健脾益肾汤联合坦索罗辛治疗良性前列腺增生疗效及对炎性细胞因子、PSA水平的影响

Jianpi Yishen Decoction combined with Tamsulosin in treating benign prostatic hyperplasia and its effects on level of inflammatory cytokines and PSA

目的探讨健脾益肾汤联合坦索罗辛治疗良性前列腺增生疗效及对炎性细胞因子、前列腺特异抗原(PSA)水平的影响。方法选取达州市中西医结合医院2014年5月至2016年5月收治良性前列腺增生患者共150例,以随机数字表法分为对照组(n=75)和观察组(n=75),分别给予坦索罗辛单用和在此基础上加用健脾益肾汤辅助治疗,比较两组患者临床疗效,治疗前后中医证候积分、国际前列腺症状评分(I-PSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)、平均尿流率(Qave)、前列腺体积、炎性细胞因子及PSA水平等。结果对照组和观察组治疗总有效率比较差异有统计学意义(P<0.05);对照组和观察组治疗后排尿困难、尿线细弱、排尿费时费力、夜尿增多、舌淡苔腻及脉细弱评分比较差异有统计学意义(P<0.05);对照组和观察组治疗后I-PSS评分和QOL评分比较差异有统计学意义(P<0.05);对照组和观察组治疗后PVR、Qmax、Qave及前列腺体积比较差异有统计学意义(P<0.05);对照组和观察组患者治疗后炎性细胞因子和PSA水平比较差异有统计学意义(P<0.05)。结论健脾益肾汤联合坦索罗辛治疗良性前列腺增生可有效缓解相关症状体征,提高生活质量,改善尿动力学指标,促进前列腺体积缩小,并有助于调节炎性细胞因子和PSA水平。

Objective To investigate the effects of Jianpi Yishen Decoction Combined with tamsulosin in treating benignprostatic hyperplasia and its effects on level of inflammatory cytokines and prostate specific antigen（PSA）. Methods Atotal of 150 cases of benign prostatic hyperplasia patients were randomly divided into control group（75 cases） andobservation group（75 cases）. Control group was treated with tamsulosin monotherapy;for the observation group,patientswere treated with tamsulosin and Jianpiyishen decoction. The clinical efficacy,TCM syndrome score,international prostatesymptom score（I-PSS）before and after treatment,quality of life score（QOL）,residual urine volume（PVR）,maximumurinary flow rate（Q（max）,mean flow rate（Qave）,prostate volume,inflammatory cytokines and PSA levels werecompared between two groups. Results There was significant difference in the total efficiency between 2 groups（P〈0.05）.There was significant difference in the dysuria,urine line thin urination time-consuming,nocturia,pale tongue,greasy andthready pulse scores between 2 groups（P〈0.05）. There was significant difference in the I-PSS score and QOL scores aftertreatment between 2 groups（P〈0.05）. There was significant difference in the PVR,Qmax,Qave and prostate volume aftertreatment between 2 groups（P〈0.05）. There was significant difference in the inflammatory cytokines and PSA aftertreatment between 2 groups（P〈0.05）. Conclusion Jianpi Yishen Decoction combined with tamsulosin for the treatment ofbenign prostatic hyperplasia could effectively alleviate the symptoms,improve the quality of life,improve urodynamicindex,promote prostate volume reduction,and contribute to the regulation of inflammatory cytokines and PSA level.