左氧氟沙星、特拉唑嗪单独和联合治疗Ⅲ型慢性前列腺炎的随机对照研究
发布时间：2018-09-14 16:27
【摘要】：目的：1.观察左氧氟沙星、特拉唑嗪单独和联合治疗Ⅲ型慢性前列腺炎的疗效；2.比较各组中ⅢA型和ⅢB型前列腺炎的治疗效果,评估Ⅲ型慢性前列腺炎分型为ⅢA和ⅢB两个亚型的临床价值；3.探讨Ⅲ型慢性前列腺炎的发病机制。材料与方法：按照美国国立卫生研究院(National Institutes of Health,NIH)诊断标准,将115例Ⅲ型前列腺炎患者随机分成3组,左氧氟沙星组38例；特拉唑嗪组38例；联合治疗组39例。按国际慢性前列腺炎症状评分(chronic prostatitis symptom index, CPSI)标准对所有患者进行总评分,并分别进行排尿症状评分、疼痛症状评分以及生活质量影响评分；国际勃起功能指数-5(International Index of Erectile Function-5, IIEF-5)评分了解患者性功能状况；显微镜下检测前列腺液标本中白细胞(white blood cell, WBC):和卵磷脂小体(small particle of lecithin, SPL)数量；经腹行前列腺彩色多普勒检查了解前列腺组织的炎症程度；并测定最大尿流率(maximum flow rates, MFR)和平均尿流率(average flow rate, AFR)。治疗6周后,观察各组治疗前后NIH-CPSI评分、ⅡEF-5评分、前列腺按摩液检查及尿流动力学指标的变化。结果：1.经过6周治疗后,NIH-CPSI评分左氧氟沙星组由治疗前(24.1±7.1)分降至(13.2±4.4)分,特拉唑嗪组由治疗前(22.4±6.8)分降至(17.8±5.3)分,联合治疗组由治疗前(22.6±6.6)分降至(11.3±2.3)分。左氧氟沙星组与特拉唑嗪组对比在统计学上有显著性差异(P0.01)；联合治疗组与特拉唑嗪组疗效对比有显著性差异(P0.01)；左氧氟沙星组与联合治疗组比较无显著性差异(p0.05)。2.前列腺液(expressed prostatic secretion,EPS)白细胞数左氧氟沙星组治疗前后分别是(13.4±4.6)、(6.8±2.9)；特拉唑嗪组分别是(12.7±4.3)、(10.1±3.8)；联合治疗组分别是(12.6±4.4)、(6.0±2.3)。左氧氟沙星组与特拉唑嗪组比较在统计学上有显著性差异(P0.01)；联合治疗组与特拉唑嗪组比较有显著性差异(P0.01)；左氧氟沙星组与联合治疗组比较无显著性差异(p0.05)。3.ⅡEF.5评分左氧氟沙星组治疗前后分别是(10.8±2.9)、(16.1±4.4)；特拉唑嗪组分别是(11.1±3.0)、(16.8±4.6)；联合治疗组分别是(11.2±3.2)、(17.2±4.3)；三组比较无显著性差异(p0.05)。4.最大尿流率(MFR)左氧氟沙星组治疗前后分别是(16.1±5.8)ml/s和(19.3±6.1)ml/s；特拉唑嗪组分别是(16.5±6.3)ml/s.(20.1± 6.7)ml/s；联合治疗组分别是(16.2±6.0)ml/s.(19.7±6.4)ml/s；三组比较无显著性差异(p0.05)。5.平均尿流率(AFR)左氧氟沙星组治疗前后分别是(8.3±3.4)ml/s和(9.9±3.3)ml/s；特拉唑嗪组分别是(8.0±3.1)ml/s.(10.1±3.2)ml/s；联合治疗组分别是(8.2±2.9)ml/s.(10.3±3.1)ml/s；三组比较无显著性差异(p0.05)。6.各组中治疗前后NIH-CPSI评分ⅢA型ⅢB型对比不存在显著性差异(p0.05)。7.各组中治疗前后EPS-SPL数量变化ⅢA型和ⅢB型对比不存在显著性差异(p0.05)。结论：1.对于一个6周的短期治疗单用左氧氟沙星比单用特拉唑嗪效果明显；2.单用左氧氟沙星与左氧氟沙星和特拉唑嗪的联合治疗疗效相比无显著性差异；3.各组中ⅢA型和ⅢB型前列腺炎治疗效果对比无显著性差异；4.以EPS-WBC分型为ⅢA和ⅢB两个亚型对诊断及评价疗效帮助有限,分型的意义有待进一步明确。
[Abstract]:Objective: 1. To observe the efficacy of levofloxacin and terazosin alone and in combination in the treatment of type III chronic prostatitis; 2. To compare the therapeutic effects of type III A and type III B prostatitis in each group, and to evaluate the clinical value of type III chronic prostatitis classified into two subtypes: type III A and type III B; 3. To explore the pathogenesis of type III chronic prostatitis. Methods: According to the National Institutes of Health (NIH) diagnostic criteria, 115 patients with type III prostatitis were randomly divided into three groups: levofloxacin group (38 cases), terazosin group (38 cases) and combined treatment group (39 cases). All patients were scored with a total score, and urinary symptom score, pain symptom score and quality of life impact score; International Index of Erectile Function-5 (IIEF-5) score to understand the sexual function of patients; microscopic detection of white blood cell (WB) in prostatic fluid samples. C: and the number of