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目的:探讨α肾上腺素能受体(α-AR)阻滞剂特拉唑嗪联合氯美扎酮治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的疗效和安全性。方法:将168例CP/CPPS患者随机分成3组:特拉唑嗪组58例、氯美扎酮组38例和特拉唑嗪+氯美扎酮组72例,每组患者均接受药物治疗4周。采用美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分作为疗效指标,分别评价各组患者的疗效和药物不良反应。结果:159例完成了4周的治疗并接受最终评估,其中特拉唑嗪组55例、氯美扎酮组35例、特拉唑嗪+氯美扎酮组69例。3组患者的NIH-CPSI总分治疗前后平均分别下降7.90、5.92、8.92分,与治疗前相比均有显著性差异(P<0.05)。特拉唑嗪+氯美扎酮组较特拉唑嗪组和氯美扎酮组总分下降均有显著性差异(P<0.05)。药物不良反应包括体位性低血压(特拉唑嗪组17.1%,特拉唑嗪+氯美扎酮组15.4%)、射精障碍(仅特拉唑嗪组3.4%)和倦怠、疲乏和厌食等(氯美扎酮组18.5%,特拉唑嗪+氯美扎酮组12.6%)。因不良事件终止治疗的共9例,其中特拉唑嗪组3例(5.2%)、氯美扎酮组3例(7.9%)、特拉唑嗪+氯美扎酮组3例(4.2%)。结论:特拉唑嗪、氯美扎酮均能有效缓解CP/CPPS患者的症状,改善患者的生活质量,两者联合治疗疗效优于单一治疗。
Objective: To investigate the efficacy and safety of α-adrenergic receptor (α-AR) blocker terazosin and clomipramine in the treatment of chronic prostatitis / chronic pelvic pain syndrome (CP / CPPS). Methods: 168 patients with CP / CPPS were randomly divided into 3 groups: terazosin group 58 cases, clomerizine 38 cases and terazosin + clomethazine group 72 cases, each group were treated with drugs 4 weeks. The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score was used as the efficacy index to evaluate the efficacy and adverse drug reactions of each group. Results: Of the 159 patients who completed 4 weeks of treatment and received the final evaluation, 55 were treated with terazosin, 35 were treated with clomerizine, and 69 were treated with terazosin and clomerizine. The NIH-CPSI total score in the three groups decreased by an average of 7.90, 5.92, and 8.92 points before and after treatment, respectively, which were significantly different from those before treatment (P <0.05). The total score of terazosin + clomipramine group was significantly lower than that of terazosin group and clomerizine group (P <0.05). Adverse drug reactions included orthostatic hypotension (terazosin group 17.1%, terazosin + clomipramine 15.4%), ejaculation disorder (terazosin group 3.4%) and fatigue, fatigue and anorexia etc. (18.5% in the clomiphene citrate group and 12.6% in the terazosin + clomiphene citrate group). There were 9 cases (5.2%) in the terazosin group, 3 cases (7.9%) in the clomerizine group and 3 cases (4.2%) in the terazosin + ). Conclusion: Both terazosin and clomipramine can effectively relieve the symptoms of CP / CPPS patients and improve the quality of life of the patients. The combination of the two is superior to the single treatment.