低能量冲击波与低频TENS治疗顽固性ⅢB型前列腺炎的临床对照研究

Comparison of outcomes between low-intensity extracorporeal shock wave and low-frequency transcutaneous electrical nerve stimulation in refractory type ⅢB prostatitis

目的探讨低能量冲击波与低频经皮神经电刺激(TENS)对顽固性ⅢB型前列腺炎的治疗效果,并分析其并发症及安全性。方法本文为随机对照试验。前瞻性选取2021年6月至2022年10月广州医科大学附属第五医院就诊的顽固性ⅢB型前列腺炎患者104例作为研究对象,采用随机数字表法分成两组,每组52例。研究组年龄24~42(33.1±7.3)岁,症状持续3~23(17.1±2.2)个月,采用低能量冲击波治疗。对照组年龄26~40(32.0±8.5)岁,症状持续3~22(17.5±2.8)个月,采用低频TENS治疗。治疗4周为1个疗程,1个疗程结束后采用慢性前列腺炎症状指数(NIH-CPSI)对两组临床症状进行评分,并分析其并发症、安全性。统计学方法采用t检验、χ^(2)检验。结果治疗前,两组患者疼痛与不适、排尿症状、生活质量影响评分和NIH-CPSI总分比较,差异均无统计学意义(均P>0.05);治疗后,研究组疼痛与不适、排尿症状、生活质量影响评分及NIH-CPSI总分均低于对照组[(9.21±2.10)分比(11.30±2.90)分、(5.13±0.60)分比(6.52±0.56)分、(5.10±1.10)分比(7.10±1.40)分、(20.26±1.05)分比(22.83±0.65)分],差异均有统计学意义(t=4.209、12.213、8.100、15.007,均P<0.05)。研究组治疗后总有效率[71.15%(37/52)]高于对照组[42.31%(22/52)],差异有统计学意义(χ^(2)=8.814,P=0.003)。治疗过程中,两组患者均未出现明显不良反应及并发症。结论低能量冲击波治疗对顽固性ⅢB型前列腺炎的效果优于传统低频TENS治疗,且低能量冲击波治疗对患者较为方便,容易接受,安全性可靠,值得在临床上进一步推广。

Objective To investigate the therapeutic effects of low-intensity extracorporeal shock wave and low-frequency transcutaneous electrical nerve stimulation(TENS)on refractory typeⅢB prostatitis,and analyze their complications and safety.Methods This was a randomized controlled trial.From June 2021 to October 2022,104 patients with refractory type ⅢB prostatitis in the Fifth Affiliated Hospital of Guangzhou Medical University were prospectively selected as the research objects.They were divided into two groups by the random number table method,with 52 patients in each group.The study group was 24-42(33.1±7.3)years old,with symptoms lasting for 3-23(17.1±2.2)months,and low-intensity extracorporeal shock wave was used.The control group was 26-40(32.0±8.5)years old,with symptoms lasting for 3-22(17.5±2.8)months,and low-frequency TENS was used.After 4 weeks of treatment,the clinical symptoms of the two groups were scored by the National Institutes of Health Chronic Prostatitis Symptoms Index(NIH-CPSI),and the complications and safety of the two groups were analyzed.Statistical methods used were t test and χ^(2) test.Results Before treatment,there were no statistically significant differences in the scores of pain or discomfort,urination symptoms,and quality of life impact and NIH-CPSI total score between the two groups(all P>0.05).After treatment,the scores of pain or discomfort,urination symptoms,and quality of life impact and NIH-CPSI total score of the study group were lower than those of the control group[(9.21±2.10)points vs.(11.30±2.90)points,(5.13±0.60)points vs.(6.52±0.56)points,(5.10±1.10)points vs.(7.10±1.40)points,(20.26±1.05)points vs.(22.83±0.65)points],with statistically significant differences(t=4.209,12.213,8.100,and 15.007,all P<0.05).The total effective rate of the study group[71.15%(37/52)]was higher than that of the control group[42.31%(22/52)],with a statistically significant difference(χ^(2)=8.814,P=0.003).No significant adverse reactions or complications were found during the treatment of both groups.Conclusion The effect of low-intensity extracorporeal shock wave therapy on refractory typeⅢB prostatitis is superior to traditional low-frequency TENS therapy,and low-intensity extracorporeal shock wave therapy is more convenient,easy to accept,safe,and reliable for patients,which is worth further promotion in clinical practice.