川芎嗪经超声电导治疗仪直肠给药治疗Ⅲ型前列腺炎应用研究

发布时间：2018-03-21 23:29

本文选题：Ⅲ型前列腺炎　切入点：川芎嗪　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景和目的:慢性前列腺炎是成年男性非常普遍一种疾病,其中,III型比较常见,所占比例超过九成,可有反复疼痛症状,严重影响患者生活质量。临床上最常使用药物进行治疗,包括抗生素、α-受体阻滞剂、植物制剂、抗抑郁或焦虑药物、中医中药等,辅以按摩、生物反馈调理以及热疗这些方法进行医治,但还没有一种方法有十分满意、确切且持久疗效。其中,前列腺腺泡上皮中类脂质膜阻碍了大部分药物渗入其中,由于前列腺炎症导致前列腺组织中pH值提升,药物弥散效果降'低,这样渗入前列腺腺管、腺泡和细胞浓度就比较有限,从而显著影响药物治疗效果。超声治疗原理是超声波能量在人身体发生疾病部位进行作用,从而实现医治疾病以及推动机体康复的目标,它所依据的是超声波对机体产生的各种生物反应,比如热、机械、声冲流和空化这些效应。除了本身的生物效应外,超声波还具有十分良好的药物透入功能,可以增强靶器官的药物浓度,提高药物疗效。川芎嗪是由中药川芎中提取出来的生物碱,能够遏制自由基生成,使超氧化物歧化酶活力得到提升,还可加速消除氧自由基,使血液流变学得到改善,另外还能遏制血小板不断积聚,抑制纤维化,调整脂质代谢,拮抗脂质过氧化等,药理作用非常广泛。本研究通过对比观察小组与对照小组接受川芎嗪经超声电导仪以直肠给药方式进行治疗的结果,分析患者治疗前、治疗2周时和治疗后第4周时的NIH慢性前列腺炎症状指数(NIH-CPSI)评分,包括疼痛不适、排尿表现、生活质量以及整体评分,根据治疗前后NIH-CPSI评分变化判断疗效,以评估治疗方法的有效性。方法:本文收集2013年5月-2015年12月期间在济钢集团有限公司总医院进行治疗的Ⅲ型前列腺炎病人100名,年龄24-56岁,平均43岁;病程4-38个月,平均28.6个月。将病人随机划分成观察以及对照两个小组各50名。两组均应用超声电导前列腺治疗仪进行治疗。观察组耦合剂使用川芎嗪注射液20ml,含川芎嗪80mg,对照组耦合剂是0.9%NaCl溶液20ml,每天进行一次,持续治疗2周。依次在治疗以前、治疗2周时和治疗后第4周时实施NIH-CPSI评分,内容包括疼痛不适、排尿表现、生活质量以及整体评分,根据治疗以前和以后评分变化判断疗效。NIH-CPSI总分减少5分为无效,总分减少5-15分为有效,总分减少15分为显效。以有效和显效计算总有效率。结果:1、两组治疗前后NIH-CPSI评分比较:两个小组治疗第2周时以及治疗后第4周时在NIH-CPSI评分都比治疗以前低,P值均0.05;而对两个小组在治疗第2周时以及治疗后第4周时NIH-CPSI评分对比,P均0.05;观察小组在治疗第2周时和治疗结束后第4周时NIH-CPSI评分都低于同时点的对照小组,P值均0.05。2、两组临床疗效比较:观察小组治疗2周时以及治疗结束后第4周的整体有效率依次是92%、92%,对照小组在这个时间点上则是80%、76%;两组同时点总有效率比较,P均0.05。结论:川芎嗪经超声电导前列腺治疗仪直肠给药可明显改善Ⅲ型前列腺炎病人临床症状,能够提升生活质量,疗效持续而稳定,因此可作为Ⅲ型前列腺炎不仅安全可靠,而且非常有效的治疗手段,建议在临床上运用及推广。
[Abstract]:Background and objective: chronic prostatitis is a very common disease in adult males, among them, the more common type III, the proportion of over 90%, can be repeated pain symptoms, serious impact on the life quality of the patients. The most commonly used clinical drugs, including antibiotics, alpha blockers, plant preparations, anti depression or anxiety medicine, Chinese medicine, combined with massage, biofeedback and conditioning hyperthermia these methods for treatment, but there is not a kind of method is very satisfactory, exact and lasting effect. Among them, the prostate acinar cells in lipid membrane prevents most of the drug to penetrate them, because prostatitis cause prostate tissue pH value, dispersion effect of reducing drug 'low, so into the prostate gland canal, and acinar cell concentration is relatively limited, which greatly affected the effect of drug treatment. Ultrasound treatment principle is the ultrasonic energy in people The body parts of the disease, in order to achieve cure disease and promote the recovery of the body, it is based on a variety of biological reactions, such as ultrasonic on the body to produce thermal, mechanical, acoustic streaming and cavitation effect. In addition to these biological effects itself, ultra sonic also has very good function of drug penetration, can increase the drug concentration in target organs, improve the curative effect of Ligustrazine. Is an alkaloid extracted from Rhizoma Chuanxiong in, can curb the generation of free radicals, superoxide dismutase activity increased, can also accelerate the elimination of oxygen free radicals, the blood rheology was improved, in