small particle of lecithin (SPL); the degree of inflammation of prostate tissue was detected by transabdominal prostate color Doppler imaging; and the maximum flow rates (MFR) and average flow rate (AFR) were measured. After 6 weeks of treatment, the NIH-CPSI score and the second EF-5 score were observed before and after treatment. Results: 1. After 6 weeks of treatment, the NIH-CPSI score of levofloxacin group decreased from 24.1 (+ 7.1) to 13.2 (+ 4.4) points, that of terazosin group from 22.4 (+ 6.8) to 17.8 (+ 5.3) points, and that of combined treatment group from 22.6 (+ 6.6) to 11.3 (+ 2.3) points. There was significant difference between the two groups (P 0.01). There was no significant difference between the levofloxacin group and the combined treatment group (P 0.05). 2. Levofloxacin group and the combined treatment group (P 0.05). 2. Levofloxacin group (expressed prostatic secretion, EPS) white blood cell count. Before and after treatment were (13.4 [4.6], (6.8 [2.9], terazosin group were (12.7 [4.3], (10.1 [3.8]), combined treatment group were (12.6 [4.4], (6.0 [2.3], levofloxacin group and terazosin group were statistically significant (P 0.01); combined treatment group and terazosin group were significantly different (P 0.01); There was no significant difference between ofloxacin group and combined treatment group (p0.05). 3. II EF.5 scores of levofloxacin group before and after treatment were (10.8 + 2.9), (16.1 + 4.4); terazosin group was (11.1 + 3.0), (16.8 + 4.6); combined treatment group was (11.2 + 3.2), (17.2 + 4.3); there was no significant difference among the three groups (p0.05). 4. The rate (MFR) of levofloxacin group before and after treatment was (16.1+5.8) ml/s and (19.3+6.1) ml/s respectively; that of terazosin group was (16.5+6.3) ml/s. (20.1+6.7) ml/s respectively; that of combined treatment group was (16.2+6.0) ml/s. (19.7+6.4) ml/s; that of levofloxacin group was (p0.05). 5. (8.3 + 3.4) ml / s and (9.9 + 3.3) ml / s; terazosin group was (8.0 + 3.1) ml / s. (10.1 + 3.2) ml / s; combined treatment group was (8.2 + 2.9) ml / s. (10.3 + 3.1) ml / s; there was no significant difference among the three groups before and after treatment (p0.05). There was no significant difference in the NIH-CPSI score between the three groups before and after treatment (p0.05). 7. There was no significant difference in the number of PS-SPL between type III A and type III B (p0.05). Conclusion: 1. Levofloxacin alone was more effective than terazosin alone for a short-term treatment of 6 weeks; 2. Levofloxacin alone was not significantly different from levofloxacin and terazosin combined therapy; 3. There was no significant difference between the therapeutic effect of type III B prostatitis and that of type III B prostatitis.
