Analysis of short-term curative effects of muscarinic-receptor blocker combined with antihistamine drugs in the treatment of alpha-receptor blocker invalid CP/CPPS
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摘要: 目的: 评估联合应用M受体拮抗剂(酒石酸托特罗定缓释片)和抗组胺药物(盐酸氯雷他定片)联合治疗α1受体阻滞剂(哈乐)无效的慢性前列腺炎/慢性盆底疼痛综合征(CP/CPPS)近期疗效与安全性。方法: 2011年9月~2013年5月,排除包茎、尿道炎、前列腺增生和尿道狭窄等病例,我院泌尿外科门诊诊治α1受体阻滞剂(哈乐)治疗无效的ⅢB CP/CPPS患者75例,随机分为3组,分别给予抗组胺药物(盐酸氯雷他定片)、M受体阻滞剂(酒石酸托特罗定缓释片)和联合治疗组(盐酸氯雷他定片+酒石酸托特罗定缓释片),持续治疗6周后门诊复查。记录治疗期间药物的不良反应,对比观察治疗前后前列腺按摩液白细胞计数和NIH-CPSI评分,评估治疗的有效性。结果: 3组患者治疗前一般情况无显著差异。治疗6周后,联合治疗组患者的NIH-CPSI评分和前列腺按摩液白细胞计数均较治疗前显著下降,与其他两组比较差异有统计学意义(P<0.05)。χ2检验结果表明,联合治疗组的治疗有效率明显优于单一抗组胺组和单一M受体阻滞剂组(P<0.05)。治疗期间3组患者均未发现明显药物不良反应。结论: 抗组胺药物联合M受体阻滞剂治疗能够显著地改善α1受体阻滞剂无效CP/CPPS的临床症状,减少前列腺按摩液白细胞计数。相对于单一抗组胺药物或单一M受体阻滞剂,联合治疗近期疗效更佳,可在临床推广。
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关键词:
- 慢性前列腺炎/慢性盆底疼痛综合征 /
- M受体拮抗剂 /
- α1受体阻滞剂 /
- 抗组胺药物 /
- 联合治疗
Abstract: Objective: To evaluate the short-term curative efficacy and safety of combination therapy of muscarinic-receptor blocker (tolterodine) and antihistamine drugs (loratadine) for alpha-receptor blocker invalid chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Method:Excluded phimosis, urethritis, hyperplasia of prostate and urethral stricture, a total of 75 patients of alpha-receptor blocker invalid CP/CPPS were randomized into three groups. Twenty patients were given loratadine alone. Another 20 patients were given tolterodine. The rest of 35 patients received combination therapy. After six weeks of medication, we assessed the therapeutic effects according to NIH-CPSI scores and the number of WBC in the prostatic fluid. Result:There were no significant differences in patients' data before medication among these groups. Six weeks later a significantly reduced NIH-CPSI score and the number of WBC in the prostatic fluid was noticed in the group of combination therapy, and a chi-square test showed that the combined therapy was more effective than antihistamine alone or M-receptor antagonist alone (P<0.05). No obvious toxicities or side effects were noticed. Conclusion: The combination of antihistamine drugs with muscarinic-receptor antagonists significantly alleviates NIH-CPSI score and reduced WBC in the prostatic fluid for alpha-receptor blocker invalid CP/CPPS. Apparently it is more effective than antihistamine drugs or muscarinic-receptor blocker alone, and is worth widely using clinically.Key words chronic prostatitis/chronic pelvic pain syndrome; muscarinic-receptor blocker; alpha-receptor blocker; antihistamine drugs; combination therapy -
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