综合心理、行为干预治疗慢性非细菌性前列腺炎效果观察

Psychotherapy and behavioral intervention in the treatment for chronic non-bacterial prostatitis

目的 评价综合心理、行为干预治疗慢性非细菌性前列腺炎 (CNP)的临床效果。方法 从调查CNP患者的性活动入手 ,将 49例调查对象随机分为两组。实验组 2 7例 ,在口服α1 肾上腺素能阻滞剂特拉唑嗪 (Terazosin)的基础上同时给予综合心理、行为干预治疗 ,其中 1 8例取得配偶 /性伴配合 ,7～ 1 0日性交 1次 ,性器官接触前即戴避孕套 ,鼓励另 9例无条件过规律性生活的患者至少 2周一次手淫排精。对照组 2 2例 ,仅予口服等剂量Terazosin。结果 两组治疗前后的前列腺炎症状评分、最大尿流率(MFR)、焦虑情绪均有改善。实验组在“疼痛或不适”、“生活质量”、及焦虑评分上改善明显 ,与对照组比较具有显著性差异 (P <0 .0 5) ;而“排尿异常”评分、MFR与对照组比较无显著性差异。

Objective To study the effect of psychotherapy and behavioral intervention in the treatment of chronic non bacterial prostatitis (CNP)/chronic pelvic pain syndrome (CPPS). Methods 49 CNP/CPPS patients were divided into two groups. The experimental group was treated by an α 1 adrenergic receptor blocker, terazosin, at a dose of 2 mg twice a day for 12 weeks, as well as behavioral intervention to prevent unhealthy sexual behaviour and comprehensive psychotherapy. The control group was only treated with a similar dose of terazosin. For those patients who have sexual partners, they were advised to have sex once per 7～10 days with condom. The single males were encouraged to masturbate every 7～10 days. Symptom scores were evaluated by the NIH chronic prostatitis symptoms index (NIH CPSI), the maximal urinary flow rate (MFR) and the degree of anxiety before and after treatment. Results The NIH CPSI, MFR and anxiety score were improved in both groups after the treatment. The experimental group showed more significant improvement than the control group in the aspects of pain, life quality and anxiety(P<0.05), but they did not show obvious differences in urinary function and MFR. Conclusion Comprehensive psychotherapy and helping patients establish a reasonable sexual life are of assistance in the treatment of CNP/CPPS.