摘要
慢性前列腺炎/慢性盆腔疼痛综合征(chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS)是一种常见的泌尿外科疾病,其病因十分复杂,西医治疗效果欠佳,病程迁延不愈,给患者带来很大困扰.中医药在辨证论治基础上,治疗该疾病的方式众多,采用中药内治、针灸推拿及其他外治疗法以综合治疗,效果显著.该研究对CP/CPPS的发病机制、病因病机及中医药治疗研究进展进行综述,发现西医对CP/CPPS病因病理及发病机制不能完全阐明,认为主要与特殊病原体感染、排尿功能障碍、精神心理异常、神经内分泌异常、免疫异常、氧化应激过强、盆腔疾病及遗传等诸多因素相关.中医则认为是由湿热、瘀血、气滞及毒浊所致,并与肝、脾、肾、肺、胃、膀胱等脏腑和冲任二脉、足三阴经等经络密切相关.在中医药治疗中,目前多采用中药内治(汤药、中成药及各著名医家的疗法)、针灸推拿治疗及其他外治方式(直肠给药、中药溻渍、中药坐浴熏洗、耳穴贴压等)相结合的综合治疗方案,进行全面综合调理,临床疗效显著,中医药特色突出,值得临床推广.该文旨在为临床防治CP/CPPS提供参考,并为该领域未来的研究提供潜在方向.
Abstract
Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)is a common urological disease with complex etiology.The treatment effect of western medicine is not satisfactory,and the course of the disease is protracted,which brings great trouble to pa-tients.Traditional Chinese medicine(TCM)has a variety of treatment methods based on syndrome differentiation and treatment,inclu-ding internal treatment with TCM,acupuncture and massage,and other external treatment methods for comprehensive treatment,with significant effect.This study summarized the etiology and pathogenesis of CP/CPPS and found that western medicine cannot fully ex-plain the etiology and pathogenesis of CP/CPPS.It was believed that CP/CPPS was mainly related to many factors such as special pathogen infection,voiding dysfunction,mental and psychological abnormalities,neuroendocrine abnormalities,immune abnormalities,excessive oxidative stress,pelvic diseases,and heredity.TCM believed that CP/CPPS was caused by damp heat,blood stasis,Qi stagnation,and poisoning and was closely related to the organs of the liver,spleen,kidney,lung,stomach,bladder,and meridians of Chong and Ren channels and three yin channels of the foot.In the treatment of TCM,multiple comprehensive treatment plans are cur-rently used,including internal treatment with TCM(decoction,proprietary Chinese medicine,and unique therapies of famous doc-tors),acupuncture and massage treatment,and other external treatment methods(rectal administration,topical application of TCM,and ear acupoint pressure).Comprehensive regulation has significant clinical efficacy and prominent characteristics of TCM,and it is worth clinical promotion.This study aims to provide a reference for clinical prevention and treatment of CP/CPPS and points out poten-tial directions for future research in this field.
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