从分经论治组方加减柴妙饮治疗慢性前列腺炎湿热瘀滞证的临床研究

Clinical Study on Treatment of Chronic Prostatitis with Damp-Heat Stagnation Syndrome by Modified ChaimiaoYin(加减柴妙饮)from Meridians Differentiation

目的探讨从分经论治组方加减柴妙饮治疗Ⅲ型慢性前列腺炎湿热瘀滞证的临床疗效和不良反应。方法纳入2020年6月—2021年12月重庆市中医院门诊的Ⅲ型慢性前列腺炎湿热瘀滞证患者72例,遵循随机、阳性对照原则,分为试验组36例采用加减柴妙饮内服,对照组36例为程氏萆薢分清饮内服,疗程为4周。以美国国立卫生院-慢性前列腺炎症状指数(National Institutes of Health-Chronic Prostatitis Symptom Index,NIH-CPSI)评分、中医证候量化评分、前列腺按摩液(expressed prostatic secretions,EPS)白细胞及卵凝脂小体变化、起效时间作为疗效评定标准,并观察患者不良反应。结果两组均能降低治疗前后NIH-CPSI评分和中医证候评分,减少EPS中白细胞计数,差异有统计学意义(P<0.05),试验组愈显率优于对照组,两组总有效率相当,但试验组对中医主症疼痛不适和次症性功能、阴囊潮湿、心烦失眠改善情况优于对照组。试验组起效时间更短,差异有统计学意义(P<0.05)。试验组不良反应发生率为11.8%(4/34),对照组为9.1%(3/33),均未经特殊处理,患者症状消失。结论从分经论治组方的加减柴妙饮能明显改善患者的NIH-CPSI评分、中医证候评分,治疗Ⅲ型慢性前列腺炎湿热瘀滞证具有确切临床疗效,尤其在改善中医主症疼痛及次症性功能、阴囊潮湿、心烦失眠方面效果更显著,起效时间更短,且安全性良好。

Objective To discuss the clinical efficacy and adverse reactions of Modified Chaimiao Yin(加减柴妙饮)from meridians differentiation in treating type III chronic prostatitis with damp-heat stagnation syndrome.Methods From June 2020 to December 2021,72 patients with damp-heat stagnation syndrome of type III chronic prostatitis in the outpatient department of Chongqing Hospital of Traditional Chinese Medicine were enrolled.Following the principle of randomization and positive control,they were divided into test group(36 cases)and control group(36 cases).National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)score,quantitative score of traditional Chinese medicine syndromes,expressed prostatic secretions(EPS)leukocyte and lecithin corpuscles changes,onset time were used as the evaluation criteria for efficacy,and adverse reactions of patients were observed.Results Both groups can reduce the NIH-CPSI scores and TCM syndrome scores before and after treatment,and reduce the leukocyte count in EPS.The difference was statistically significant(P<0.05).The recovery rate of the test group was better than the control group.The total effective rates of the two groups were similar,but the improvement of the main symptoms of pain and discomfort,secondary functions,scrotum dampness,upset and insomnia of the test group was better than that of the control group.The onset time of the test group was shorter,and the difference was statistically significant(P<0.05).The incidence of adverse reactions was 11.8%(4/34)in the test group and 9.1%(3/33)in the control group.Without special treatment,the symptoms of patients disappeared.Conclusion Modified Chaimiao Yin can significantly improve the NIH-CPSI scores and TCM syndrome scores of patients,and has a definite clinical effect in treating type Ⅲ chronic prostatitis with damp-heat stagnation syndrome,especially in improving the main symptoms of pain and secondary symptoms of TCM,scrotum dampness,heart trouble and insomnia,and the onset time is shorter.And the safety is good.