微创医学

目的探讨左氧氟沙星联合超声中频及中药灌肠综合治疗重度ⅢA型前列腺炎的有效性及安全性。方法通过Stamey试验、前列腺液(EPS)常规及国际慢性前列腺炎症状评分(NIH-CPSI),筛选出符合诊断标准的ⅢA型前列腺炎且NIH-CPSI≥19分患者120例,采用随机、双盲、平行对照临床研究方法,分为实验组(60例,脱落1例)和对照组(60例)。实验组予口服左氧氟沙星片0.5 g 1次/d,对照组予安慰剂,两组同时予超声中频及中药灌肠综合治疗,疗程28 d。所有患者均行入组前、治疗后2周和4周随访并行NIH-CPSI评分、EPS等检查及不良反应的评估。结果治疗后2周和4周,实验组与对照组NIH-CPSI总分、疼痛、排尿和生活质量评分均降低,两组治疗前后的自身对比差异均有统计学意义(P<0.01);组间比较,实验组较对照组治疗后2周和4周NIH-CPSI总分、疼痛、排尿和生活质量评分差异均有统计学意义(P<0.01)。两组治疗前后EPS中白细胞计数差异有统计学意义(P<0.01),无严重不良反应事件发生。结论左氧氟沙星联合超声中频及中药灌肠综合治疗能更有效地缓解重度ⅢA型前列腺炎患者的疼痛和排尿症状、改善患者的生活质量,安全可靠,但长期疗效尚待进一步的临床研究。

Objective To explore the efficacy and safety of integration therapy of levofloxacin in combination with ultra wave united computered mild-frequency electric pulse and enema with traditional Chinese medicine therapy on serious type ⅢA chronic prostatitis． Methods We used the randomized and parallel contrasted method，selected 120 serious ⅢA type chronic prostatitis ( NIH-CPSI≥19) patients via the Stamey test，EPS examination and NIH-CPSI scores，and equally randomized them into an experimental group ( with 1 case missing) and a control group． Experimental group were given levofloxacin，and the control group were given placebo． But two groups were both given ultra wave united computered mild-frequency electric pulse and enema with traditional Chinese medicine therapy at the same time． Treatment time was 28 days． All the patients were evaluated by NIH-CPSI scores and EPS results，and followed up for adverse events after 2 and 4 weeks of treatment． Results The total NIH-CPSI score，the pain index，voiding index，and quality of life ( QOL) score in both groups decreased two and four weeks after treatment，all with statistical significance． There was significant difference in total NIH-CPSI score，the pain index，voiding index，and quality of life ( QOL) score between the two groups 2 weeks and 4 weeks after treatment． And the difference in the count of WBCs in EPS before and after the treatment was of statistical significance in both groups． No serious adverse event was recorded． Conclusion Integration therapy of levofloxacin in combination with ultra wave united computered mild-frequency electric pulse and enema with traditional Chinese medicine can effectively relieve pain and voiding symptoms，improve QOL，and reduce WBC in the EPS of serious ⅢA type chronic prostatitis patients，and therefore well deserves to be recommended in clinical application． But its long-term efficacy is yet to be further studied．