【学位授予单位】：山东大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R697.3
本文编号：2243249
[Abstract]:Objective: 1. To observe the efficacy of levofloxacin and terazosin alone and in combination in the treatment of type III chronic prostatitis; 2. To compare the therapeutic effects of type III A and type III B prostatitis in each group, and to evaluate the clinical value of type III chronic prostatitis classified into two subtypes: type III A and type III B; 3. To explore the pathogenesis of type III chronic prostatitis. Methods: According to the National Institutes of Health (NIH) diagnostic criteria, 115 patients with type III prostatitis were randomly divided into three groups: levofloxacin group (38 cases), terazosin group (38 cases) and combined treatment group (39 cases). All patients were scored with a total score, and urinary symptom score, pain symptom score and quality of life impact score; International Index of Erectile Function-5 (IIEF-5) score to understand the sexual function of patients; microscopic detection of white blood cell (WB) in prostatic fluid samples. C: and the number of small particle of lecithin (SPL); the degree of inflammation of prostate tissue was detected by transabdominal prostate color Doppler imaging; and the maximum flow rates (MFR) and average flow rate (AFR) were measured. After 6 weeks of treatment, the NIH-CPSI score and the second EF-5 score were observed before and after treatment. Results: 1. After 6 weeks of treatment, the NIH-CPSI score of levofloxacin group decreased from 24.1 (+ 7.1) to 13.2 (+ 4.4) points, that of terazosin group from 22.4 (+ 6.8) to 17.8 (+ 5.3) points, and that of combined treatment group from 22.6 (+ 6.6) to 11.3 (+ 2.3) points. There was significant difference between the two groups (P 0.01). There was no significant difference between the levofloxacin group and the combined treatment group (P 0.05). 2. Levofloxacin group and the combined treatment group (P 0.05). 2. Levofloxacin group (expressed prostatic secretion, EPS) white blood cell count. Before and after treatment were (13.4 [4.6], (6.8 [2.9], terazosin group were (12.7 [4.3], (10.1 [3.8]), combined treatment group were (12.6 [4.4], (6.0 [2.3], levofloxacin group and terazosin group were statistically significant (P 0.01); combined treatment group and terazosin group were significantly different (P 0.01); There was no significant difference between ofloxacin group and combined treatment group (p0.05). 3. II EF.5 scores of levofloxacin group before and after treatment were (10.8 + 2.9), (16.1 + 4.4); terazosin group was (11.1 + 3.0), (16.8 + 4.6); combined treatment group was (11.2 + 3.2), (17.2 + 4.3); there was no significant difference among the three groups (p0.05). 4. The rate (MFR) of levofloxacin group before and after treatment was (16.1+5.8) ml/s and (19.3+6.1) ml/s respectively; that of terazosin group was (16.5+6.3) ml/s. (20.1+6.7) ml/s respectively; that of combined treatment group was (16.2+6.0) ml/s. (19.7+6.4) ml/s; that of levofloxacin group was (p0.05). 5. (8.3 + 3.4) ml / s and (9.9 + 3.3) ml / s; terazosin group was (8.0 + 3.1) ml / s. (10.1 + 3.2) ml / s; combined treatment group was (8.2 + 2.9) ml / s. (10.3 + 3.1) ml / s; there was no significant difference among the three groups before and after treatment (p0.05). There was no significant difference in the NIH-CPSI score between the three groups before and after treatment (p0.05). 7. There was no significant difference in the number of PS-SPL between type III A and type III B (p0.05). Conclusion: 1. Levofloxacin alone was more effective than terazosin alone for a short-term treatment of 6 weeks; 2. Levofloxacin alone was not significantly different from levofloxacin and terazosin combined therapy; 3. There was no significant difference between the therapeutic effect of type III B prostatitis and that of type III B prostatitis.
【学位授予单位】：山东大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R697.3
【参考文献】
相关期刊论文 前10条
1 高佃军;郭永顺;于海易;王玉军;崔为国;;青年人群中前列腺炎样症状及其相关因素的调查[J];中华男科学杂志;2007年12期
2 周强;李兰群;李曰庆;;慢性前列腺炎证治中存在的问题与对策[J];中华中医药杂志;2007年01期
3 叶章群;蓝儒竹;王少刚;蔡松良;陈戈明;李宁忱;宋毅;那彦群;;舍尼通~和抗生素联合用药治疗慢性非细菌性前列腺炎临床研究[J];中华男科学杂志;2006年09期
4 李战松;;特拉唑嗪联合抗生素及锌硒宝治疗慢性前列腺炎的疗效观察[J];中华男科学杂志;2006年04期
5 商学军;黄宇烽;邵永;薛晓同;管凤刚;李光;王杰;;龙金通淋胶囊治疗慢性前列腺炎/慢性骨盆疼痛综合征的初步研究[J];中华男科学杂志;2006年04期
6 黄海;刘紫庭;杨罗艳;;前列腺液白细胞计数与炎症性慢性骨盆疼痛综合征的关系[J];医学临床研究;2006年01期
7 陈琦,魏莎莉;慢性非细菌性前列腺炎/慢性盆腔疼痛综合征发病机制研究进展[J];国外医学.泌尿系统分册;2005年05期
8 庞自力,石理华;慢性非细菌性前列腺炎患者的前列腺液和前列腺组织中的细菌16SrRNA基因检测[J];临床泌尿外科杂志;2005年02期
9 梁朝朝,张学军,郝宗耀,施浩强,王克孝;慢性前列腺炎与性功能障碍的调查分析[J];中华男科学;2004年06期
10 王尉,何恢绪,胡卫列,张小明,王元利;前列腺内直接注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征[J];中华男科学;2004年03期
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