Clinical observation of erectile function and quality of life in patients with benign prostatic hyperplasia of kidney deficiency and blood stasis syndrome
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摘要: 目的:探讨良性前列腺增生(BPH)患者勃起功能及生活质量、健康状况的影响,为临床制定诊疗方案提供参考。方法:选择91例50~69岁有中度以上下尿路症状(LUTS)的中医辨证为肾虚血瘀证BPH患者,进行国际前列腺症状评分(IPSS)、国际勃起功能指数评分(IIEF-5)、生活质量评分(QOL)、生活质量调查问卷(ERTC QLQ-C30,3.0版本)等问卷调查,同时检测血清总睾酮(TT),并进行统计学分析。结果:随着年龄增长,前列腺增生程度、勃起功能障碍(ED)的发病率均呈现增高的趋势,IIEF-5评分60~69岁组明显低于50~59岁组(P<0.05),但ED发病率比较差异无统计学意义(P>0.05)。不同前列腺的体积,IIEF-5评分的有一定程度的差异,Ⅲ度增生与Ⅰ度比较差异有统计学意义(P<0.05)。不同程度LUTS的BPH患者IIEF-5评分差异均有统计学意义(P<0.01或P<0.05),但ED的发病率相近(P>0.05)。本组患者无论有无ED,其TT水平均在正常范围,但轻度ED及无ED患者的整体健康状况(Q29)、整体生活质量(Q30)及QOL均优于中、重度患者(均P<0.01)。结论:BPH不仅是中老年男性引起LUTS的因素,并且可增加患者ED的发生风险,而且BPH及LUTS的加重,ED呈现加重趋势,ED与TT无明显相关,ED可能是影响BPH患者的生活质量及健康水平的重要因素,临床诊疗时应综合分析患者情况制定更好的治疗方案。Abstract: Objective: To explore the effects of benign prostatic hyperplasia(BPH) on erectile function, quality of life and health status in patients, and to provide reference for the clinical diagnosis and treatment plan. Method: Ninety-one cases of 50-69 years old patients with moderate to high degree of lower urinary tract symptoms(LUTS) were selected as patients with BPH of kidney deficiency and blood stasis syndrome. International Prostate Symptom Score(IPSS), International Index of Erectile Function(IIEF-5) were selected, and Quality of Life(QOL), EORTC Quality of Life Questionnaire(QLQ-C30) and other questionnaires were used. Serum total testosterone(TT) was measured and statistical analysis was performed. Result: With the increase of age, the degree of prostatic hyperplasia and the incidence of erectile dysfunction(ED) increased. The IIEF-5 score was significantly lower in the 60-69-year-old group than that in the 50-59-year-old group(P<0.05), but the difference of the incidence of ED between them was not significant(P>0.05). There was difference in the IIEF-5 between the different sizes of prostates. The difference between the Ⅲ degree hyperplasia and the Ⅰ degree was significant(P<0.05). The IIEF-5 scores of BPH patients with different degrees of LUTS were different(P<0.01 or P<0.05), but the incidence of ED was similar(P>0.05). The TT level of this group of patients with or without ED was in the normal range, but the overall health status(Q29), overall quality of life(Q30) and QOL of patients with mild ED and non-ED were better than those of moderate and severe patients(both P<0.01).Conclusion: BPH can not only cause LUTS in middle-aged and old men, but also increase the risk of ED. Moreover, with the increase of BPH and LUTS, ED appears to be aggravating. However, ED and TT are not significantly related. ED may affect the quality of life and health of BPH patients. Clinical diagnosis and treatment should be comprehensively analysed according to patients' condition.
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