前列康片能彻底治愈缓慢前列腺炎吗?:前列康片联合头孢呋辛酯片对缓慢前列腺炎患者血清细胞因子的影响及效果剖析

来源:中国现代医生 ·2018年12月02日 19:58 浏览量:0

周利平 陈娟英 沈华 任黎刚 腾腾

[摘要] 意图 探討前列康片联合头孢呋辛酯片对缓慢前列腺炎患者血清细胞因子的影响及作用。 办法 挑选我院2013年1月~2015年12月接诊的148例缓慢前列腺炎患者,随机分红两组,调查组74例患者给予前列康片联合头孢呋辛酯片医治,对照组74例患者给予头孢呋辛酯片医治,经过比较两组患者临床症状改进、中医征兆及前列腺液中排泄型免疫球蛋白A(SIgA)、血管细胞粘附分子-1(VCAM-1)及血清VCAM-1改动,评论前列康片联合头孢呋辛酯片对缓慢前列腺炎患者血清细胞因子的影响及作用。 成果 调查组临床作用总有功率94.59%,高于对照组临床作用总有功率78.38%,两组比较差异有计算学含义(P<0.05)。两组医治前NIH-CPSI指数没有显着差异,两组医治后NIH-CPSI指数均有显着改进,调查组的改进更优于对照组,两组比较差异有计算学含义(P<0.05)。两组医治前中医证候积分没有显着差异,医治后均有所削减,调查组的削减大于对照组(t=3.0447,P=0.0033)。调查组中医证候作用总有功率91.89%,高于对照组中医证候作用总有功率72.97%,差异有计算学含义(P<0.05)。两组医治前前列腺液中SIgA、VCAM-1及血清VCAM-1均无显着差异,医治后均有下降,调查组的改进更优于对照组,两组比较差异有计算学含义(P<0.05)。 定论 前列康片联合头孢呋辛酯片的医治办法,能有用调理血清细胞因子操控炎症,对缓慢前列腺炎医治起到较好作用,值得临床使用。

[要害词] 前列康片;头孢呋辛酯片;缓慢前列腺炎;血清细胞因子

[中图分类号] R697.3 [文献标识码] A [文章编号] 1673-9701(2017)14-0028-04

[Abstract] Objective To investigate the influence and therapeutic effect of Qianliekang tablets combined with cefuroxime axetil tablets on serum cytokines in patients with chronic prostatitis. Methods 148 patients with chronic prostatitis who were admitted to our hospital from January 2013 to December 2015 were selected and randomly divided into two groups. The patients(n=74) in the observation group were treated with Qianliekang tablets combined with cefuroxime axetil tablets and 74 patients in the control group were treated with cefuroxime axetil tablets.The influence and therapeutic effect of Qianliekang tablets combined with cefuroxime axetil tablets on serum cytokines in patients with chronic prostatitis were explored by comparing the clinical symptoms improvement, Chinese medicine symptoms and the changes of secretory immunoglobulin A (SIgA),vascular cell adhesion molecule-1 (VCAM-1) and serum VCAM-1 between the two groups. Results The clinical total effective rate was 94.59% in the observation group, higher than 78.38% of the control group. The difference was statistically significant(P<0.05). There was no significant difference in NIH-CPSI index between the two groups before treatment, and the NIH-CPSI index was significantly improved in both groups after treatment. The improvement of the observation group was better than that of the control group, and the difference between the two groups was statistically significant(P<0.05). There was no significant difference in traditional Chinese medicine syndrome score between the two groups before treatment, and the score was reduced after treatment. The reduction in the observation group was greater than that in the control group(t=3.0447, P=0.0033). The total effective rate of traditional Chinese medicine syndrome was 91.89% in the observation group, which was higher than that in the control group(72.97%), and the difference was statistically significant(P<0.05). There was no significant differences in SIgA,VCAM-1 in prostatic fluid and serum VCAM-1 between the two groups before treatment,and the SIgA,VCAM-1 in prostatic fluid and serum VCAM-1were reduced after treatment.The improvement of the observation group was better than that of the control group,and the difference between the two groups was statistically significant(P<0.05). Conclusion The treatment of Qianliekang tablets combined with cefuroxime axetil tablets can effectively regulate the serum cytokines to control inflammation,which has a good effect on the treatment of chronic prostatitis,and is worthy of clinical application.

