目的 探討萆薢分清丸聯(lián)合克拉霉素治療ⅢA型前列腺炎的臨床效果。方法 選取2018年6月—2019年12月天津市東麗區(qū)東麗醫(yī)院收治的154例ⅢA型前列腺炎患者，隨機分為對照組和治療組，每組各77例。對照組口服克拉霉素片，0.25 g/次，2次/d。治療組在對照組基礎上口服萆薢分清丸，6 g/次，2次/d。兩組均連續(xù)治療4周。比較兩組臨床療效，觀察兩組慢性前列腺炎癥狀指數(shù)（NIH-CPSI）評分、排尿日記相關指標、前列腺按摩液（EPS）中白細胞（WBC）數(shù)量及腫瘤壞死因子（TNF）-α、白介素（IL）-8、巨噬細胞炎性蛋白（MIP）-1α、基質金屬蛋白酶（MMP）-9、C反應蛋白（CRP）水平的變化情況。結果 治療后，治療組總有效率是94.8%顯著高于照組84.4%（P<0.05）。兩組治療后NIH-CPSI中各部分（疼痛或不適癥狀、排尿癥狀、生活質量3個部分）評分及總評分均顯著低于本組治療前（P<0.05）；但治療組NIH-CPSI各評分比對照組的改善均更顯著（P<0.05）。兩組治療后尿急次數(shù)、日間和夜間排尿次數(shù)均顯著減少（P<0.05），但平均排尿量均顯著增加（P<0.05）；且治療后，治療組以上排尿日記相關指標較同期對照組的改善均更顯著（P<0.05）。治療后，兩組EPS中WBC數(shù)量、TNF-α、IL-8、MIP-1α、MMP-9和CRP水平均顯著降低（P<0.05）；且治療后，治療組這些EPS檢查指標較同期對照組顯著更低（P<0.05）。結論 萆薢分清丸聯(lián)合克拉霉素治療ⅢA型前列腺炎具有確切的臨床療效，對患者的骨盆生殖區(qū)域疼痛或不適、排尿異常和生活質量均有明顯改善作用，具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Bixie Fenqing Pills combined with clarithromycin in treatment of type ⅢA prostatitis. Methods A total of 154 patients with type ⅢA prostatitis admitted to Dongli Hospital Dongli District from June 2018 to December 2019 were randomly divided into control group (n=77) and treatment group (n=77). The control group was po administered with Clarithromycin Tablets, 0.25 g/time, twice daily. The treatment group was po administered with Bixie Fenqing Pills on the basis of the control group, 6 g/time, twice daily. All patients were treated for 4 weeks. The clinical efficacy in two groups were compared, and the changes of NIH-CPSI score, indicators related to urination diary, WBC amount, TNF-α, IL-8, MIP-1α, MMP-9, and CRP in prostate massage fluid (EPS) were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 94.8%, which was significantly higher than that of the control group (84.4%) (P<0.05). The scores of pain or discomfort symptoms, urination symptoms, life quality and the total scores of NIH-CPSI scores in two groups after treatment were significantly lower than those before treatment (P<0.05). However, the improvement of NIH-CPSI scores in the treatment group was more significant than that in the control group (P<0.05). After treatment, the times of urination urgency, daytime and night urination were significantly reduced in both groups (P<0.05), but the average urination volume was significantly increased in both groups (P<0.05). After treatment, the improvement of urinary diary related indexes in the treatment group was more significant than that in the control group (P<0.05). After treatment, WBC amount, TNF-α, IL-8, MIP-1α, MMP-9, and CRP levels in EPS in both groups were significantly reduced (P<0.05). After treatment, these EPS indicators were significantly lower in the treatment group than in the control group (P<0.05). Conclusion Bixie Fenqing Pills combined with clarithromycin has definite clinical effect in treatment of type ⅢA prostatitis, and can improve pelvic pain or discomfort, urination abnormalities of the genital area and life quality of patients, which has a certain clinical application value.

R976

天津市衛(wèi)生和計劃生育委員會科研基金項目（2017KZ059）