盐酸帕罗西汀联合艾司唑仑治疗伴有情绪反应和睡眠问题的Ⅲ型前列腺炎的临床研究

欧阳海+谢胜++康照鹏+王万荣+谢子平+王澍弘+李韬+谭艳

【摘要】目的：观察盐酸帕罗西汀联合艾司唑仑治疗伴有情绪反应和睡眠问题的Ⅲ型前列腺炎的用药效果。方法：500例入选患者在入院第1d完善NIH-CPSI，HAMD，PSQI评分。实验组（300例）用药：盐酸帕罗西汀、艾司唑仑、盐酸坦洛新缓释胶囊。对照组（200例）用药：安慰剂和盐酸坦洛新缓释胶囊。500例患者均接受前列腺按摩、药物灌肠治疗。每周排精1～2次。住院疗程共2周。出院后继续服用盐酸帕罗西汀和艾司唑仑2周，盐酸坦洛新缓释胶囊4周。所有病例分别于治疗第4d、第14d再次进行NIH-CPSI、HAMD、PSQI量表评估。以治愈和有效来计算总有效率。结果：治疗第4d，实验组NIH-CPSI、HAMD，PSQI评分分别较治疗前平均下降9.5分、6.8分、3.9分，对照组较治疗前平均下降3.9分、3.4分、1.4分。治疗第14d，实验组NIH-CPSI、HAMD，PSQI评分分别较治疗前平均下降16.6分、10.8分、5.3分，对照组较治疗前平均下降9.0分、7.5分、2.8分。实验组评分下降幅度比安慰剂组更明显，差异有显著统计学意义（P<0.01）。实验组在治疗第4d总有效率为40.3%，对照组为16%。治疗第14d实验组总有效率87%，对照组为47%，两组差异有显著性（P<0.01）。结论：慢性前列腺炎的治疗模式应该是一个综合治疗的过程，对于有情绪反应和睡眠问题的III型CP患者，早期加用盐酸帕罗西汀和艾司唑仑，能够在短时间内控制情绪反应和睡眠质量，有利于症状快速缓解。

【关键词】帕罗西汀；艾司唑仑；情绪反应；睡眠问题；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

【中图分类号】R697+.33【文献标志码】A

Ⅲ型前列腺炎（chronic prostatitis，CP）是男科患者中最常见的一种疾病，占男科就诊患者中半数以上，在这部分患者当中，伴有情绪反应（焦虑或抑郁状态）或睡眠问题的比比皆是。我科是湖北省唯一一家三甲医院中独立开设男科病房的科室，对于有症状的Ⅲ型前列腺炎患者我们一般采取收住院进行治疗，疗程14d。笔者曾在前期研究中采用黛力新治疗合并抑郁症的CP[1]，效果较好，但起效较慢，若患者入院3天后症状仍不能改善，情绪反应在此时就表现的相当明显。……