甲磺酸多沙唑嗪联合翁沥通治疗前列腺增生的效果及对MMP-9、S100P水平的影响

Effect of doxazosin mesylate combined with Wenglitong on benign prostatic hyperplasia and its effect on matrix metalloproteinase-9 and S100 calcium-binding protein P levels

目的观察甲磺酸多沙唑嗪联合翁沥治疗前列腺增生(BPH)的临床效果,并探讨其对患者基质金属蛋白酶-9 (MMP-9)及S100钙结合蛋白P (S100P)水平的影响。方法选取2016年4月至2018年3月于上海市浦东新区光明中医院就诊的240例BPH患者,根据随机数表法将其分为对照组和观察组,每组120例。两组患者均限制酒精、咖啡因等摄入,控制睡前的饮水量。对照组给予甲磺酸多沙唑嗪控释片,观察组在对照组治疗的基础上给予翁沥通胶囊,疗程均为4周。比较两组患者的临床疗效、不良反应发生率、治疗前后国际前列腺症状评分(IPSS)、受困扰评分(QOL)及前列腺体积,同时比较两组患者的S100P、MMP-9阳性率。结果观察组患者的临床总有效率为91.7%,明显高于对照组的82.5%,差异具有统计学意义(P<0.05);观察组与对照组不良反应发生率分别为2.5%、3.3%,差异无统计学意义(P>0.05);治疗后,观察组患者的MPP-9和S100P阳性率分别为85.0%、7.5%,明显低于对照组的93.3%、15.8%,差异均具有统计学意义(P<0.05);治疗前,观察组患者的IPSS评分、QOL评分及前列腺体积分别为(21.95±3.91)分、(3.94±1.15)分、(73.41±29.45) m L,对照组分别为(22.46±3.89)分、(3.89±1.21)分及(74.03±30.92) mL,两组比较差异均无统计学意义(P>0.05);治疗后,观察组患者的IPSS评分及QOL评分分别为(13.49±6.84)分、(2.03±0.94)分,明显低于对照组的(16.56±7.42)分、(2.52±1.18)分,差异均有统计学意义(P<0.05);但前列腺体积无明显变化[(72.19±11.43) m L vs (73.51±33.06) m L],差异无统计学意义(P>0.05)。结论甲磺酸多沙唑嗪联合翁沥通治疗前列腺增生具有良好的临床疗效,其不仅能缓解患者尿路梗阻症状,明显降低MMP-9、S100P水平,而且还改善患者的生活质量。

Objective To observe the clinical effect of doxazosin mesylate combined with Wenglitong in the treatment of benign prostatic hyperplasia(BPH), and to explore its clinical effect on the levels of matrix metalloproteinase-9(MMP-9) and S100 calcium-binding protein P(S100 P). Methods A total of 240 BPH patients who were admitted to Guangming Chinese Medicine Hospital of Pudong New Area of Shanghai from April 2016 to March 2018 were randomly divided into a control group and an observation group according to the random number table method, with 120 cases in each group. Both groups of patients restricted the intake of alcohol and caffeine, and controlled the amount of water before going to bed. The control group was given doxazosin mesylate controlled release tablets, and the observation group was further given Wenglitong capsule on the basis of the control group. The course of treatment both was 4 weeks. The clinical efficacy, adverse reaction rate, international prostate symptom score(IPSS), quality of life(QOL),and prostate volume before and after treatment were compared between the two groups. The positive rates of S100 P and MMP-9 were compared between the two groups. Results The total effective rate of the observation group was 91.7%,which was significantly higher than 82.5% of the control group, and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group and the control group were 2.5% and 3.3%, respectively, and the difference was not statistically significant(P>0.05). After treatment, the positive rates of MPP-9 and S100 P in the observation group were 85.0% and 7.5%, respectively, which were significantly lower than corresponding 93.3% and 15.8%in the control group(P<0.05). Before treatment, the IPSS score, QOL score and prostate volume of the observation group were respectively 21.95±3.91, 3.94±1.15, 73.41±29.45 m L, versus 22.46±3.89. 3.89±1.21 and 74.03±30.92 m L in the control group(P>0.05). After treatment, the IPSS score and QOL score of the observation group were 13.49±6.84 and2.03±0.94, which were significantly lower than corresponding 16.56±7.42 and 2.52±1.18 of the control group(P<0.05);but the prostate volume did not change significantly:(72.19±11.43) vs(73.51±33.06), P>0.05. Conclusion Doxazosin mesylate combined with Wenglitong has a good clinical effect in the treatment of benign prostatic hyperplasia, which can not only relieve the symptoms of urinary obstruction, significantly reduce the levels of MMP-9 and S100 P, but also improve the patients’ quality of life.