Harvard Medical School, Children's Hospital Boston, Enders Research Building, Room 1061, 300 Longwood Avenue, Boston, MA 02115, USA.
Nat Rev Urol. 2010 Mar;7(3):127-35. doi: 10.1038/nrurol.2010.4. Epub 2010 Feb 9.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition among men of a wide age range, with detrimental effects on quality of life. The etiology, pathogenesis, and optimal treatment of CP/CPPS remain unknown, although progress has been made in these domains in recent years. A wide variety of pharmacologic and nonpharmacologic therapies have been studied in clinical trials, but most have shown limited efficacy in symptom alleviation. CP/CPPS is increasingly viewed as a condition that involves variable degrees of neuropathic pain. Medications such as gabapentin, pregabalin, memantine, and tricyclic antidepressants are often used in other neuropathic pain conditions and, therefore, are considered potential treatments for CP/CPPS. Few studies of these agents in patients with CP/CPPS have been reported, but future clinical trials should help to determine their utility and to characterize the pathogenetic mechanisms of pain in CP/CPPS. Combining treatment trials with biomarker, genomic, and imaging studies, in addition to epidemiologic and symptom-based assessments, will maximize the ability to probe disease etiology and pathogenesis, as well as identify effective treatment.
慢性前列腺炎/慢性骨盆疼痛综合征（CP/CPPS）是一种常见于广泛年龄段男性的疾病，对生活质量有不良影响。尽管近年来在这些领域取得了进展，但 CP/CPPS 的病因、发病机制和最佳治疗方法仍不清楚。在临床试验中已经研究了各种药物和非药物治疗方法，但大多数方法在缓解症状方面的疗效有限。CP/CPPS 越来越被认为是一种涉及不同程度神经病理性疼痛的疾病。加巴喷丁、普瑞巴林、美金刚和三环类抗抑郁药等药物常用于其他神经病理性疼痛疾病，因此被认为是 CP/CPPS 的潜在治疗方法。虽然已经有一些关于这些药物在 CP/CPPS 患者中的研究报告，但未来的临床试验将有助于确定它们的效用，并描述 CP/CPPS 中疼痛的发病机制。将治疗试验与生物标志物、基因组和影像学研究结合起来，以及进行流行病学和基于症状的评估，将最大限度地提高探究疾病病因和发病机制以及确定有效治疗方法的能力。
