracorporeal shock wave therapy on patients with type ⅢB chronic prostatitis(CP/CPPS)

目的阐述体外冲击波治疗(extracorporeal shock wave therapy,ESWT)对ⅢB型慢性前列腺炎(CP/CPPS)患者的疗效及其可能的治疗机制。方法收集2015年6月至2017年2月在我科门诊诊治的90例CP/CPPS患者,采用随机数字表法分为试验组与对照组,各45例。对照组给予体外热疗治疗,试验组予ESWT治疗,两组均治疗2个疗程。治疗后收集两组患者慢性前列腺炎症状评分(NIH-CPSI)、国际前列腺症状评分(IPSS)、前列腺液中IL-8、TNF-α、IL-1β、卵磷脂小体含量变化及尿液中IL-8、TNF-α、IL-6的含量变化。结果治疗2个疗程,与对照组相比,试验组总体有效率明显提高(91.11%vs.66.67%,P<0.05);NIH-CPSI(13.12±1.71 vs.18.16±1.33,P<0.05)和IPSS(8.03±1.78 vs.13.04±1.89,P<0.05)评分明显降低。在炎症影响方面,与对照组相比,试验组前列腺液中卵磷脂小体含量明显升高,前列腺液和尿液中炎性因子IL-8、TNF-α、IL-1β水平明显降低。结论与体外热疗相比,ESWT治疗ⅢB型CP/CPPS是安全有效的,其可能的作用机制与降低前列腺局部炎症反应有关。

Objective To investigate the effect and mechanism of extracorporeal shock wave therapy （ESWT） on type BIB chronic prostatitis. Methods A total of 90 patients with CP/CPPS in our department from June 2015 to February 2017 were collected and randomly divided into experimental and control groups, each with 45 cases. The control group was treated with hyperthermia. The experimental group was treated with ESWT. Both two groups were treated for 2 courses. Following parameters were collected after two groups were treated for 2 courses ： chronic prostatitis symptom score （NIH-CPSI） , the International Prostate Symptom Score （IPSS） , the content changes in prostate fluid IL-8, TNF- alpha, IL-1 beta, lecithin and the content change of urine IL-8, TNF- alpha, IL-6. Results After 2 courses of treatment, compared with the control group, the overall efficiency of experimental group was increased （91.11% vs. 66.67% ,P〈0.05）. NIH-CPSI（13.12 ± 1.71 vs. 18.16 ± 1.33,P〈0.05）and IPSS （8.03 ±1.78 vs. 13.04 ± 1.89, P〈0.05） scores were decreased. In terms of inflammatory, compared with the control group, in the experimental group, the content of lecithin body was significantly increased. The levels of inflammatory factors IL-8, TNF-α, IL-1β were significantly decreased in the prostatic fluid and urine. Conclusion ESWT is safe and effective in the treatment of type m B prostatitis, which may be caused by reducing the local inflammatory response in the prostate.