Article(id=1322922736447783321, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.02.007, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793338959085, onlineDateStr=2026-10-30, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793338959085, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793338959085, creator=13701087609, updateTime=1793338959085, updator=13701087609, issue=Issue{id=1322922680609014711, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='2', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793338945772, creator='13701087609', updateTime=1793340618065, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929694785536732, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929694785536733, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=33, endPage=36, ext={EN=ArticleExt(id=1322922738293277082, articleId=1322922736447783321, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Randomized Controlled Study of Longdan Xiegan Decoction(龙胆泻肝汤)Combined with Thunder-Fire Moxibustion in Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the effect of Longdan Xiegan Decoction(龙胆泻肝汤)combined with thunder-fire moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome.

Methods

A total of 160 patients with chronic prostatitis/chronic pelvic pain syndrome diagnosed and treated from January 2022 to December 2023 were selected as the research objects. According to the random number table method,they were randomly divided into four groups:western medicine group,western medicine+thunder fire moxibustion group,Chinese medicine group and Chinese medicine+thunder fire moxibustion group,with 40 cases in each group. The efficacy,pain symptom score(VAS),international prostate symptom score(IPSS),international erectile function score-5(IIEF-5),the maximum urinary flow rate(Qmax),urine volume(VV),prostate-specific extracellular vesicle protein(PSEP)and adverse reactions of the four groups were observed and compared.

Results

The total effective rates of the western medicine group,the western medicine+thunder fire moxibustion group,the Chinese medicine group and the Chinese medicine+thunder fire moxibustion group were 80.00%(32/40),87.50%(35/40),77.50%(31/40)and 97.50%(39/40),respectively,and the differences between the groups were statistically significant(P<0.05). After treatment,the VASand IPSS scores of the four groups decreased,and the IIEF-5 scores increased,and the scores of the traditional Chinese medicine+thunder fire moxibustion group changed more significantly(P<0.05). There was no significant difference in Qmax,VV or PSEP among the four groups before treatment(P>0.05). After treatment,the values of Qmax and VV of the four groups were significantly increased,and PSEPlevels were significantly decreased. The values of Qmax and VV in the Chinese medicine+thunder fire moxibustion group were the highest,and the PSEP level was the lowest. Compared with those of the other three groups,the difference was statistically significant(P<0.05).

Conclusion

The effect of Longdan Xiegan Decoction combined with thunderfire moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome is significant. It can significantly relieve the symptoms of patients,improve their urination and sexual dysfunction,and has good safety and high application value.

, authors=Qun CAI1, Qin GUO1, Yingjun LIU1, Fangfang GUO1, Kangni YUAN2, authorsList=Qun CAI, Qin GUO, Yingjun LIU, Fangfang GUO, Kangni YUAN, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322922739346047393, articleId=1322922736447783321, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的随机对照研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

研究龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果。

方法

选择2022年1月—2023年12月诊治的160例慢性前列腺炎/慢性骨盆疼痛综合征患者作为研究对象,根据随机数字表法随机均分为4组,单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组各40例。观察并比较4组的疗效,疼痛症状评分(visual analogue scale/score,VAS)、国际前列腺症状评分(international prostate symptom score,IPSS)、国际勃起功能评分表(international index of erectile function-5,IIEF-5)、最大尿流率(the maximum urine flow rate,Qmax)、尿量(urine volume,VV)、前列腺小体外泄蛋白(prostate-specific extracellular vesicle protein,PSEP),不良反应情况。

结果

单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组总有效率分别为80.00%(32/40)、87.50%(35/40)、77.50%(31/40)、97.50%(39/40),组间差异均有统计学意义(P<0.05),中药+雷火灸组总有效率最高。治疗前4组VAS、IPSS、IIEF-5评分差异均无统计学意义(P>0.05),治疗后4组VAS、IPSS评分均降低,IIEF-5评分均升高,且以中药+雷火灸组各项评分变化更显著(P<0.05)。治疗前4组Qmax、VV、PSEP水平差异均无统计学意义(P>0.05),治疗后4组患者Qmax、VV均显著升高,PSEP水平均显著下降,以中药+雷火灸组Qmax、VV值最高,PSEP水平最低,与其他3组比较差异均有统计学意义(P<0.05)。单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组不良反应发生率分别为15.00%(6/40)、12.50%(5/40)、7.50%(3/40)、10.00%(4/40),组间差异无统计学意义(P>0.05)。

