磁振磁电疗法联合丹红通精方治疗慢性前列腺炎/盆腔疼痛综合征及其对分泌型IgA、血管细胞黏附分子-1、白介素-8的影响

Magnetic resonance and magnetoelectric therapy combined with Danhong Tongjing Prescription for the treatment of CP/CPPS and its effects on secretory IgA,vascular cell adhesion molecule-1 and interleukin-8

目的:观察磁振磁电疗法联合中药协定方丹红通精方干预下慢性前列腺炎/盆腔疼痛综合征(CP/CPPS)患者疾病的疗效与细胞因子分泌型IgA(sIgA)、血管细胞黏附分子-1(VCAM-1)、白介素-8(IL-8)水平的变化。方法:CP/CPPS(气滞血瘀证)患者随机分成3组,实验组70例,予磁振磁电疗法并联合丹红通精方口服;对照1组71例,予磁振磁电疗法治疗,对照2组69例,予丹红通精方口服;6周为1个疗程,共2个疗程。治疗后统计治疗的总有效率、NIH-CPSI评分、中医证候评分、前列腺液中sIgA、VCAM-1、IL-8水平。结果:实验组、对照1组、对照2组实际完成例数分别为68、67、65例,总有效率分别为86.76%、79.10%、78.46%,实验组与各对照组的总有效率比较,差异具有统计学意义(P<0.05或P<0.01)。3组患者治疗后的疼痛或不适评分为(4.61±2.37)、(5.86±3.26)、(6.94±2.25)分,排尿异常症状评分为(2.98±1.75)、(3.85±2.01)、(3.94±1.95)分,生活质量评分为(3.26±1.87)、(4.54±2.13)、(4.69±1.72)分,NIH-CPSI总评分为(10.64±5.91)、(4.59±6.87)、(15.54±5.76)分,治疗后实验组与对照1、2组比较,差异有统计学意义(P<0.05)。3组患者治疗后中医证候评分(5.56±3.42)、(7.37±4.57)、(8.16±3.65)分,实验组与对照1、2组比较,差异有统计学意义(P<0.05)。各组治疗前后比较,实验组sIgA(Z=-7.170)、VCAM-1(Z=-7.182)、IL8(Z=-7.18)显著降低;对照1组sIgA(Z=-7.032)、VCAM-1(Z=-7.130)、IL8(Z=-7.116)显著降低;对照2组sIgA(Z=-6.802)、VCAM-1(Z=-6.973)、IL8(Z=-6.768)显著降低;均具有统计学差异(P<0.05)。治疗后组间比较,实验组sIgA、VCAM-1、IL-8显著低于对照1组、对照2组(P<0.05)。结论:磁振磁电疗法联合丹红通精方对气滞血瘀证CP/CPPS的治疗效果良好,其作用机制可能通过调节sIgA、VCAM-1、IL-8等细胞因子,激活免疫系统功能,抑制炎症,促进局部炎性物质吸收有关。

Objective:To investigate the therapeutic effect of magnetic resonance and magnetoelectric therapy(MRMT)combined with oral Danhong Tongjing Prescription(DTP)on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and the changes in the levels of cytokine-secretory IgA(sIgA),vascular cell adhesion molecule-1(VCAM-1)and interleukin-8(IL-8)after treatment.Methods:Totally 200 patients with CP/CPPS of the qi stagnation and blood stasis type were randomly divided into three groups to receive MRMT+DTP(n=68),MRMT(n=67)and DTP(n=65),respectively,all for 12 weeks.After treatment,we compared the total effectiveness rate,patients’scores on NIH-CPSI and traditional Chinese medicine(TCM)syndrome,and the expressions of sIgA,VCAM-1 and IL-8 in the EPS among the three groups of the patients.Results:After treatment,the patients in the MRMT+DTP group,compared with those in the MRMT and DTP groups,showed a significantly higher total effectiveness rate(86.76%vs 79.10%and 78.46%,P<0.05 and P<0.01)and lower scores on pain or discomfort(4.61±2.37 vs 5.86±3.26 and 6.94±2.25 P<0.01),abnormal urination symptoms(2.98±1.75 vs 3.85±2.01 and 3.94±1.95)and quality of life(3.26±1.87 vs 4.54±2.13 and 4.69±1.72).There were statistically significant differences in the total NIH-CPSI scores among the three groups(10.64±5.91 vs 4.59±6.87 vs 15.54±5.76,P<0.05).The MRMT+DTP group also exhibited a remarkably lower TCM syndrome score than the MRMT and DTP groups(5.56±3.42 vs 7.37±4.57 and 8.16±3.65,P<0.05).Compared with the baseline,the expressions sIgA,VCAM-1 and IL8 were all markedly decreased after treatment in the MRMT+DTP(Z=-7.170,Z=-7.182,Z=-7.18),MRMT(Z=-6.802,Z=-6.973,Z=-6.768)and DTP groups(Z=-5.963,Z=-6.990 Z=-5.618)(P<0.05),even more significantly in the former than in the latter two groups(P<0.05).Conclusion:Magnetic resonance and magnetoelectric therapy combined with Danhong Tongjing Prescription has a good therapeutic effect on CP/CPPS of the qi stagnation and blood stasis type,probably by regulating sIgA,VCAM-1,IL-8 and other cytokines,activating the function of the immune system,inhibiting inflammation,and promoting the absorption of local inflammatory substances.