瘀热型慢性前列腺炎与心理性因素及性功能的相关性

Associations of stasis-heat type chronic prostatitis with psychological factors and sexual function

目的分析瘀热型慢性前列腺炎(CP)临床症状与心理性因素及性功能的相关性。方法收集2020年6月至2021年6月在南京市江宁中医院泌尿外科门诊诊治的91例瘀热型CP患者的临床资料进行回顾性分析,使用美国国立卫生研究院慢性前列腺炎症状指数评分表(NIH-CPSI)、中医证候量表、7项广泛性焦虑障碍量表(GAD-7)、抑郁症筛查量表(PHQ-9)、疼痛灾难化量表(PCS)、国际勃起功能评分表(IIEF-5)和早泄诊断量表(PEDT)对患者进行评估,对量表评定结果进行Pearson相关性分析和多元线性回归分析。结果(1)症状量表:NIH-CPSI总分与中医量表总分、GAD-7总分呈正相关,中医证候量表总分与CPSI、GAD-7、PHQ-9、PCS、PEDT总分呈正相关(P<0.05);CPSI总分随中医量表总分递增而升高,中医证候量表总分随CPSI疼痛症状、PHQ-9总分递增而升高(P<0.05)。(2)情绪量表:GAD-7总分与CPSI、中医证候量表总分、排尿症状、PHQ总分、PEDT总分呈正相关,PHQ-9总分与中医证候量表总分、疼痛及排尿症状、PCS总分、PEDT总分呈正相关,PCS总分与中医证候量表总分及疼痛症状分值呈正相关(P<0.05);GAD-7总分随PHQ-9总分递增而升高;PHQ-9总分随中医证候量表排尿症状、GAD-7、PCS分值递增而升高;PCS总分随中医证候量表疼痛症状、PHQ-9分值递增而升高(P<0.05)。(3)性功能量表:IIEF-5总分与中医证候量表疼痛分值呈负相关,PEDT总分与中医证候量表总分及疼痛症状、GAD-7、PHQ-9分值呈正相关(P<0.05);IIEF-5总分随中医证候量表疼痛症状分值递减而升高(P<0.05)。结论瘀热型CP患者表现为以疼痛为主,伴随排尿异常、情绪异常、认知障碍和性功能障碍的系列症状,同时使用中医证候量表及CPSI评估能较好的反映其病情的严重程度。

Objective To investigate the correlations among the clinical symptoms,psychosexual factors and sexual function in stasis-heat type chronic prostatitis(CP).Methods Ninety-one patients with stasis-heat type CP treated from June 2020 to June 2021 were evaluated by National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI),TCM Syndrome Scale,7-item generalized anxiety disorder scale(GAD-7),9-item patient health questionnaire(PHQ-9),pain catastrophizing scale(PCS),international index of erectile function-5(IIEF-5)and premature ejaculation diagnostic tool(PEDT).The evaluation results of the scale were analyzed by Pearson correlation and multiple linear regression analysis.Results(1)Symptom scale:NIH-CPSI total scores were positively correlated with TCM syndrome scales and GAD-7 scores,and TCM syndrome scale were positively correlated with CPSI,GAD-7,PHQ-9,PCS,and PEDT scores(P<0.05).CPSI total scores increased with increasing of TCM syndrome scales,and TCM syndrome scales increased with increasing of CPSI scores of pain or discomfort and PHQ-9 scores(P<0.05).(2)Emotion scale:GAD-7 scores were positively correlated with CPSI,TCM syndrome scales and micturition symptoms,PHQ,and PEDT scores.PHQ-9 scores were positively correlated with TCM syndrome scales,pain and micturition symptoms,PCS and PEDT scores,and there was a positive relationship between PCS and TCM syndrome scales(P<0.05).GAD-7 scores increased with increasing of PHQ-9 scores,and PHQ-9 scores increased with increasing of TCM syndrome scales and micturition symptom,GAD-7 and PCS scores.PCS scores increased with increasing of TCM syndrome scale of pain symptoms and PHQ-9 scores(P<0.05).(3)Sexual function scale:IIEF-5 scores were negatively correlated with TCM syndrome scale of pain symptoms,and PEDT scales were positively correlated with TCM syndrome scales and pain symptom,GAD-7 and PHQ-9 scores(P<0.05).IIEF-5 scores increased with decreasing TCM syndrome scale of pain symptom(P<0.05).Conclusions The patients with stasis-heat type CP present with the predominant pain accompanied by abnormal urination,abnormal emotion behaviors,cognitive impairment and sexual dysfunction.Both TCM syndrome scale and CPSI can better reflect the severity of disease.