摘要
目的:观察黄莪胶囊治疗ⅢA型前列腺炎的临床疗效及其对患者前列腺按摩液(EPS)炎症细胞因子中性粒细胞弹性蛋白酶(NE)、白细胞介素-8(IL-8)和转化生长因子β1(TGF-β1)水平的影响.方法:选取符合纳入标准的120例ⅢA型前列腺炎患者随机分为治疗组60例和对照组60例.治疗组采用黄莪胶囊治疗,对照组口服左氧氟沙星片配合盐酸坦洛新缓释片治疗,4周为一疗程.比较两组临床疗效,观察两组治疗后慢性前列腺炎症状指数(NIH-CPSI)评分改善情况,以及EPS中NE、IL-8和TGF-β1的变化情况.结果:最终纳入116例,治疗组59例,对照组57例.治疗组总有效率为89.8％,对照组总有效率为77.2％,两组比较差异具有统计学意义(P＜0.05).治疗前,治疗组与对照组患者NIH-CPSI总分及各项评分(疼痛症状评分、排尿症状评分、生活质量影响评分)分别为[(32.5±7.4)、(13.7±3.9)、(6.9±2.4)、(8.3±2.7)分]、[(30.8±7.8)、(14.2±4.1)、(7.1±2.7)、(8.1±2.4)分],治疗后分别为[(13.2±5.1)、(4.2±2.3)、(5.1±3.2)、(3.7±1.5)分]、[(17.3±4.9)、(7.8±2.9)、(4.9±3.4)、(5.6±1.9)分],两组较均有显著下降(P＜0.05),且治疗组疼痛症状评分、生活质量影响评分改善效果明显优于对照组,差异具有统计学意义(P＜0.05).治疗前,治疗组与对照组患者EPS中NE、IL-8、TGF-β1 含量分别为[(1135.4±321.5)、(974.9±231.6)、(591.0±172.1)ng/L]、[(1 052.8±280.3)、(1 007.5±287.7)、(607.8±201.3)ng/L],治疗后分别为[(347.6±207.3)、(431.3±207.2)、(1 402.1±221.5)ng/L]、[(761.1±225.1)、(775.7±182.5)、(871.3±192.5)ng/L],两组 EPS 中 NE 含量、IL-8 均有显著下降,TGF-β1含量显著提高,差异具有统计学意义(P＜0.05);且治疗组改善情况明显优于对照组,差异具有统计学意义(P＜0.05).结论:黄莪胶囊治疗ⅢA型前列腺炎临床疗效显著,可有效缓解患者症状,减轻患者疼痛,对炎症细胞因子NE、IL-8和TGF-β1水平有较好的改善作用,且安全可靠.
Abstract
Objective:To investigate the clinical efficacy of Huang'e Capsules in the treatment of type Ⅲ A chronic prostatitis,and its effects on the levels of the inflammatory cytokines neutrophil elastase(NE),IL-8 and TGF-β1 in the expressed prostatic secre-tion(EPS)of the patients.Methods:We selected 120 patients with type Ⅲ A chronic prostatitis and randomly assigned them to medication with Huang'e Capsules(the trial group,n=60)or Levofloxacin and Tamsulosin(the control group,n=60),both for a course of 4 weeks.We obtained the NIH-CPSI scores and the levels of NE,IL-8 and TGF-β1 in the EPS,and compared them between the two groups before and after treatment.Results:Totally,116 of the patients completed the study,59 in the trial and 57 in the control group.The overall clinical effectiveness was significantly higher in the trial group than in the control(89.8％vs77.2％,P＜0.05).Compared with the baseline,the patients of the trial group showed significant decreases after treatment in the total NIH-CPSI scores(32.5±7.4 vs 13.2±5.1),pain symptom scores(13.7±3.9 vs 4.2±2.3),urination symptom scores(6.9±2.4 vs 5.1±3.2)and quality of life(QOL)scores(8.3±2.7 vs 3.7±1.5)(all P＜0.05),and so did the controls in the total NIH-CPSI scores(30.8±7.8 vs 13.7±3.9),pain symptom scores(14.2±4.1 vs 7.8±2.9),urination symptom scores(7.1±2.7 vs 4.9±3.4)and quality of life(QOL)scores(8.1±2.4 vs 5.6±1.9)(allP＜0.05),and the decreases were even more significant in the trial than in the control group in the pain symptom and QOL scores(P＜0.05).The patients of the trial group also exhibited a marked reduction after treatment in the contents of NE([1135.4±321.5]vs[347.6±207.3]ng/L,P＜0.05)and IL-8([974.9±231.6]vs[431.3±207.2]ng/L,P＜0.05)but an elevation in that of TGF-β1([591.0±172.1]vs[1 402.1±221.5]ng/L,P＜0.05)in the EPS,and so did the controls in the levels of NE([1052.8±280.3]vs[761.1±225.1]ng/L,P＜0.05),([1007.5±287.7]vs[775.7±182.5]ng/L,P＜0.05),([607.8±201.3]vs[871.3±192.5]ng/L,P＜0.05),with even more significant improvement in the trial than in the control group(P＜0.05).Conclusion:Huange Capsules has a significant clinical efficacy and safety in the treatment of type ⅢA prostatitis,which can effectively relieve the pain and urination symptoms and improve the levels of the inflammatory cytokines NE,IL-8 and TGF-β1 in the patients.
维普
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