结论

龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果显著,能够显著缓解患者症状,改善其排尿及性功能障碍状况,并且安全性良好,具有较高的应用价值。

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蔡群(1974-),女,浙江杭州人,副教授,学士,研究方向:中医康复。

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组别例数显效有效无效总有效
单纯西药组4016(40.00)16(40.00)8(20.00)32(80.00)
西药+雷火灸组4018(45.00)17(42.50)5(12.50)35(87.50)
单纯中药组4015(37.50)16(40.00)9(22.50)31(77.50)
中药+雷火灸组4020(50.00)19(47.50)1(2.50)39(97.50)ab
χ2值7.871
P值0.049
), ArticleFig(id=1322922744492458447, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922736447783321, language=CN, label=表1, caption=

4组慢性前列腺炎/慢性骨盆疼痛综合征患者临床疗效比较

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组别例数显效有效无效总有效
单纯西药组4016(40.00)16(40.00)8(20.00)32(80.00)
西药+雷火灸组4018(45.00)17(42.50)5(12.50)35(87.50)
单纯中药组4015(37.50)16(40.00)9(22.50)31(77.50)
中药+雷火灸组4020(50.00)19(47.50)1(2.50)39(97.50)ab
χ2值7.871
P值0.049
), ArticleFig(id=1322922744718950864, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922736447783321, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别VAS评分IPSS评分IIEF-5评分
治疗前治疗后治疗前治疗后治疗前治疗后
单纯西药组4.92±0.972.53±0.3118.60±3.119.83±0.987.76±1.1012.19±0.83
西药+雷火灸组4.89±1.031.90±0.2918.49±2.979.23±1.087.81±1.0613.39±0.52
单纯中药组4.90±0.932.68±0.4618.53±3.0610.09±0.867.72±1.2211.92±0.60
中药+雷火灸组4.87±1.101.64±0.36abc18.61±2.877.80±0.95abc7.79±1.0815.16±0.43abc
F值1.06113.5971.29721.4750.95426.983
P值0.183<0.0010.143<0.0010.205<0.001
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4组慢性前列腺炎/慢性骨盆疼痛综合征患者VAS、IPSS、IIEF-5评分比较(±s)

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组别VAS评分IPSS评分IIEF-5评分
治疗前治疗后治疗前治疗后治疗前治疗后
单纯西药组4.92±0.972.53±0.3118.60±3.119.83±0.987.76±1.1012.19±0.83
西药+雷火灸组4.89±1.031.90±0.2918.49±2.979.23±1.087.81±1.0613.39±0.52
单纯中药组4.90±0.932.68±0.4618.53±3.0610.09±0.867.72±1.2211.92±0.60
中药+雷火灸组4.87±1.101.64±0.36abc18.61±2.877.80±0.95abc7.79±1.0815.16±0.43abc
F值1.06113.5971.29721.4750.95426.983
P值0.183<0.0010.143<0.0010.205<0.001
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组别Qmax/(mL/s)VV/(mL)PSEP/(ng/mL)
治疗前治疗后治疗前治疗后治疗前治疗后
单纯西药组7.76±1.219.13±0.74203.47±18.63227.10±20.944.90±1.142.56±0.64
西药+雷火灸组8.03±1.0610.36±0.81205.12±19.54231.64±22.054.82±0.962.28±0.32
单纯中药组7.91±1.309.87±0.79203.96±20.17224.58±19.824.92±1.072.70±0.45
中药+雷火灸组8.02±0.9811.29±1.15abc204.19±18.90248.71±26.53abc4.87±0.921.97±0.52abc
F值2.01110.5820.3568.6251.7219.947
P值0.069<0.0010.373<0.0010.092<0.001
), ArticleFig(id=1322922745192907220, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922736447783321, language=CN, label=表3, caption=

4组慢性前列腺炎/慢性骨盆疼痛综合征患者Qmax、VV、PSEP水平比较(±s)

