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目的探讨良性前列腺增生(Benign Prostatic Hyperplasia BPH)合并慢性前列腺炎(Chronic Prostatitis CP)患者的有效治疗方法。方法 198例BPH合并CP患者随机分成A、B、C三组,A组前列腺注药、按摩加盐酸坦索罗辛66例;B组:非那雄胺加抗生素和盐酸坦索罗辛65例;C组:抗生素加盐酸坦索罗辛67例,三种方法各治疗2个月,对比治疗前后三种方法的疗效。结果经过8周治疗,A、B、C三组的IPSS(国际前列腺症状评分)由治疗前的13.8±4.4、13.5±3.6、13.5±3.5分别减少到治疗后的6.4±4.3、8.4±2.2、8.2±2.2,三组的IPSS平均分值分别减少7.4±0.5、5.1±1.4、5.4±1.3。A、B、C三组的QOL(生活质量评分)分别由治疗前的4.4±0.6、4.5±0.5、4.6±0.4减少到治疗后的2.2±0.3、3.7±0.4、2.8±0.2。三组的QOL平均分值分别减少2.2±0.3、0.8±0.1、1.8±0.2。A、B、C三组的MFR(最大尿流率)分别由治疗前的12.6±2.2ml/s、12.4±2.4ml/s、12.5±2.3ml/s增加到治疗后的16.6±3.4ml/s、15.5±3.6ml/s、和15.6±3.4ml/s。A、B、C三组的RVU(残余尿)分别由治疗前的16—96ml(平均56ml)、17—95ml(平均56ml)、18—94ml(平均56ml)减少到10—60ml(平均35ml)、12—72ml(平均42ml)、14—70ml(平均42ml)。A组、B组、C组的EPS镜检WBC﹤10/Hp的患者分别为50例(50/66,75.9%),45例(45/65,69.2%),和43例(42/67,62.9%)。A组、B组、C组、细菌培养转阴的患者为18例(18/22,81.8%),16例(16/21,76.2%),15例(15/22,68.2%)。A组与B、C二组在治疗后EPS镜检WBC﹤10/Hp和细菌转阴率比较有统计学差异。按成组设计的方差分析,A、B、C三组之间有统计学差异,X?=8.7 p﹤0.05。前列腺注药、按摩加盐酸坦索罗辛治疗的66例患者在症状改善方面明显优于其它二组。结论前列腺注药按摩加盐酸坦索罗辛治疗BPH合并CP的疗效优于非那雄胺、盐酸坦索罗辛加抗生素和盐酸坦索罗辛加抗生素。
Objective To investigate the effective treatment of benign prostatic hyperplasia (BPH) complicated with chronic prostatitis (Chronic Prostatitis CP). Methods A total of 198 patients with BPH and CP were randomly divided into three groups (A, B and C). Group A received prostatic injection and massage plus tamsulosin hydrochloride (66 cases). Group B: finasteride plus antibiotics and tamsulosin hydrochloride (65 cases) ; Group C: Antibiotics plus tamsulosin hydrochloride 67 cases, three methods of treatment for 2 months, compared with the efficacy of three methods before and after treatment. Results After 8 weeks of treatment, the IPSS (International Prostate Symptom Score) in groups A, B and C decreased from 13.8 ± 4.4, 13.5 ± 3.6 and 13.5 ± 3.5 before treatment to 6.4 ± 4.3 and 8.4 ± 2.2 after treatment respectively, 8.2 ± 2.2. The IPSS scores of the three groups decreased by 7.4 ± 0.5, 5.1 ± 1.4 and 5.4 ± 1.3, respectively. The QOL (quality of life scores) in groups A, B and C decreased from 4.4 ± 0.6, 4.5 ± 0.5 and 4.6 ± 0.4 before treatment to 2.2 ± 0.3, 3.7 ± 0.4 and 2.8 ± 0.2 respectively after treatment. Three groups of QOL average scores decreased by 2.2 ± 0.3,0.8 ± 0.1,1.8 ± 0.2. The MFR (maximum flow rate) of group A, B and C increased from 12.6 ± 2.2ml / s, 12.4 ± 2.4ml / s and 12.5 ± 2.3ml / s before treatment to 16.6 ± 3.4ml / s, 15.5 ± 3.6 ml / s, and 15.6 ± 3.4 ml / s. RVU (Residual Urine) of Groups A, B and C were reduced to 10-60 ml (average 35 ml) from 16-96 ml (mean 56 ml), 17-95 ml (average 56 ml) and 18-94 ml (average 56 ml) , 12-72 ml (average 42 ml), 14-70 ml (average 42 ml). Fifty patients (50/66, 75.9%), 45 (45/65, 69.2%), and 43 (42/67) patients with EPS of WBC <10 / Hp in group A, , 62.9%). 18 cases (18/22, 81.8%), 16 cases (16/21, 76.2%) and 15 cases (15 / 22,68.2%) were in group A, group B and group C, with bacterial culture negative. A group and B, C two groups in the treatment of EPS microscopy WBC <10 / Hp and bacterial conversion rate was statistically significant difference. According to the variance analysis of group design, there were significant differences among the three groups A, B and C, X = 8.7 p <0.05. Prostate injection, massage plus tamsulosin hydrochloride treatment of 66 patients was significantly better than the other two groups in improving symptoms. Conclusion Prostate injection plus tamsulosin hydrochloride is superior to finasteride, tamsulosin plus antibiotics and tamsulosin plus antibiotics in the treatment of BPH with CP.