目的:运用前列腺小体外泄蛋白(PSEP) 检测评价景天四物汤对气滞血瘀型Ⅲ型慢性前列腺炎患者的疗效。方法:收集江苏省中西医结合医院泌尿外科收治的135 例Ⅲ型前列腺炎患者，按照指南诊断标准及中医症候分为气滞血瘀Ⅲ A 型、气滞血瘀Ⅲ B 型。每型分为观察组和对照组，分别采用景天四物汤和宁泌泰治疗，疗程4 周。采用NIH-CPSI 评分表评价患者治疗前后的NIH-CPSI 评分；PSEP 剂盒检测患者尿液PSEP 浓度值；免疫组织化学法检测治疗前后前列腺液中白细胞介素(IL)-6、IL-10、肿瘤坏死因子(TNF)-α 水平；采用经直肠超声观察前列腺内回声改变并测量前列腺体积。结果:与治疗前相比，Ⅲ A 型、Ⅲ B 型患者经景天四物汤治疗1 个月后，NIH-CPSI 评分均有较好的改善，差异有统计学意义；经景天四物汤治疗，Ⅲ A 型、Ⅲ B 型患者的PSEP 检测浓度均降低，均较宁泌泰明显，差异有统计学意义(P <0.05)；患者治疗后的IL-6、IL-10、TNF-α 水平均有明显改善，差异有统计学意义；通过经直肠超声检查测定，景天四物汤对于前列腺炎症区域有着较好的治疗作用，但对于改善患者前列腺体积大小并不明显。结论:景天四物汤可改善患者的NIH-CPSI 评分，降低PSEP 检测浓度，下调IL-6、IL-10、TNF-α 水平，缓解前列腺炎症区域，对Ⅲ型气滞血瘀证前列腺炎有较好的治疗作用。
Combine PSEP to Evaluate the Curative Effect of Jingtian Siwu Decoction on Type III Prostatitis of Qi Stagnation and Blood Stasis Syndrome
YANG Zhi-chao,YANG Jian-jun,ZHANG Li
Abstract:
Objective To evaluate the therapeutic effect of Jingtian Siwu Decoction on type III chronic prostatitis of Qi stagnation and blood stasis syndrome by PSEP and other tests. Methods 135 outpatients with type III prostatitis were collected and divided into Qi stagnation and blood stasis type III A and Qi stagnation and blood stasis type III B according to the diagnostic criteria and TCM symptoms. Each type was divided into observation group and control group. Jingtian Siwu Decoction and Ningmitai were used for 4 weeks. Before and after treatment, the patients were scored by NIH-CPSI scale. The levels of IL-6, IL-10 and TNF-alpha in prostatic fluid were detected by immunohistochemistry, the changes of intraprostatic echoes were observed by transrectal ultrasound, the volume of prostate and the concentration of PSEP in urine were measured by small extracorporeal protein release kit. Results After the treatment of Jingtian Siwu Decoction, NIH-CPSI scores of patients with type III A and type III B were better than those before treatment, with significant statistical significance (P < 0.01). The decrease of the PSEP concentration of patients with type III A and type III B were better than those of Ningmitai (P < 0.05). After treatment for one month, the levels of IL-6, IL-10 and TNF-α were significantly improved, with significant statistical difference (P < 0.01). However, the improvement on the size of prostate by Jingtian Siwu Decoctionis was not obvious. B-ultrasonography was recommended because it also has a better therapeutic effect on prostatic inflammation area. Conclusion Jingtian Siwu Decoction can improve the NIH-CPSI score of patients, reduce the detection concentration of PSEP, down-regulate the levels of IL-6, IL-10 and TNF-alpha, alleviate the in?ammation area of prostate, which has a good therapeutic effect on type III prostatitis of qi stagnation and blood stasis syndrome.