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组别Qmax/(mL/s)VV/(mL)PSEP/(ng/mL)
治疗前治疗后治疗前治疗后治疗前治疗后
单纯西药组7.76±1.219.13±0.74203.47±18.63227.10±20.944.90±1.142.56±0.64
西药+雷火灸组8.03±1.0610.36±0.81205.12±19.54231.64±22.054.82±0.962.28±0.32
单纯中药组7.91±1.309.87±0.79203.96±20.17224.58±19.824.92±1.072.70±0.45
中药+雷火灸组8.02±0.9811.29±1.15abc204.19±18.90248.71±26.53abc4.87±0.921.97±0.52abc
F值2.01110.5820.3568.6251.7219.947
P值0.069<0.0010.373<0.0010.092<0.001
), ArticleFig(id=1322922745482314197, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922736447783321, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心呕吐头晕瘙痒烫伤合计
单纯西药组401(2.50)3(7.50)2(5.00)0(0.00)6(15.00)
西药+雷火灸组401(2.50)2(5.00)1(2.50)1(2.50)5(12.50)
单纯中药组403(7.50)0(0.00)0(0.00)0(0.00)3(7.50)
中药+雷火灸组401(2.50)0(0.00)2(5.00)1(2.50)4(10.00)
χ2值4.943
P值0.176
), ArticleFig(id=1322922747113898454, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922736447783321, language=CN, label=表4, caption=

4组慢性前列腺炎/慢性骨盆疼痛综合征患者不良反应比较

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组别例数恶心呕吐头晕瘙痒烫伤合计
单纯西药组401(2.50)3(7.50)2(5.00)0(0.00)6(15.00)
西药+雷火灸组401(2.50)2(5.00)1(2.50)1(2.50)5(12.50)
单纯中药组403(7.50)0(0.00)0(0.00)0(0.00)3(7.50)
中药+雷火灸组401(2.50)0(0.00)2(5.00)1(2.50)4(10.00)
χ2值4.943
P值0.176
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龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的随机对照研究
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蔡群 1 , 郭勤 1 , 刘盈君 1 , 郭芳芳 1 , 袁康妮 2
中华中医药学刊 | 国家项目点击 2025,43(2): 33-36
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中华中医药学刊 |国家项目点击 2025 , 43 (2) : 33 -36
龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的随机对照研究
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蔡群1, 郭勤1, 刘盈君1, 郭芳芳1, 袁康妮2
作者信息
  • 1.浙江中医药大学附属第三医院,浙江 杭州 310005
  • 2.浙江中医药大学,浙江 杭州 310052
作者简介:

蔡群(1974-),女,浙江杭州人,副教授,学士,研究方向:中医康复。

Randomized Controlled Study of Longdan Xiegan Decoction(龙胆泻肝汤)Combined with Thunder-Fire Moxibustion in Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Qun CAI1, Qin GUO1, Yingjun LIU1, Fangfang GUO1, Kangni YUAN2
Affiliations
  • 1.The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China
  • 2.Zhejiang Chinese Medical University,Hangzhou 310052,Zhejiang,China
出版时间: 2025-02-10 doi: 10.13193/j.issn.1673-7717.2025.02.007
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目的

研究龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果。

方法

选择2022年1月—2023年12月诊治的160例慢性前列腺炎/慢性骨盆疼痛综合征患者作为研究对象,根据随机数字表法随机均分为4组,单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组各40例。观察并比较4组的疗效,疼痛症状评分(visual analogue scale/score,VAS)、国际前列腺症状评分(international prostate symptom score,IPSS)、国际勃起功能评分表(international index of erectile function-5,IIEF-5)、最大尿流率(the maximum urine flow rate,Qmax)、尿量(urine volume,VV)、前列腺小体外泄蛋白(prostate-specific extracellular vesicle protein,PSEP),不良反应情况。

结果

单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组总有效率分别为80.00%(32/40)、87.50%(35/40)、77.50%(31/40)、97.50%(39/40),组间差异均有统计学意义(P<0.05),中药+雷火灸组总有效率最高。治疗前4组VAS、IPSS、IIEF-5评分差异均无统计学意义(P>0.05),治疗后4组VAS、IPSS评分均降低,IIEF-5评分均升高,且以中药+雷火灸组各项评分变化更显著(P<0.05)。治疗前4组Qmax、VV、PSEP水平差异均无统计学意义(P>0.05),治疗后4组患者Qmax、VV均显著升高,PSEP水平均显著下降,以中药+雷火灸组Qmax、VV值最高,PSEP水平最低,与其他3组比较差异均有统计学意义(P<0.05)。单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组不良反应发生率分别为15.00%(6/40)、12.50%(5/40)、7.50%(3/40)、10.00%(4/40),组间差异无统计学意义(P>0.05)。

结论

龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果显著,能够显著缓解患者症状,改善其排尿及性功能障碍状况,并且安全性良好,具有较高的应用价值。

慢性前列腺炎/慢性骨盆疼痛综合征  /  雷火灸  /  龙胆泻肝汤  /  左氧氟沙星  /  盐酸坦索罗辛
Objective

To study the effect of Longdan Xiegan Decoction(龙胆泻肝汤)combined with thunder-fire moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome.

