慢性前列腺炎患者抑郁状态调查及小剂量抗抑郁药物的治疗效果观察

Investigation of depression in patients with chronic prostatitis and effect of low-dose antidepressant drugs

目的分析慢性前列腺炎患者的抑郁状态,评估小剂量抗抑郁药物联合常规药物对伴有抑郁的慢性前列腺炎患者临床治疗效果,为慢性前列腺炎的临床诊治提供依据。方法选取2014年3月至2016年2月门诊1 053例慢性前列腺炎患者采用Zung氏抑郁自评量表(SDS)进行评价。将200例伴有抑郁状态患者随机双盲分为试验组和对照组,皆予抗前列腺炎药物(左氧氟沙星片、坦索罗辛缓释片、塞来昔布片),试验组加小剂量阿米替林,疗程4周。比较两组治疗前后4周国际前列腺炎症状指数表(NIH-CPSI)、SDS评分。结果 1 053例慢性前列腺炎患者伴有抑郁症状208例(19.76%),其中轻度129例(12.25%)、中度65例(6.17%)、重度14例(1.33%)。对照组抑郁症状缓解率27.08%,慢性前列腺炎症状缓解率37.50%,试验组分别为85.71%和87.75%,差异均有统计学意义(χ~2分别为67.55和52.21,均P<0.05)。结论慢性前列腺炎患者存在较高的抑郁发生率,联合小剂量抗抑郁药物可明显提高慢性前列腺炎患者的治疗效果。

Objective To investigate depression status in patients with chronic prostatitis and observe the clinical effect of low-dose antidepressant drugs,and to provide a clinical basis for diagnosis and treatment of chronic prostatitis.Methods From Mar.2014 to Feb.2016,1 053 outpatients with chronic prostatitis were evaluated by Zung's self rating depression scale(SDS).Two hundred patients with depression were randomly divided into two groups,and both groups were treated with anti prostatitis drugs,such as levofloxacin,tamsulosin,celecoxib.The experimental group was given low-dose amitriptyline for 4 weeks.The international prostatitis symptom index(NIH-CPSI) and SDS score were compared between the two groups before and after treatment.Results There were 208 cases(19.75%) with depression symptoms in 1 053 chronic prostatitis patients,including 129 mild cases(12.25%),65 moderate cases(6.17%),14 severe cases(1.33%).The remission rate of depressive symptoms and chronic prostatitis in the control group was 27.08% and 37.50% respectively,and that in the experimental group was 85.71% and 87.75% respectively,and the differences were statistically significant(χ2=67.55 and 52.21,all P<0.05).Conclusion The rate of depression is considerably high in chronic prostatitis patients.Combined with low-dose antidepressant drugs can significantly improve the psychiatric symptoms as well as physical symptoms of chronic prostatitis.