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经尿道前列腺等离子电切术联合前列逐癃汤治疗老年湿热下注型前列腺增生的临床疗效研究
顾鑫,景立伟,王岸迪,扈有芹,刘英莉
泌尿外科;中医内科河北沧州 061001
摘要:
目的:探讨经尿道前列腺等离子电切术(PKRP)联合前列逐癃汤治疗湿热下注型前列腺增生(BPH)的临床疗效。方法:选取2017 年1 月—2019 年3 月我院收治的湿热下注型BPH 患者232 例,随机分为对照组和观察组,各116例,两组患者均进行PKRP 治疗,对照组于围手术期给予盐酸坦索罗辛缓释胶囊治疗,观察组在对照组的基础上加用前列逐癃汤治疗。比较两组患者的治疗效果。结果:两组患者的手术时间、术中冲洗液中血红蛋白含量、膀胱冲洗时间及尿管留置时间差异均无统计学意义(P > 0.05)。两组患者术前血清白细胞介素(IL)-6 和C 反应蛋白(CRP)水平无显著差异(P > 0.05),术后24 h,两组的IL-6 和CRP 水平明显高于术前,且对照组明显高于观察组(P < 0.05)。对照组患者的临床总有效率为80.17%,低于观察组(97.41%),差异有统计学意义(P < 0.05)。术后2 周,观察组血清E2、LH 及FSH 水平均低于对照组,血清T 水平高于对照组(P < 0.05) ;且观察组最大尿流率(MFR),残余尿量(PVR)、国际前列腺症状(IPSS)评分、生活质量(QOL) 评分变化幅度明显大于对照组(P < 0.05)。此外,观察组患者术后并发症的发生率显著低于对照组(12.93% vs 51.72%,P < 0.05)。结论:PKRP 联合前列逐癃汤可显著改善湿热下注型BPH 患者的临床症状,优于PKRP常规治疗,疗效显著且并发症少,值得临床推广。
关键词:  良性前列腺增生  经尿道前列腺等离子电切术  前列逐癃汤  湿热下注型
DOI:10.3969/j.issn.1007-6948.2020.00.024
投稿时间:2020-01-07
基金项目:河北省中医药管理局科研课题资助项目(2017147)
Clinical Efficacy Study of Transurethral Resection of Prostate Plasma Combined with Qianlie Zhulong Decoction in Treating Senile Benign Prostatic Hyperplasia with Syndrome of Dampness-Heat Diffusing Downward
GU Xin,JING Li-wei,WANG An-di
Abstract:
Objective To investigate the clinical efficacy of transurethral plasmakinetic resection of prostate (PKRP) combined with Qianlie Zhulong Decoction in the treatment of Benign Prostatic Hyperplasia (BPH) with syndrome of dampness-heat diffusing downward. Methods A total of 232 patients with BPH admitted from January 2017 to March 2019 were selected and divided into the control group and the observation group by random number table method (116 cases each). All the 2 groups were treated with PKRP. The control group was treated with tamsulosin hydrochloride sustained-release capsules and the observation group was treated with the front row Qianlie Zhulong Decoction on the basis of the control group. Compare the therapeutic effect of 2 groups of patients. Results There were no significant differences in the operation time, intraoperative flushing fluid hemoglobin content, bladder irrigation time and catheter indwelling time (P >0.05). There was no significant difference in serum IL-6 and CRP levels between the two groups (P >0.05), but it was significantly higher than that before operation at 24h, and the control group was significantly higher than the observation group (P <0.05).The total effective rate of the control group was 80.17% and the total effective rate of the observation group was 97.41%. There was a statistical difference between the two groups (P <0.05). The levels of serum E2, LH, and FSH in the observation group were lower than those in the control group (P <0.05). The serum T levels were higher than those in the control group (P <0.05). Significantly larger than the control group, the difference was signi?cant (P<0.05). In addition, the incidence of postoperative complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusion PKRP combined with Qianlie Zhulong Decoction can significantly improve the clinical symptoms of BPH patients with downward ?ow of damp and heat pattern. The curative effect is signi?cantly better than that of the conventional treatment of PKRP and the complications are few. It is worth popularizing.
Key words:  Benign prostatic hyperplasia  transurethral prostatic plasma electrotomy  Qianlie Zhulong Decoction  syndrome of dampness-heat diffusing downward

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