Methods

A total of 160 patients with chronic prostatitis/chronic pelvic pain syndrome diagnosed and treated from January 2022 to December 2023 were selected as the research objects. According to the random number table method,they were randomly divided into four groups:western medicine group,western medicine+thunder fire moxibustion group,Chinese medicine group and Chinese medicine+thunder fire moxibustion group,with 40 cases in each group. The efficacy,pain symptom score(VAS),international prostate symptom score(IPSS),international erectile function score-5(IIEF-5),the maximum urinary flow rate(Qmax),urine volume(VV),prostate-specific extracellular vesicle protein(PSEP)and adverse reactions of the four groups were observed and compared.

Results

The total effective rates of the western medicine group,the western medicine+thunder fire moxibustion group,the Chinese medicine group and the Chinese medicine+thunder fire moxibustion group were 80.00%(32/40),87.50%(35/40),77.50%(31/40)and 97.50%(39/40),respectively,and the differences between the groups were statistically significant(P<0.05). After treatment,the VASand IPSS scores of the four groups decreased,and the IIEF-5 scores increased,and the scores of the traditional Chinese medicine+thunder fire moxibustion group changed more significantly(P<0.05). There was no significant difference in Qmax,VV or PSEP among the four groups before treatment(P>0.05). After treatment,the values of Qmax and VV of the four groups were significantly increased,and PSEPlevels were significantly decreased. The values of Qmax and VV in the Chinese medicine+thunder fire moxibustion group were the highest,and the PSEP level was the lowest. Compared with those of the other three groups,the difference was statistically significant(P<0.05).

Conclusion

The effect of Longdan Xiegan Decoction combined with thunderfire moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome is significant. It can significantly relieve the symptoms of patients,improve their urination and sexual dysfunction,and has good safety and high application value.

