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目的研究α-受体阻滞剂和抗抑郁药联合治疗Ⅲ型前列腺炎的效果。方法本组48例被诊断为Ⅲ型前列腺炎(CP/CPPS)的患者,年龄20~50岁,平均30岁。均有会阴区域疼痛、尿频及紧张、焦虑等症状。病程3月~2年,平均18个月。均有抗生素治疗史,疗效不佳。采用α-受体阻滞剂(多沙唑嗪控释片4mg/d或坦索罗辛2mg/d口服)、抗抑郁药(舍曲林50mg/d或文拉法辛75mg/d口服)联合疗法,3个月为一疗程。在治疗前、治疗后4周、8周和12周对患者进行美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分并记录不良反应情况。疗效评定标准为:(1)显效:NIH-CPSI较治疗前下降>15分;(2)有效:NIH-CPSI较治疗前下降>5分;(3)无效:NIH-CPSI较治疗前下降<5分或上升。总有效率为显效率与有效率之和。结果显效16例,有效25例,无效4例,总有效率91%(41/45)。2例患者因药物不良反应退出治疗。结论α-受体阻滞剂和抗抑郁药联合治疗方案安全有效,可以明显缓解Ⅲ型前列腺炎患者的临床症状。
Objective To study the effect of combination of α-blockers and antidepressants on type Ⅲ prostatitis. Methods 48 patients were diagnosed as type Ⅲ prostatitis (CP / CPPS) patients, aged 20 to 50 years, mean 30 years. Have perineal area pain, frequent urination and tension, anxiety and other symptoms. Duration of 3 months to 2 years, an average of 18 months. Antibiotic treatment history, poor efficacy. Anti-depressants (sertraline 50 mg / day or venlafaxine 75 mg / day orally) were administered with alpha-blockers (doxazosin controlled-release tablets 4 mg / day or tamsulosin 2 mg / day orally) Combination therapy, 3 months for a course of treatment. Patients underwent NIH-CPSI scores before treatment, 4 weeks, 8 weeks, and 12 weeks after treatment and adverse events were recorded. (2) Effective: NIH-CPSI decreased more than 5 points before treatment; (3) Invalid: NIH-CPSI decreased compared with that before treatment < 5 points or up. The total effective rate for the efficiency and effectiveness of the sum. The results were markedly effective in 16 cases, effective in 25 cases, ineffective in 4 cases, the total effective rate was 91% (41/45). Two patients withdrew due to adverse drug reactions. Conclusion The combination therapy of α-blockers and anti-depressant drugs is safe and effective, which can obviously relieve the clinical symptoms of type Ⅲ prostatitis.