Section of Endocrinology, Andrology and Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggiero 73, 94018 Troina, Italy.
Nutrients. 2017 Nov 3;9(11):1208. doi: 10.3390/nu9111208.
This study investigated the effects of long-term treatment with rifaximin and the probiotic VSL#3 on uro-genital and gastrointestinal symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) plus diarrhoea-predominant irritable bowel syndrome (D-IBS) compared with patients with D-IBS alone. Eighty-five patients with CP/CPPS (45 with subtype IIIa and 40 with IIIb) plus D-IBS according to the Rome III criteria and an aged-matched control-group of patients with D-IBS alone ( = 75) received rifaximin and VSL#3. The primary endpoints were the response rates of IBS and CP/CPPS symptoms, assessed respectively through Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) and The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and performed at the start of therapy (V0) and three months after (V3). In IIIa prostatitis patients, the total NIH-CPSI scores significantly ( < 0.05) decreased from a baseline mean value of 21.2 to 14.5 at V3 , as did all subscales, and in the IIIb the total NIH-CPSI score also significantly decreased (from 17.4 to 15.1). Patients with IBS alone showed no significant differences in NIH-CPSI score. At V3, significantly greater improvement in the IBS-SSS and responder rate were found in IIIa patients. Our results were explained through a better individual response at V3 in IIIa prostatitis of urinary and gastrointestinal symptoms, while mean leukocyte counts on expressed prostate secretion (EPS) after prostate massage significantly lowered only in IIIa cases.
本研究旨在探讨利福昔明和益生菌 VSL#3 长期治疗对慢性前列腺炎/慢性骨盆疼痛综合征（CP/CPPS）合并腹泻型肠易激综合征（D-IBS）患者与单纯 D-IBS 患者泌尿生殖和胃肠道症状的影响。85 例 CP/CPPS（45 例 IIIa 亚型和 40 例 IIIb 亚型）合并 D-IBS 患者（符合罗马 III 标准）和年龄匹配的单纯 D-IBS 患者对照组（n = 75）接受利福昔明和 VSL#3 治疗。主要终点是 IBS 和 CP/CPPS 症状的缓解率，分别通过肠易激综合征严重程度评分系统（IBS-SSS）和美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）评估，于治疗开始时（V0）和 3 个月后（V3）进行评估。在 IIIa 前列腺炎患者中，NIH-CPSI 总分从基线时的 21.2 显著（<0.05）降至 V3 时的 14.5，所有亚量表均如此，而在 IIIb 患者中，NIH-CPSI 总分也显著下降（从 17.4 降至 15.1）。单纯 IBS 患者 NIH-CPSI 评分无显著差异。在 V3 时，IIIa 患者 IBS-SSS 和应答率的改善更为显著。我们的结果可以通过 IIIa 型前列腺炎患者在 V3 时泌尿和胃肠道症状的个体反应更好来解释，而前列腺按摩后前列腺分泌物（EPS）中的平均白细胞计数仅在 IIIa 型患者中显著降低。
