加味金黄散局部外敷联合抗生素治疗急性附睾炎临床研究

Clinical study of local external application of Jiawei Jinhuang powder combined with antibiotics in the treatment of acute epididymitis

目的探讨加入冰片的金黄散(加味金黄散)局部外敷联合抗生素治疗急性附睾炎的疗效及安全性。方法选取该科门诊2016年6月至2018年6月收治的急性附睾炎患者128例,被随机分为试验组66例和对照组62例。试验组给予加味金黄散局部外敷联合头孢他啶静脉滴注治疗;对照组给予单纯头孢他啶静脉滴注治疗。对两组患者短期疗效及治疗后1个月的精液参数进行对比分析;经过24个月随访,对两组患者复发率进行对比分析。结果试验组、对照组患者治疗后患侧阴囊疼痛缓解时间[(4.6±1.1)dvs.(5.1±1.2)d]、附睾肿物消散平均时间[(9.5±7.6)dvs.(12.5±5.7)d]比较,差异均有统计学差异(P=0.011、0.014)。试验组、对照组患者治疗1个月后精液质量[精子密度:(66.5±7.5)×10^(6)m L^(-1)vs.(63.0±5.9)×10^(6)m L^(-1),精子活动率:(66.2±6.1)%vs.(63.8±5.3)%,a+b活力:(42.3±5.0)%vs.(39.3±6.2)%]比较,差异均有统计学意义(P=0.005、0.023、0.003)。试验组、对照组患者治疗后24个月内整体复发率(12.1%vs.25.8%)比较,差异有统计学意义(P=0.047)。结论加味金黄散局部外敷联合抗生素治疗急性附睾炎在缓解阴囊疼痛、附睾肿物消散、改善精液质量、降低复发率等方面优于单纯使用抗生素治疗,值得临床推广。

Objective To investigate the efficacy and safety of local external application of Jinhuang powder with borneol(Jiawei Jinhuang Powder)combined with antibiotics in the treatment of acute epididymitis.Methods A total of 128 patients with acute epididymitis admitted to this department from June 2016 to June 2018 were randomly divided into the experimental group(66 cases)and the control group(62 cases).The experimental group was treated with local external application of Jiawei Jinhuang powder combined with ceftazidime intravenous drops;the control group was treated with intravenous drops of ceftazidime alone.The short-term efficacy and semen parameters one month after treatment of the two groups were compared and analyzed.After 24 months follow-up,the recurrence rate of the two groups were compared and analyzed.Results After treatment,the pain relief time of affected side scrotum[(4.6±1.1)d vs.(5.1±1.2)d]and the average dissipation time of epididymal mass[(9.5±7.6)d vs.(12.5±5.7)d]were significantly different between the experimental group and the control group(P=0.011,0.014).After one month of treatment,there was a statistically significant difference in the semen quality[semen density:(66.5±7.5)×10^(6) mL^(-1) vs.(63.0±5.9)×10^(6) mL^(-1),P=0.005;semen activity rate:(66.2±6.1)%vs.(63.8±5.3)%,P=0.023;a+b activity:(42.3±5.0)%vs.(39.3±6.2)%,P=0.003]between the two groups.After treatment of 24 months,there was a significant difference in the overall recurrence rate between the experimental group and the control group(12.1%vs.25.8%,P=0.047).Conclusion Jiawei Jinhuang powder combined with antibiotics in the treatment of acute epididymitis is better than antibiotics alone in relieving scrotal pain,dispersing epididymal mass,improving semen quality and reducing recurrence rate,and is worthy of clinical promotion.