Ⅲ型慢性前列腺炎综合治疗分析.docVIP

Ⅲ型慢性前列腺炎综合治疗分析 　 作者：刘军平 葛金山 陈文彬 崔书平 李辉 刘建震 【摘 要】 目的 探讨Ⅲ型慢性前列腺炎（CPⅢ型）的有效治疗方法。方法 分析205例CPⅢ型患者的病史和实验室检查结果，依据美国国立卫生研究院（NIH）前列腺炎的诊断标准进行分类，综合治疗8～12周。Ⅲa型77例给予甲砜霉素或复方新诺明抗生素口服4周，并给予硝基呋喃类栓剂（呋喃妥因栓）纳肛8周。Ⅲb型128例给予甲砜霉素或复方新诺明抗生素口服4周，消炎痛栓纳肛8～12周。所有患者加服中成药清淋冲剂、参阳胶囊8～12周并配合心理治疗及热水坐浴。根据慢性前列腺炎症状指数评分（CPSI）、症状及体征判断疗效。结果 治疗8～12周后显效155例（75.6%），有效36例(17.6%)，无效14例(6.8%)。结论 综合性治疗是CPⅢ型的有效治疗方法。 　【关键词】 慢性前列腺炎；综合性治疗 　【Abstract】 Objective To study the clinical treatment of the type Ⅲ chronic prostatitis (CPⅢ). Methods Based on National Institute Health (NIH) classification, 205 cases of the type Ⅲ chronic prostatitis were surveyed by analysis of their laboratory results and clinical history. In addition, the type Ⅲ chronic prostatitis symptom index (CPSI) of each patient was evaluated. 77 cases were type Ⅲa and 128 cases were type Ⅲb. All patients were comprehensively treated for 8 to 12 weeks. Thiamphenicol or Sulfamethoxazole tablet compound and Nitrofurantion suppositorum were given to type Ⅲa for 8 weeks.Thiamphenicol or Sulfamethoxazole tablet compound for 4 weeks, and with Indomethacin suppositorum for 8 to 12 weeks were given to type Ⅲb. All patients were additionally treated by psychological and physical therapies. Traditional Chinese Medicine was also used in all patients. Results 155 patients (75.6%) were significantly improved, 36(17.6 %) slightly improved and only 14 (6.8%) did not respond to the therapy. Conclusion Comprehensive treatment is an effective method for the patients with type Ⅲ chronic prostatitis. 　【Key words】 Chronic prostatitis；Comprehensive treatment 慢性前列腺炎（CP）Ⅲ型是泌尿外科的常见病，严重影响患者的生活质量，迁延难愈，治疗效果不佳，任何单一疗法的疗效均不甚理想。作者自2004年3月～2005年7月应用综合疗法治疗205例CPⅢ型患者，现报告如下。 1 资料与方法 1.1 临床资料 本组205例，年龄17～70岁，平均31岁，病程3个月～4年。186例有不同程度的尿频、尿急、尿等待、排尿不尽等排尿异常，伴有会阴部、外生殖器、小腹、腹股沟、腰骶部不同程度的疼痛不适；19例以早泄、性欲低下、射精痛、遗精频繁等性功能异常为主要表现；78例伴有情绪紧张、焦虑、压抑、失眠、多梦、乏力等精神症状。所有患者均进行直肠指诊,检查前列腺大小、质地、压痛程度，了解肛门括约肌、肛提肌等压痛情况。全部患者均有前列腺压痛。肛诊时一并行前列腺按摩取前列腺液检查。肉眼观察前列腺液呈黄色脓样或前列腺液常规检查提示白细胞满视野者行前列腺液细菌培养及药敏试验。细菌培养阳性者（细菌性前列腺炎）不在本研究之列