包皮环切术联合α受体阻滞剂治疗慢性前列腺炎的临床研究

目的:探讨α-受体阻滞剂联合包皮环切术治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床疗效。方法:目标选择2016年7月至2017年10月上海市第一人民医院收治的100例年龄18～50岁的包皮过长同时合并CP/CPPS患者为研究对象,将其随机分为包皮环切术组58例和对照组52例。包皮环切术组的患者接受α-受体阻滞剂治疗的同时进行包皮环切术,对照组仅给予α-受体阻滞剂治疗。采用国际慢性前列腺炎症状指数NIH-CPSI的变化评估和比较两组的治疗效果。结果:以NIH-CPSI总分3个月从基线减少4分为治疗有效,包皮环切术组和对照组治疗有效率分别为82.6%、62.5%,包皮环切术组显著高于对照组(P0.001)。治疗12周后,包皮环切术组NIH-CPSI总分的中位数从24.0±4.0降至12.0±8.0(P0.001),对照组从24.0±3.0降至15.0±7.0(P0.001),两组比较差异具有统计学意义(P0.001)。包皮环切组NIH-CPSI总分、疼痛评分、尿路评分和生活质量评分均明显低于对照组(P0.001)。结论:与单独应用α受体阻滞剂相比,联合包皮环切术联合α-受体阻滞剂药物治疗更有效提高CP/CPPS患者的临床疗效,改善患者的慢性前列腺炎症状评分。

A Clinical Study on Circumcision Combined with Alpha Receptor Blocker in the Treatment of Chronic Prostatitis/chronic Pelvic Pain Syndrome

ABSTRACT Objective: To evaluate the efficacy of circumcision combined with alpha-blocker therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: 121 uncircumcised men age 18-50 years old with redundant prepuce and CP/CPPS were selected in Shanghai general hospital from July 2016 to October 2017. Subjects assigned to the circumcision group were given medications(alpha-blocker) and set for surgery the same period in each sites by study clinicians. Subjects assigned to the control group were asked to only take the same medications and remain uncircumcised status. The changes of National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) were used to compare the therapeutic effect of two groups. Results: The primary outcome was a reduction of at least 4 points in the score on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). The ratio of men with a decrease of at least 4 points in their total NIH-CPSI score from baseline to 12 weeks was 82.6% in the circumcision group and 62.5% in the control group(P<0.001). The median of total NIH-CPSI score decreased significantly from 24.0±3.0 to 12.0±8.0(P<0.001) in the circumcision group, and in the control group the change was from 24.0±3.0 to 15.0±7.0(P<0.001), it could be ob- served that there was significant difference between circumcision group and control group(P<0.001). Conclusion: Our findings shows that circumcision plus alpha-blocker therapy results in improvement in the NIH-CPSI scores compared with the medications therapy alone for CP/CPPS patients.