心理干预对西藏阿里地区慢性前列腺炎/慢性盆腔疼痛综合征患者NIH-CPSI评分及各维度的影响

Effects of psychological intervention on NIH-CPSI score of CP/CPPS patients in Ngari Prefecture of Tibet

目的对西藏阿里地区慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者心理状况进行调查,分析CP/CPPS患者焦虑情绪对美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)总分及各维度评分的影响,并进行临床干预研究。方法纳入2019年10月-2021年10月来自西藏阿里地区的117例CP/CPPS患者。将患者按照有无合并焦虑分为2组,无焦虑组给予常规药物治疗,焦虑组采用药物治疗联合心理干预,疗程为3个月。结果共纳入117例患者,其中合并焦虑情绪患者68例,无焦虑情绪患者49例;2组在年龄、体质指数(BMI)、婚姻状况、吸烟史、文化程度方面差异均无统计学意义(P>0.05);焦虑组患者NIH-CPSI总分高于无焦虑组[(18.53±3.47)分vs.(15.67±3.33)分],主要表现为疼痛及生活质量维度评分升高;通过亚组分析发现焦虑症状与NIH-CPSI总分及生活质量评分呈正相关。无焦虑组采用药物治疗后疼痛及排尿症状较前改善,但生活质量维度及NIH-CPSI总分未见明显改变,而焦虑组采用心理干预联合药物治疗后,患者NIH-CPSI总分及各子项评分均较前明显下降(P<0.001)。结论西藏阿里地区CP/CPPS患者中合并焦虑情绪的患者并不少见,NIH-CPSI总分升高主要体现在疼痛症状及生活质量维度两方面,心理干预联合药物治疗能够明显改善患者焦虑、排尿、疼痛症状,提高生活质量。

Objective To investigate the psychological status of patients with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),and to analyze the effects of anxiety on the total National Institute of Health Chronic Prostatitis Symptom Index(NIH-CPSI)in patients in Ngari Prefecture of Tibet.Methods CP/CPPS patients treated during Oct.2019 and Oct.2021 were involved and divided into anxiety group and non-anxiety group.The non-anxiety group received routine drug treatment,while the anxiety group received drugs and psychological intervention.Results A total of 117 patients were involved,including 68 in the anxiety group and 49 in the non-anxiety group.There were no statistical differences between the two groups in terms of age,body mass index(BMI),marital status,smoking history,and education level(P>0.05).The total NIH-CPSI score in the anxiety group(18.53±3.47)was higher than that in non-anxiety group(15.67±3.33),which was mainly manifested by the increase of pain and decrease of quality of life scores.Further stratification of anxiety level revealed that quality of life score and total NIH-CPSI score increased as anxiety symptoms worsened.After drug treatment,pain and urination symptoms were improved in the non-anxiety group,but the quality of life score and total NIH-CPSI score did not change significantly.After psychological intervention,the anxiety group had lower total NIH-CPSI score and other scores.Conclusion It is not uncommon for CP/CPPS patients to have a comorbidity of anxiety.The increase in the total NIH-CPSI score is caused by the increase of pain score and decrease of quality of life score.Active psychological intervention can improve anxiety,urinary symptoms,pain symptoms and quality of life.