chronic prostatitis/chronic pelvic pain syndrome  /  thunder-fire moxibustion  /  Longdan Xiegan Decoction(龙胆泻肝汤)  /  levofloxacin  /  tamsulosin hydrochloride
蔡群, 郭勤, 刘盈君, 郭芳芳, 袁康妮. 龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的随机对照研究. 中华中医药学刊, 2025 , 43 (2) : 33 -36 . DOI: 10.13193/j.issn.1673-7717.2025.02.007
Qun CAI, Qin GUO, Yingjun LIU, Fangfang GUO, Kangni YUAN. Randomized Controlled Study of Longdan Xiegan Decoction(龙胆泻肝汤)Combined with Thunder-Fire Moxibustion in Treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (2) : 33 -36 . DOI: 10.13193/j.issn.1673-7717.2025.02.007
慢性前列腺炎是男性最常见的疾病之一,分为急性细菌性前列腺炎、慢性细菌性前列腺炎、慢性非细菌性前列腺炎、前列腺痛,慢性非细菌性前列腺炎与前列腺痛合称为慢性前列腺炎/慢性骨盆疼痛综合征[1]。慢性前列腺炎/慢性骨盆疼痛综合征是前列腺炎中最常见、最难治疗的类型,引起相关工作者的重视[2-3]。以往研究提示单一治疗措施的治疗效果很不理想,近年来中医药疗法在慢性前列腺炎/慢性骨盆疼痛综合征中的应用逐渐得到认可[4-6]。前列腺炎属于中医学“精浊”“淋证”“白浊”等范畴,多由于湿热蕴结下焦,扰乱精室或情志不畅,肝郁气滞,久病入络入血,气血运行受阻,经时血液瘀滞不通所造成,病机主要考虑为湿热蕴积、气滞血瘀、肝气郁结、肾阴不足、脾肾阳虚,中医药治疗前列腺炎主要是辨证治疗,根据不同证型选用不同的治疗方案[7]。本研究观察龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果,以期为该疾病的治疗提供新思路,现总结分析相关资料并报道如下。
选择2022年1月—2023年12月诊治的160例慢性前列腺炎/慢性骨盆疼痛综合征患者作为研究对象,纳入标准:①均符合《慢性前列腺炎/慢性盆腔疼痛综合征诊疗指南》[8]中相关诊断标准,并且依据《慢性前列腺炎中西医结合诊疗专家共识》[9]中医辨证为湿热型;②生命体征平稳,意识清楚,具备正常交流能力;③知情同意研究内容并且自愿参与研究项目。排除标准:①合并前列腺增生、尿道炎、精索静脉曲张等影响前列腺功能的疾病;②严重心、肝、肾等器质性疾病;③严重过敏体质、对研究所用药物有过敏史;④有皮肤疾病等艾灸治疗禁忌证。所有患者根据随机数字表法随机均分为4组,单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组各40例。单纯西药组患者年龄27~64岁、平均(51.9±4.6)岁,病程3~25个月、平均(9.7±1.8)个月;西药+雷火灸组年龄29~62岁、平均(52.2±3.9)岁,病程4~26个月、平均(9.9±1.5)个月;单纯中药组年龄26~65岁、平均(52.0±4.2)岁,病程3~24个月、平均(9.7±2.0)个月;中药+雷火灸组年龄28~63岁、平均(51.9±4.1)岁,病程5~26个月、平均(10.0±1.7)个月;4组患者的一般资料进行比较,差异均无统计学意义(P>0.05),具有均衡可比性。研究内容经浙江中医药大学附属第三医院医学伦理委员会审核批准(ZSLLKY-2022-033-01)进行。
单纯西药组:口服左氧氟沙星0.2 g,2次/d,盐酸坦索罗辛0.2 mg,1次/d。西药+雷火灸组西药治疗同上,雷火灸:取神阙、气海、关元、中极、横骨、肾俞、肝俞、足三里、承山穴,以长斗式雷火灸具盒(内燃2枚药柱)置于以上穴位进行熏灸30 min,根据个体情况每个疗程5~7 d,休息3 d后进行下1个疗程。单纯中药组:采用龙胆泻肝汤治疗,药物组分如下:龙胆草(酒炒)6 g,黄芩(酒炒)9 g,山栀子(酒炒)9 g,泽泻12 g,木通9 g,车前子9 g,当归(酒炒)8 g,生地黄20 g,柴胡10 g,生甘草6 g,1剂/d,水煎服,分早晚2次服用。中药+雷火灸组:雷火灸方法同上,并同单纯中药组给予龙胆泻肝汤治疗。4组患者均治疗4周。
(1)临床疗效:根据中医症状积分评估疗效,症状积分下降>70%为显效、下降30%~70%为有效、下降<30%为无效[10],总有效率=(显效+有效)例数/总例数×100%。(2)疼痛症状评分(visual Analogue Scale/Score,VAS)、国际前列腺症状评分(international prostate symptom score,IPSS)、国际勃起功能评分表(international index of erectile function-5,IIEF-5):VAS评分以0分为无痛、10分为剧烈疼痛,总分0~10分、评分越高则表明疼痛越严重[11];IPSS评分通过对患者排尿不尽、排尿间隔小于2 h、间断性排尿、憋尿困难、尿线变细、排尿费力、夜尿次数增多7个相关条目进行分段评分,每个条目依次对应0~5分,总分0~35分,评分越高则表明症状越严重[12];IIEF-5评分包括5个有关勃起功能障碍的条目,每个条目根据患者情况依次对应0到5分,总分范围0~25分,分值越低表明勃起功能障碍越严重[13]。(3)最大尿流率(the maximum urine flow rate,Qmax)、尿量(urine volume,VV)、前列腺小体外泄蛋白(prostate-specific extracellular vesicle protein,PSEP):应用全自动尿流动力仪测定Qmax、VV,采用PSEP试剂盒检测患者中段尿液PSEP浓度值。(4)不良反应:观察记录治疗过程中发生的恶心呕吐、头晕、瘙痒、皮下瘀紫等不良反应情况。
