药物联合治疗慢性前列腺炎临床疗效观察(附153例报告)

A clinical survey of combined use of different drugs in the treatment of chronic prostatitis(report of 153 cases)

目的 探讨慢性前列腺炎联合药物治疗的临床疗效。 方法 选择中重度慢性前列腺炎 15 3例 ,其中细菌性前列腺炎 2 0例 ,非细菌性前列腺炎 133例 ,按照美国国立卫生研究所 (NIH)制定的前列腺炎症状评分标准 (CPSI)和前列腺按摩液 (EPS)指标变化及细菌学检查结果评估疗效。应用敏感抗生素、α1受体阻滞剂、选择性COX 2抑制剂、中成药等联合治疗 1.5～ 5个月 ,对比分析疗效。 结果 15 3例平均随访 11.8个月 ,行两次CPSI,平均 13.4分 ,与治疗前平均 32 .6分比较差异有显著性意义 (P <0 .0 0 0 0 1)。依据CPSI进行疗效判定 ,治愈 15 .7% ,显效 4 9.1% ,有效 18.8% ,无效 16 .7% ,总有效率 83.6 % ;治疗后平均WBC 11.6个 /HP ,与治疗前 (32 .4个 /HP)比较差异有显著性意义 (P <0 .0 0 0 0 1)。 2 0例慢性细菌性前列腺炎患者治疗后两杯判定试验 (PPMT)法行细菌培养 ,14例转为阴性 ,转阴率 70 .0 %。 结论 两杯判定试验对慢性前列腺炎分类简单易行 ,CPSI是一种较好的疗效评价方法 ,合适的抗生素、α1受体阻滞剂、选择性COX 2抑制剂和中药等联合应用对慢性前列腺炎有较好疗效。

Objective To study the efficacy of consecutive drugs in the treatment of chronic prostatitis. Methods 153 cases of moderate & severes chronic prostatitis were treated with consecutive drugs with sensitive antibiotics,α 1-blocker,inhibitor of cox-2 and traditional Chinese herb,20 cases being chronic bacterial and 133 nonbacterial. They were classified and evaluated according to the CPSI & EPS examinations as analyzed by T test. Results All cases were followed up for an average of 11.8 months(8～18 months).The average CPSI score was 32.6(32.7±5.3) before treatment and 13.4(12.8±7.3) after treatment (P<0.00001).Based on the study of CPSI ,the curative rate was 15.7%,the remarkable effective rate 49.1%,and the improving rate was 18.8%,the total effective rate being 83.6%,whereas the non-effective rate was 16.7%.The average WBC count in EPS after treatment was 11.6(11.6±10.9)and 32.4(32.4±29.7) before treatment (P<0.00001).20 cases of chronic bacterial prostatitis had positive bacterial culture of EPS,14 of which turned negative after treatment and the negative rate being 70.0%. Conclusions PPMT is a reliable method to diagnose prostatitis,and easy to carry out.NIH-CPSI is an reliable method to evaluate the drug therapy.The consecutive drugs treatment,including the proper antibiotics,α 1-blocker ,the inhibitor of COX-2 and traditional Chinese herb can be an effective therapy for chronic prostatitis.