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[普乐泰克斯(Prostatex)治疗慢性前列腺炎/慢性盆腔疼痛综合征患者的有效性和安全性。IV期PRESTIGE试验结果]

[Efficiency and safety of Prostatex in patients with chronic prostatitis/chronic pelvic pain syndrome. Results of the phase IV PRESTIGE trial].

作者信息

Morozov A O, Vovdenko S V, Maltsagova P Sh, Spivak L G

机构信息

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Institute of the Clinical Medicine named after N.V. Sklifosovsky of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

出版信息

Urologiia. 2023 May(2):41-47.

Abstract

INTRODUCTION

A large number of both preclinical and clinical studies demonstrates the efficiency of bioregulatory peptides for the treatment of prostatitis and chronic pelvic pain syndrome (CPPS). A relatively new drug in this group is Prostatex, the active ingredient of which is bovine prostate extract.

AIM

To evaluate the effect of taking Prostatex on the intensity of CPPS, the sexual function, and the results of microscopy of expressed prostate secretions and urinalysis.

MATERIALS AND METHODS

A cohort of patients aged 25-65 years with chronic abacterial prostatitis and complaints of chronic pelvic pain was analyzed. The abacterial type of prostatitis was confirmed by bacteriological examination of expressed prostate secretions. The patients received Prostatex for 30 days according to the following scheme: 1 suppository rectally 1 time per day. The follow-up was 30 days. Before starting the drug and at the end of the 30-day course, patients completed the Chronic Prostatitis Symptom Index (NIH-CPSI) and the sexual function questionnaire. In addition, urinalysis and microscopic study of expressed prostate secretions was performed.

RESULTS

A total of 1700 patients were included in the study. While taking the drug, there was a significant decrease in pain during digital rectal examination, as well as in the intensity of pain as a symptom of CPPS. The severity of symptoms after treatment was lower in all domains of NIH-CPSI. Microscopic study of the expressed prostate secretions during treatment showed a decrease in the number of patients with excessive number of leukocytes. The sexual function improved, while urinalysis and microscopy of expressed prostate secretions returned to the reference values.

CONCLUSION

The use of Prostatex for the treatment of patients with CPPS reduces the severity of pain and other symptoms of chronic prostatitis, increases sexual function and normalizes the expressed prostate secretions and urinalysis. In order to obtain data of a higher level of evidence, it is necessary to carry out randomized, blind, placebo-controlled studies.

摘要

引言

大量临床前和临床研究均表明生物调节肽对前列腺炎和慢性盆腔疼痛综合征(CPPS)具有治疗效果。该类药物中一种相对较新的药物是前列腺素(Prostatex),其活性成分是牛前列腺提取物。

目的

评估服用前列腺素对CPPS强度、性功能、前列腺按摩液显微镜检查结果及尿液分析的影响。

材料与方法

分析了一组年龄在25 - 65岁、患有慢性非细菌性前列腺炎且有慢性盆腔疼痛主诉的患者。通过对前列腺按摩液进行细菌学检查确诊为非细菌性前列腺炎类型。患者按照以下方案接受前列腺素治疗30天:每天经直肠给药1次,每次1枚栓剂。随访期为30天。在开始用药前及30天疗程结束时,患者完成慢性前列腺炎症状指数(NIH - CPSI)和性功能问卷。此外,还进行了尿液分析和前列腺按摩液显微镜检查。

结果

共有1700名患者纳入研究。服药期间,直肠指检时的疼痛以及作为CPPS症状之一的疼痛强度均显著降低。治疗后,NIH - CPSI所有领域的症状严重程度均降低。治疗期间对前列腺按摩液进行显微镜检查显示,白细胞数量过多的患者数量减少。性功能有所改善,同时尿液分析和前列腺按摩液显微镜检查结果恢复至参考值。

结论

使用前列腺素治疗CPPS患者可减轻慢性前列腺炎的疼痛及其他症状的严重程度,提高性功能,并使前列腺按摩液和尿液分析结果恢复正常。为获得更高证据水平的数据,有必要开展随机、盲法、安慰剂对照研究。

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