经会阴超声治疗慢性前列腺炎临床研究

目的:观察NIH-CPSI积分、前列腺常规检查等指标,评价超声疗法治疗慢性前列腺炎的临床疗效以及安全性。方法:采用随机、双盲、多中心试验设计。共纳入96例符合标准的慢性前列腺炎患者,北京中医药大学东直门医院、卫生部中日友好医院各48例,均分为两组。A组超声治疗仪为实际真实的超声治疗仪,在治疗过程中产生超声;B组的超声治疗仪为外形、操作完全一致,但不产生超声的超声治疗仪。治疗2周,隔日治疗1次,每次10 min,共7次。比较治疗后两组有效率,治疗前与治疗后组内、组间NIH-CPSI评分、白细胞、卵磷脂小体变化。监测安全性。结果:A组总有效率为70.83%,B组总有效率为25%,差异有统计学意义(P<0.001);A组NIH-CPSI疼痛与不适评分、NIH-CPSI排尿症状评分、NIH-CPSI生活质量评分、NIH-CPSI总评分较治疗前均有显著改善(P<0.05);B组NIH-CPSI疼痛与不适评分、NIH-CPSI总评分较治疗前有显著改善(P<0.05);治疗前两组各指标积分比较无显著差异(P>0.05);治疗后两组组间比较NIH-CPSI疼痛与不适评分、NIH-CPSI排尿症状评分、NIH-CPSI总评分有显著差异(P<0.05);白细胞、卵磷脂小体治疗前后组内、组间比较均无统计学意义(P>0.05)。不良事件方面A组2例、B组1例,组间比较差别不显著(P>0.05)。结论:经会阴超声治疗慢性前列腺炎疗效显著(尤其是在改善疼痛方面),安全可靠、操作简单,患者易接受,值得进一步推广。

Transperineal ultrasonic therapy for chronic prostatitis

Objective: To evaluate the clinical efficacy and safety of transperineal ultrasonic therapy for chronic prostatitis(CP) by analyzing the scores of NIH-CPSI and the results of prostate fluid routine examination.Methods: We conducted a randomized,double-blind,multi-centered trial on 96 CP patients that met the inclusion criteria.We divided the patients into groups A(trial) and B(control) of equal number,the former treated by transperineal ultrasound,while the latter with the same machine but no ultrasound waves,10 min a time qd alt for 2 weeks.Then we evaluated the therapeutic effect and safety by comparing the scores of NIH-CPSI and counts of white blood cells(WBC) and lecithin corpuscles(LC) in the prostate fluid between the two groups before and after treatment.Results: The total effectiveness rate was 70.83% in group A and 25% in group B(P<0.01).The scores on prostate pain,urinary symptoms and quality of life as well as the total NIH-CPSI score were significantly improved in group A as compared with pretreatment(P<0.05),and so were the prostate pain score and total NIH-CPSI score in group B(P<0.05).Statistically significant differences were observed between the two groups in the scores on prostate pain and urinary symptoms and total NIH-CPSI score after treatment(P<0.05),but not in any of the NIH-CPSI scores before treatment(P>0.05),nor were there any significant differences in the counts of WBCs and LC either between the two groups or within each group before and after treatment(P>0.05).Two patients experienced adverse events in group A,and 1 in group B(P>0.05).Conclusion: Transperineal ultrasonic therapy is highly effective for CP,especially in relieving prostate pain.With its advantages of safety,easy operation and high acceptability,it deserves a wider clinical application.