采用SPSS 23.0统计软件包进行数据分析,计数资料用[例(%)]表示、采用χ2检验,研究所述计量资料经Levene's检验呈正态分布,均以()表示,多组间方差分析、两组间采用t检验、组内配对t检验,P<0.05表示差异有统计学意义。
单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组总有效率分别为80.00%、87.50%、77.50%、97.50%,组间差异均有统计学意义(P<0.05),中药+雷火灸组总有效率最高。见表1。
治疗前4组VAS、IPSS、IIEF-5评分差异均无统计学意义(P>0.05),治疗后4组VAS、IPSS评分均降低,IIEF-5评分均升高,且以中药+雷火灸组各项评分变化更显著(P<0.05)。见表2。
治疗前4组Qmax、VV、PSEP水平差异均无统计学意义(P>0.05),治疗后4组患者Qmax、VV均显著升高,PSEP水平均显著下降,以中药+雷火灸组Qmax、VV值最高,PSEP水平最低,与其他3组比较差异均有统计学意义(P<0.05)。见表3。
单纯西药组、西药+雷火灸组、单纯中药组、中药+雷火灸组不良反应发生率分别为15.00%、12.50%、7.50%、10.00%,组间差异无统计学意义(P>0.05)。见表4。两组患者发生的恶心呕吐、头晕、瘙痒等症状均较轻微,无须特殊处理,能够自行缓解,雷火灸治疗发生2例Ⅰ°烫伤,经冷敷处理,未影响后续治疗。
慢性前列腺炎/慢性骨盆疼痛综合征多表现为长期、反复骨盆区疼痛或不适,可伴有下尿路症状及性功能障碍,这也是本研究中选取尿动力及性功能相关指标作为观察项目的原因。有研究提示该疾病虽不是一种直接危及生命的疾病,但严重影响患者的生活质量,并对公共卫生事业造成巨大的经济负担,需要积极治疗[2,14]。
本研究结果提示龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果最佳,优于单纯西药组、西药+雷火灸组、单纯中药组。纳入的研究对象为湿热型患者,湿热阻络、气滞血瘀,当以清热利湿、疏肝通络、活血化瘀为治则。龙胆泻肝汤可见于《医方集解》,方中龙胆草大苦大寒,既能清利肝胆实火,又能清利肝经湿热;黄芩、栀子苦寒泻火,燥湿清热;泽泻、木通、车前子渗湿泄热,导热下行;当归、生地养血滋阴,邪去而不伤阴血;柴胡舒畅肝经之气,引诸药归肝经;甘草调和诸药;共同发挥泻肝胆实火,清肝经湿热的功效[15-17]。雷火灸是中医的一种传统疗法,用中药粉末加上艾绒制成艾条,装入特制的盒内,施灸于穴位,其利用药物燃烧时的热量,通过悬灸的方法刺激相关穴位,热效激发经气,使局部皮肤肌理开放,药物透达相应穴位内,可以发挥通经活络、活血化瘀、消肿止痛、追风除湿、温经散寒、扶正祛邪等功效[18-19]。其燃烧时的物理因子和药化因子,与腧穴的特殊作用、经络的特殊途径相结合,产生一种综合效应[20]。在中药汤剂口服调节人体阴阳平衡、增强免疫力、提高机体的抗病能力的同时,增加雷火灸局部治疗,在临床疗效、尿动力及性功能相关指标方面均体现出显著优势。
本研究中龙胆泻肝汤结合雷火灸取穴,神阙当元神之门户,有回阳救逆、开窍苏厥之功;气海为人体先天元气聚会之处,男子生气之海,利下焦、补元气、行气散滞;关元培肾固本、补益元气、回阳固脱;中极通利膀胱、温肾助阳;横骨益肾兴阳,清热利淋[21-23];肾俞补肾强腰、温补肾阳、利水祛湿;肝俞疏肝利胆、清热利湿、平肝潜阳、补益肝肾;足三里调理脾胃、补中益气、通经活络、疏风化湿、扶正祛邪;承山穴运化水湿,固化脾土;雷火灸以上穴位共奏回阳固脱、疏肝理气、补中益气、扶正祛邪固本之功,促进患者康复[21-23]。
综上所述可见,龙胆泻肝汤结合雷火灸治疗慢性前列腺炎/慢性骨盆疼痛综合征的效果显著,能够显著缓解患者症状,改善其排尿及性功能障碍状况,并且安全性良好,具有较高的应用价值。
  • 国家自然科学基金项目(82205269)
  • 浙江省中医药科技计划项目(2022ZB187)
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2025年第43卷第2期
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doi: 10.13193/j.issn.1673-7717.2025.02.007
  • 首发时间:2026-10-30
  • 出版时间:2025-02-10
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国家自然科学基金项目(82205269)
浙江省中医药科技计划项目(2022ZB187)
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    1.浙江中医药大学附属第三医院,浙江 杭州 310005
    2.浙江中医药大学,浙江 杭州 310052
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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