[Key words] Qianliekang tablets; Cefuroxime axetil tablets; Chronic prostatitis; Serum cytokines

缓慢前列腺炎是泌尿生殖疾病的一种,约有一半男性会在某个时期受其困扰,严重影响男性健康[1-2]。缓慢前列腺炎可分为缓慢细菌性前列腺炎和缓慢非细菌性前列腺炎,细菌性前列腺炎的病因主要为葡萄球菌属感染,临床多表现为重复发作的尿路感染[3-4]。非细菌性前列腺炎致病因较为杂乱,由多种原因一同导致,临床多表现为骨盆邻近痛苦。缓慢前列腺炎医治时间长,久治不愈可能会导致患者日子质量下降,影响患者身体及心理健康。针对性医治缓慢前列腺炎,不少药物取得了必定的成效,包含头孢呋辛酯片、前列舒通及宁泌泰胶囊等。有学者研讨发现[5-6],中医药医治缓慢前列腺炎有较好作用,其间选用前列康片医治缓慢前列腺炎更是具有共同优势。本研讨以我院2013年1月~2015年12月接诊的148例缓慢前列腺炎患者作为研讨目标,经过比较两组患者临床症状改进、中医征兆及前列腺液中SIgA、VCAM-1及血清VCAM-1改动,评论前列康片联合头孢呋辛酯片对缓慢前列腺炎患者血清细胞因子的影响及作用,现报导如下。

1 材料与办法

1.1 一般材料

挑选我院2013年1月~2015年12月接诊的148例缓慢前列腺炎患者,随机分红两组各74例,调查组患者给予前列康片联合头孢呋辛酯片医治,对照组患者给予头孢呋辛酯片医治。其间,调查组74例,年纪为22~50岁,均匀(32.4±7.1)岁;体重52~89 kg,均匀(64.7±11.4)kg;病程3~48个月,均匀(23.6±10.4)个月。对照组74例,年纪为21~49岁,均匀(34.1±8.4)岁;体重53~87 kg,均匀(66.2±11.8)kg;病程3~47个月,均匀(23.8±10.3)个月。本试验经医院道德委员会批阅经过,患者知情赞同并签署知情赞同书,归入扫除规范参照世界泌尿外科前列腺炎症确诊规范[7],一切患者确诊均契合缓慢前列腺炎,两组患者的年纪、体重和病程等一般材料无计算学含义(P>0.05),具有可比性。

1.2 办法

对照组:给予头孢呋辛酯片医治,头孢呋辛酯片规范型号0.25 g×6 s,出产企业Glaxo Operations UK Limited(英国),批准文号H20130343,口服1次1片,一日2次。接连服用1个月。调查组:在对照组的医治基础上加服前列康片,前列康片规范0.5 g×60片,浙江康恩贝制药股份有限公司,国药准字Z33020303,口服一次4片,每日3次。两组均医治30 d为一个阶段。

1.3 调查目标

调查患者医治前后痛苦或不适、排尿反常及日子质量改动,监测前列腺液中SIgA、VCAM-1及血清VCAM-1改动,记载中医证候医治前后积分及作用。

1.4 鉴定规范

①临床作用鉴定[8]:临床操控:接连两次查看正常及症状积分削减90%以上;显效:白细胞计数削减及症状积分较医治前削减60%以上;有用:白细胞计数削减及症状积分较医治前削减30%以上;无效:白细胞计数削减及症状积分较医治前削减30%以下或都没削减。②NIH-CPSI指数:是美国国立卫生研讨院缓慢前列腺炎症状指数[9],依据评分表评分,用于患者医治前后比较。③中医证候作用鉴定:治好为中医证候积分削减≥90%,显效为中医证候积分削减≥60%且<90%,有用为中医证候积分削减≥30%且<60%,无效为中医证候积分削减<30%,治好+显效+有用=总有用[10]。

1.5 计算学剖析

选用软件SPSS 19.0进行数据计算[11],数据运用(x±s)来标明,计量材料比较选用t查验,计数材料运用[n(%)]标明、选用χ2查验,等级材料比较运用Wilcoxon两样本比较法,P<0.05为差异有计算学含义。

2 成果

2.1 两组患者临床作用比较

调查组临床作用总有功率94.59%,高于对照组临床作用总有功率78.38%,两组比较差异有计算学含义(P<0.05)。见表1。

2.2 两组患者医治前后NIH-CPSI指数比较

两组医治前NIH-CPSI指数没有显着差异,两组医治后NIH-CPSI指數均有显着改进,调查组的改进更优于对照组,两组比较差异有计算学含义(P<0.05)。见表2。

