度洛西汀治疗慢性非感染性前列腺炎的疗效观察

Efficiency of duloxetine in treatment of chronic non-infectious prostatitis

目的观察度洛西汀治疗慢性非感染性前列腺炎的疗效。方法选取浙江大学医学院附属第一医院2014年1至12月收治的慢性非感染性前列腺炎患者90例为研究对象,按随机数字表法分为观察组(度洛西汀+常规治疗)、对照组(仅常规治疗),每组45例。治疗前及治疗8周末,采用美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)、汉密尔顿抑郁量表17项(HAMD-17)、汉密尔顿焦虑量表(HAMA)、90项症状清单(SCL-90)评价疗效,采用副反应量表(TESS)评估药物不良反应。结果治疗前,两组患者NIH-CPSIH、HAMA、HAMD-17及SCL-90评分比较,差异均无统计学意义(均P>0.05)。治疗8周末,观察组上述量表评分均低于对照组,差异均有统计学意义(均P<0.05);两组TESS评分比较,差异无统计学意义(P>0.05);观察组血压升高、恶心发生率均明显高于对照组(均P<0.05),但两组患者口干、腹泻、便秘、失眠、头痛、呕吐等不良反应发生率比较,差异均无统计学意义(均P>0.05)。结论度洛西汀治疗慢性非感染性前列腺炎效果明显,可改善患者抑郁、焦虑情绪及躯体疼痛症状,且无明显药物不良反应。

Objective To observe the clinical efficacy and adverse reactions of duloxetine in the treatment of chronic non infectious prostatitis.Methods Ninety patients with chronic non-infectious prostatitis in the First Affiliated Hospital of Zhejiang University Medical College from January to December 2014 were randomly divided into observation group and control group with 45 cases in each group.Patients in observation group were treated with conventional therapy plus duloxetine hydrochloride enteric coated capsules,while those in control group were treated with conventional therapy only.All subjects received cognitive behavioral therapy for 8 weeks.The NIH-chronic prostatitis symptom index(NIH-CPSI),Hamilton depression scale(HAMD-17),Hamilton anxiety scale(HAMA)and symptomchecklist-90(SCL-90)were used for evaluation of patients before and after treatment.The safety was assessed with treatment emergent side-effect scale(TESS).Results Before treatment,there were no statistically significant differences in NIH-CPSIH,HAMA,HAMD-17 and SCL-90 scores between two groups(all P<0.05).After 8 weeks of treatment,the scores of the above scales in observation group were lower than those in control group(all P<0.05).There was no significant difference in TESS scores between the two groups(P>0.05).The incidence of elevated blood pressure and nausea in observation group was significantly higher than that in control group(P<0.05),but there was no statistical significance in the incidence of adverse reactions such as dry mouth,diarrhea,constipation,insomnia,headache and vomiting between the two groups(all P<0.05).Conclusion Duloxetine is effective in the treatment of chronic non-infectious prostatitis,and can improve the depression,anxiety and physical pain symptoms of patients at the same time without obvious side effects.