addition to curb platelet accumulation, inhibition of fibrosis, adjustment lipid metabolism, antagonize lipid peroxidation, pharmacological effect is very extensive. This study through the observation group and the control group received Ligustrazine by ultrasound conductimeter in the rectum Administration of treatment results, analysis of patients before treatment, NIH chronic prostatitis symptom index after fourth weeks of treatment and 2 weeks during treatment (NIH-CPSI) score, including pain, urination, and overall quality of life score, according to the NIH-CPSI score before and after treatment to determine efficacy, in order to assess the effectiveness of treatment methods: this collection from May 2013 -2015 year in December during the period of type III prostatitis patients 100 were treated in general hospital of Jinan Steel Group Co. Ltd, 24-56 years of age, an average of 43 years; the course of disease was 4-38 months, with an average of 28.6 months. The patients were randomly divided into observation and control groups of two each 50. Two groups were used electric ultrasonic prostate therapeutic apparatus for treatment. The observation group used couplant Ligustrazine Injection 20ml, ligustrazine contained 80mg, the control group is 0.9%NaCl coupling agent solution for 20ml, once a day, according to the therapy lasted for 2 weeks. In the implementation of the NIH-CPSI score before the treatment, after 2 weeks of treatment and fourth weeks after treatment, including pain, urination, and overall quality of life scores before and after treatment, according to the score changes to determine the efficacy of.NIH-CPSI score reduced 5 points for the total score of 5-15 points for reducing invalid, effective, total 15 decrease markedly divided into to calculate the total effective rate of 1. Results: the NIH-CPSI scores between the two groups before and after treatment: two groups after second weeks and fourth weeks after treatment in NIH-CPSI score than before treatment, P value was 0.05; while the two group in the treatment of second weeks and fourth weeks after treatment the NIH-CPSI score comparison, P 0.05; NIH-CPSI in the observation group after second weeks of treatment and fourth weeks after treatment were lower than that of the control group at the same time, the P value was 0.05.2, compared the clinical efficacy of two groups: the observation group therapy at 2 weeks and treatment Fourth weeks after the end of treatment the overall efficiency are 92%, 92%, the control group at this point in time is 80%, 76%; the total efficiency of two groups at the same time, P was 0.05. conclusion: Ligustrazine transrectal ultrasound prostate therapy administered conductance can significantly improve the clinical symptoms of prostatitis patients, can to enhance the quality of life, sustained and stable curative effect, it can be used as type III prostatitis is not only safe, but also very effective treatment, use and promotion recommendations in clinic.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R697.33

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