2.3 两组患者中医证候医治前后积分及作用比较

两组医治前中医证候积分没有显着差异,医治后均有所削减,调查组的削减大于对照组(t=3.0447,P=0.0033)。调查组中医证候作用总有功率91.89%,高于对照组中医证候作用总有功率72.97%,两组比较差异有计算学含义(P<0.05)。见表3。

2.4 两组患者医治前后前列腺液中SIgA、VCAM-1及血清VCAM-1的比较

两组医治前前列腺液中SIgA、VCAM-1及血清VCAM-1均无显着差异,医治后均有下降,调查组的改进更优于对照组,两组比较差异有计算学含义(P<0.05)。见表4。

3 评论

缓慢前列腺炎是常见的男性疾病,经过了解具体病史、体格查看、试验室及器械查看等能够确诊,常使用NIH-CPSI指数对患者症状进行评分[12]。缓慢前列腺炎病因很多,炎症感染、盆底肌功用损害、免疫能力下降、神经病变及神经行为反常等要素作用,都可能引起前列腺安排炎症,导致缓慢前列腺炎发作[9]。炎症反响调理中血清细胞因子起到了重要作用,SIgA由泌尿生殖道中浆细胞排泄到前列腺液中,按捺微生物黏附细胞安排,对黏膜免疫及炎症发作开展起到重要作用[13-14]。VCAM-1依据结构归于免疫球蛋白超家族,与其他粘附分子一同引导淋巴细胞或白细胞,穿过血管壁进入安排,常经过有活化的神经元细胞、内皮细胞、滑润肌细胞等表达。VCAM-1的表达不只与免疫和炎症反响有关,还与血管生成有关,随VCAM-1的表达添加,血液中VCAM-1含量也添加,VCAM-1在血液中测定较简单,临床有用价值较大。

缓慢前列腺炎属中医学的“精浊”、“白淫”、“劳淋”等领域[15-16]。缓慢前列腺炎病因杂乱、病机多样,临床应依据缓慢前列腺炎患者的病因及病机特色,针对病变的要害,阻挠疾病开展,对症下药然后到达治好的意图[17]。对不同体质患者,在药物剂量上,应不同酌量;在化湿清热药物中,配伍温阳益气药物;以药物特点来医治疾病特点,即“实者泻之”,“虚者补之”等[18]。研讨标明,前列康片在一些男性疾病医治中,得到广泛使用,对缓慢前列腺炎、男性不育等作用显着[19]。前列康片中:丹参有活血祛瘀,通經止痛,清心除烦成效;水蛭有破血逐瘀,祛邪扶正成效;红花有活血化瘀,散湿去肿的成效;桃仁有活血祛瘀,润肠通便成效;黄柏有湿热泻痢,止痒止痛成效;失笑散有活血祛瘀,散结止痛成效;川牛膝有逐瘀通经,利尿通淋成效;穿破石有祛风利湿,散瘀止痛成效;红景天有补气清肺,益智养心成效;牡蛎有安定心神,平肝潜阳成效;黄芪有增强免疫,保肝利尿成效[20]。

本研讨经过比较患者临床作用发现:调查组临床操控24例、显效28例、有用18例、无效4例、总有用70例,对照组临床操控16例、显效32例、有用10例、无效16例、总有用58例。前列康片联合头孢呋辛酯片医治患者临床作用总有功率94.59%,高于头孢呋辛酯片医治患者临床作用总有功率78.38%。比较患者医治前后NIH-CPSI指数发现:医治前一切患者痛苦或不适、排尿反常及日子质量没有显着差异,医治后痛苦或不适、排尿反常及日子质量都有显着改进,前列康片联合头孢呋辛酯片医治患者的改进优于头孢呋辛酯片医治患者。以上成果标明,前列康片联合头孢呋辛酯片医治使患者症状改进更佳,作用更好。

本研讨经过比较患者中医证候医治前后积分及作用发现:医治前一切患者中医证候没有显着差异,医治后均有所改进,前列康片联合头孢呋辛酯片医治的患者改进大于头孢呋辛酯片医治患者。前列康片联合头孢呋辛酯片医治患者中医证候作用总有功率91.89%,高于头孢呋辛酯片医治患者中医证候作用总有功率72.97%。比较患者医治前后前列腺液中SIgA、VCAM-1及血清VCAM-1改动发现:医治前一切患者前列腺液中SIgA、VCAM-1及血清VCAM-1均无显着差异,医治后均显着下降,前列康片联合头孢呋辛酯片医治患者下降大于头孢呋辛酯片医治患者。以上成果阐明,前列康片使用其间医药特性,有用改进中医征兆,作用于前列腺液中SIgA、VCAM-1及血清VCAM-1,对调理血清细胞因子按捺炎症起到较好作用。

综上所述,前列康片联合头孢呋辛酯片的医治办法,能有用调理血清细胞因子操控炎症,对缓慢前列腺炎医治起到较好作用,值得临床使用。

[参考文献]

[1] 袁少英,何超拔,金明昱,等.前列康片医治缓慢前列腺炎及其对排泄型IgA、血管细胞黏附分子-1表达的影响[J].中华中医药学刊,2016,34(4):966-969.

