体外冲击波疗法联合药物治疗慢性盆腔疼痛综合征：一项随机临床试验。
Extracorporeal Shockwave Therapy Combined with Drug Therapy in Chronic Pelvic Pain Syndrome : A Randomized Clinical Trial.
作者信息
Rayegani Seyed Mansour, Razzaghi Mohammad Reza, Raeissadat Seyed Ahmad, Allameh Farzad, Eliaspour Dariush, Abedi Amir Reza, Javadi Atefeh, Rahavian Amir Hossein
机构信息
Physical Medicine and Rehabilitation Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Laser Application in Medical Sciences Research Center, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Urol J. 2020 Mar 16;17(2):185-191. doi: 10.22037/uj.v0i0.4673.
PURPOSE
Chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS) is a nonspecific pelvic pain in the absence of signs of infection or other obvious local pathology for at least three of the last 6 months. Evidence for treatment approach is limited. So the aim of this study is to investigate the effect of extracorporeal shock wave therapy (ESWT) combined with pharmacotherapy in the treatment of CP/CPPS.
MATERIALS AND METHODS
In this randomized clinical trial, 31 patients with CP/CPPS were investigated in two groups: the intervention group (n=16) was treated with a combination of an alpha-blocker, an anti-inflammatory agent, a muscle relaxant and a short course of antibiotic in combination with 4 sessions of focused ESWT (a protocol of 3000 impulses, 0.25 mJ/mm2 and 3 Hz of frequency). The control group (n=15) received the aforementioned pharmacotherapy with 4 sessions of sham-ESWT . Follow-up was performed 4 and 12 weeks following ESWT by using the Visual Analogue Scale (VAS), International index of Erectile function (IIEF) 5, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) and International Prostate Symptom Score (IPSS) questionnaires. Post void residual (PVR) urine and maximum flow rate (Qmax) were also assessed in both groups.
RESULTS
The patients mean age was 43.7 ±12.6 years. In both groups, the mean scores of NIH-CPSI (total and sub-domains) and VAS showed statistically significant improvements after 4 and 12 weeks compared to the baseline (P < .001). In the intervention group, IPSS (mean difference: 4.25) and Qmax (mean difference: 2.22) were also significantly improved (P < .001). There was a significant improvement in NIH-CPSI (mean difference: 1.1) and VAS scores (mean difference: 1.1) in the intervention group as compared to the control group (P < .01). Qmax, PVR and IIEF score were not statistically different in the two groups.
CONCLUSION
ESWT in combination with pharmacotherapy could improve the treatment outcome in patients with CP/CPPS.
目的
慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）是指在过去6个月中至少有3个月出现无感染迹象或其他明显局部病变的非特异性盆腔疼痛。治疗方法的证据有限。因此，本研究的目的是探讨体外冲击波疗法（ESWT）联合药物治疗CP/CPPS的效果。
材料与方法
在这项随机临床试验中，31例CP/CPPS患者被分为两组进行研究：干预组（n=16）接受α受体阻滞剂、抗炎药、肌肉松弛剂和短期抗生素联合治疗，并结合4次聚焦ESWT（方案为3000次脉冲、0.25 mJ/mm2和3 Hz频率）。对照组（n=15）接受上述药物治疗并进行4次假ESWT治疗。在ESWT治疗后4周和12周，使用视觉模拟量表（VAS）、国际勃起功能指数（IIEF）5、美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）和国际前列腺症状评分（IPSS）问卷进行随访。两组还评估了残余尿量（PVR）和最大尿流率（Qmax）。
结果
患者的平均年龄为43.7±12.6岁。与基线相比，两组患者在4周和12周后的NIH-CPSI（总分及各子领域）和VAS平均得分均有统计学意义的改善（P<.001）。干预组的IPSS（平均差值：4.25）和Qmax（平均差值：2.22）也有显著改善（P<.001）。与对照组相比，干预组的NIH-CPSI（平均差值：1.1）和VAS评分（平均差值：1.1）有显著改善（P<.01）。两组的Qmax、PVR和IIEF评分无统计学差异。
结论
ESWT联合药物治疗可改善CP/CPPS患者的治疗效果。
Zotero 插件