Efficacy and Safety of Guihuang Formula in Treating Type Ⅲ Prostatitis Patients with Dampness-Heat and Blood Stasis Syndrome: A Randomized Controlled Trial

Objective: To observe the efficacy and safety of Guihuang Formula(GHF) in treating patients with type Ⅲ prostatitis and Chinese medicine syndrome of dampness-heat and blood stasis. Methods: Sixty-six type Ⅲ prostatitis patients with dampness-heat and blood stasis syndrome were randomly divided into the treatment group(GHF) and the control group(tamsulosin) using a random number table, with 33 cases each group. The treatment group received GHF twice a day, and the control group received tamsulosin 0.2 mg once daily before bedtime. Patients in both groups received treatment for 6 weeks and was followed up for 2 weeks. The outcomes included the National Institute of Health Chronic Prostatitis Symptom Index(NIH-CPSI) score, Chinese Medicine Symptoms Score(CMSS), expressed prostatic secretions(EPS) and adverse events(AEs). Results: After treatment, the NIH-CPSI total score and domain scores of pain discomfort, urination and quality of life decreased significantly from the baseline in both groups(P<0.05). The CMSS score decreased in both groups(P<0.05). The white blood cell(WBC) count decreased and lecithin body count increased in both groups(P<0.05). GHF showed a more obvious advantage in reducing the pain discomfort and quality of life domain scores of NIH-CPSI, reducing the CMSS score, increasing the improvement rate of the WBC and lecithin body counts, compared with the control group(P<0.05). There were no significant differences in decreasing urination domain score of NIH-CPSI between two groups(P>0.05). In addition, no serious AEs were observed. Conclusion: GHF is effective in treating type Ⅲ prostatitis patients with dampness-heat and blood stasis syndrome without serious AEs.(Registration No. ChiCTR1900026966)

归黄方治疗Ⅲ型前列腺炎精室湿热瘀滞证的临床研究

目的:观察归黄方治疗Ⅲ型前列腺炎精室湿热瘀滞证的有效性与安全性。方法:纳入Ⅲ型前列腺炎精室湿热瘀滞证患者120例,随机分为试验组(归黄方)60例,对照组(盐酸坦索罗辛缓释胶囊)60例。连续服药6周,随访4周。观察治疗前后美国国立卫生研究院慢性前列腺炎临床症状积分指数(NIH-CPSI)、中医症状评分、前列腺按摩液常规,以及血尿常规、肝肾功能、心电图。结果:两组治疗后均可显著降低NIH-CPSI总评分、疼痛评分、排尿评分、生活质量影响评分、中医症状评分、WBC数量(P<0.05),增加卵磷脂小体数量(P<0.05)。试验组在治疗6周结束后,NIH-CPSI评分由(28.34±9.23)分降低为(6.78±3.53)分;对照组在治疗结束后,NIH-CPSI评分由(27.81±8.28)分降低为(14.48±4.27)分。试验组与对照组比较,除治疗第2周时排尿评分与对照组无明显差别以外(P>0.05),第4、6、10周时试验组在降低NIH-CPSI总评分、疼痛评分、排尿评分、生活质量影响评分及中医症状评分方面,均优于对照组(P<0.05)。试验组在减少WBC数目、增加卵磷脂小体数量方面优于对照组(P<0.05)。安全性检查两组治疗后均未见明显异常,治疗过程未见明显不良反应。结论:归黄方治疗Ⅲ型前列腺炎精室湿热瘀滞证安全、有效。

从“脑-心-肾-精室”轴探讨归黄方治疗湿热瘀滞型慢性前列腺炎

临床中慢性前列腺炎以湿热瘀滞证型为多,其形成是一个由湿化热进而痹阻气血运行的过程。治疗过程中既顾及湿、热、瘀等病理因素,又要清热不苦寒、燥湿不伤津、化瘀不动血等,以平为期,这也是遵用药“整体观”的具体体现,故在选方用药上较为棘手。“脑-心-肾-精室”轴理论强调整体辨证,将精室失用作为慢性前列腺炎发病的最终环节,采用脑、心、肾同调的手段,结合特色用药,达到整体与局部同治的效果,从而在缓解或治愈前列腺局部症状的同时也一定程度上改善了患者的全身症状。基于该理论拟定的归黄方即涵盖了以上理念,在治疗湿热瘀滞型慢性前列腺炎的临床实践中取得了良好的效果,现将其作用机理作如下探讨,以资临床参考。