鹽酸帕羅西汀聯合艾司唑侖治療伴有情緒反應和睡眠問題的Ⅲ型前列腺炎的臨床研究

歐陽海+謝勝++康照鵬+王萬榮+謝子平+王澍弘+李韜+譚艷

【摘要】目的：觀察鹽酸帕羅西汀聯合艾司唑侖治療伴有情緒反應和睡眠問題的Ⅲ型前列腺炎的用藥效果。方法：500例入選患者在入院第1d完善NIH-CPSI，HAMD，PSQI評分。實驗組（300例）用藥：鹽酸帕羅西汀、艾司唑侖、鹽酸坦洛新緩釋膠囊。對照組（200例）用藥：安慰劑和鹽酸坦洛新緩釋膠囊。500例患者均接受前列腺按摩、藥物灌腸治療。每周排精1～2次。住院療程共2周。出院后繼續服用鹽酸帕羅西汀和艾司唑侖2周，鹽酸坦洛新緩釋膠囊4周。所有病例分別于治療第4d、第14d再次進行NIH-CPSI、HAMD、PSQI量表評估。以治愈和有效來計算總有效率。結果：治療第4d，實驗組NIH-CPSI、HAMD，PSQI評分分別較治療前平均下降9.5分、6.8分、3.9分，對照組較治療前平均下降3.9分、3.4分、1.4分。治療第14d，實驗組NIH-CPSI、HAMD，PSQI評分分別較治療前平均下降16.6分、10.8分、5.3分，對照組較治療前平均下降9.0分、7.5分、2.8分。實驗組評分下降幅度比安慰劑組更明顯，差異有顯著統計學意義（P<0.01）。實驗組在治療第4d總有效率為40.3%，對照組為16%。治療第14d實驗組總有效率87%，對照組為47%，兩組差異有顯著性（P<0.01）。結論：慢性前列腺炎的治療模式應該是一個綜合治療的過程，對于有情緒反應和睡眠問題的III型CP患者，早期加用鹽酸帕羅西汀和艾司唑侖，能夠在短時間內控制情緒反應和睡眠質量，有利于癥狀快速緩解。

【關鍵詞】帕羅西汀；艾司唑侖；情緒反應；睡眠問題；慢性前列腺炎

Clinical research of paroxetine and estazolam in the treatment ofchronic prostatitis accompanied with emotional response and somnipathyOUYANG Hai， XIE Sheng， KANG Zhaopeng， WANG Wanrong， XIE Ziping， WANG Shuhong， LI Tao， TAN Yan. Department of Andrology， Renmin Hospital Affiliated to Hubei University of Medicine， Shiyan 442000， Hubei， China

【Abstract】Objectives： To observe the effect of paroxetine and estazolam in the treatment of chronic prostatitis accompanied with emotional response and somnipathy. Methods： 500 patients were required to finish NIH-CPSI， HAMD and PSQI questionnaire at the first day of admission. The experimental group （300 cases） was treated with paroxetine， estazolam and tamsulosin hydrochloride sustained-release capsules， and the control group （200 cases） was treated with placebo and tamsulosin hydrochloride sustained-release capsules. All patients received prostate massage， enema and spermiation once or twice a week. The treatment course was 2 weeks. During the treatment， the NIH-CPSI， HAMD and PSQI questionnaire at the end of the fourth day and the fourteenth day were done and the therapeutic effect was observed. Results： Compared with prior treatment， the questionnaire scores of NIH-CPSI， HAMD and PSQI in experimental group decreased by 9.5， 6.8 and 3.9 respectively on the fourth day of the treatment， but the questionnaire scores of NIH-CPSI， HAMD and PSQI in control group decreased by 3.9， 3.4 and 1.4 respectively. On the fourteenth day， the questionnaire scores of NIH-CPSI， HAMD and PSQI in experimental group decreased by 16.6， 10.8 and 5.3 respectively， but the questionnaire scores of NIH-CPSI， HAMD and PSQI in control group decreased by 9.0， 7.5 and 2.8 respectively. The differences between the two groups had statistical significance （P<0.01）. The overall response rates were 40.3% in experimental group and 16% in control group on the fourth day， but the value turned into 87% in experimental group， 47% in control group on the fourteenth day， which were significantly different （P<0.01）. Conclusion： The treatment of prostatitis should be a comprehensive therapy model. Using paroxetine and estazolam to treat chronic prostatitis patients accompanied with emotional response and somnipathy in early stage help control the patients emotional response and sleep quality and fast relief symptoms in a short time.endprint

【Key words】Paroxetine； Estazolam； Emotional response； Somnipathy； Chronic prostatitis

【中圖分類號】R697+.33【文獻標志碼】A

Ⅲ型前列腺炎（chronic prostatitis，CP）是男科患者中最常見的一種疾病，占男科就診患者中半數以上，在這部分患者當中，伴有情緒反應（焦慮或抑郁狀態）或睡眠問題的比比皆是。我科是湖北省唯一一家三甲醫院中獨立開設男科病房的科室，對于有癥狀的Ⅲ型前列腺炎患者我們一般采取收住院進行治療，療程14d。筆者曾在前期研究中采用黛力新治療合并抑郁癥的CP[1]，效果較好，但起效較慢，若患者入院3天后癥狀仍不能改善，情緒反應在此時就表現的相當明顯。……