[2] 朱闽,徐楠.中医药干涉缓慢前列腺炎细胞因子研讨进展[J].辽宁中医药大学学报,2013,15(8):110-112.

[3] Touvier M,Fezeu L,Ahluwalia N,et al.Pre-diagnostic levels of adiponectin and soluble vascular cell adhesion molecule-1 are associated with colorectal cancer risk[J].World J Gastroenterol,2012,18(22):2805-2812.

[4] 邱小宇.血必净注射液联合头孢呋辛酯片医治急性前列腺炎的作用调查[J].药物点评研讨,2016,39(1):105-107.

[5] 谢毓芳,杨荣华,陈红.宁泌泰胶囊医治缓慢非细菌性前列腺炎及对患者血清炎症因子的影响[J].我国性科学,2015,24(11):13-16.

[6] 李鸣涛,王荣江.宁泌泰胶囊联合头孢呋辛酯片片对缓慢前列腺炎患者前列腺液中排泄型免疫球蛋白A的影响[J].我国性科学,2015,24(5):12-14.

[7] 严永峰,刘明勇.癃清片与阿夫唑嗪联合头孢呋辛酯片医治缓慢前列腺炎的作用比较[J].广东医学,2014,35(10):1617-1619.

[8] 刘杰.头孢呋辛酯片与前列舒通胶囊合用医治缓慢前列腺炎临床研讨[J].河北医学,2012,18(3):378-379.

[9] Zeng Xiaoyong,Liang Chen,Ye Zhangqun.Extracorporeal shock wave treatment for non-inflammatory chronic pelvic pain syndrome:aprospective,randomized and sham-controlled study[J].Chinese Medical Journal,2012,12(5): 114-118.

[10] 符贻翻,史南,沈仕兴.热淋清颗粒联合多沙唑嗪和头孢呋辛酯片医治缓慢细菌性前列腺炎的作用调查[J].现代药物与临床,2016,31(10):1632-1635.

[11] 翁感.头孢呋辛酯片联合盐酸特拉唑嗪医治缓慢非细菌性前列腺炎68例作用调查[J].有用临床医药杂志,2013,17(7):141-143.

[12] Zhao Z.Rebuttal:A prospective study on association of prostatic calcifications with sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)[J].J Sex Med,2014,11(12):3128-3130.

[13] 杨彩云,齐进春,薛文勇.前列舒通联合头孢呋辛酯片医治缓慢细菌性前列腺炎的临床作用及安全性点评[J].我国临床药理学杂志,2015,31(22):2187-2189.

[14] 彭建.丹参片辅佐盐酸头孢呋辛酯片片医治缓慢前列腺炎临床作用调查[J].有用医院临床杂志,2015,12(5):211-213.

[15] 种庆贵,宋爱君,郭艳,等.宁泌泰胶囊医治缓慢前列腺炎临床调查[J].我国中西医结合外科杂志,2014,20(2):178-180.

[16] 祝群,邵雪景,聂玲玲,等.头孢呋辛酯片和前列康片联合氯沙坦对缓慢前列腺炎并弱精子证患者微量白蛋白尿及氧化应激的影响[J].我国有用医药,2010,12(34):43-47.

[17] Chan HP,Lewis C,Thomas PS,et al.Exhaled breath analysis:Novel approach for early detection of gastric cancer[J].Gastric Cancer,2012,63(2):164-168.

[18] Lane DP. Cancer,P53,guardian of the genome[J]. Nature,2012,358(6):815-816.

[19] Lowe SW,Svhmitt EM,Smith JW,et al.P53 is required for radiation- induced apoptosis in mouse thymocytes[J].Nature,2014,362(4): 847-849.

[20] Mathieu V,de Lassalle EM,Toelen J,et al. Galectin-1 in melanoma biology and related neo-angiogenesis processes[J]. J Invest Dermatol,2015,27(12): 2245-2254.

(收稿日期:2017-01-05)

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