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目的探讨α肾上腺素能受体(α-AR)阻滞剂治疗Ⅲ型前列腺炎(慢性非细菌性前列腺炎/慢性骨盆疼痛综合征,CP/CPPS)的疗效和药物副作用。方法CP/CPPS患者325例,平均年龄33.2岁,平均病程2.4年,分为盐酸哌唑嗪组95例、盐酸特拉唑嗪组78例、盐酸酚苄明组27例和甲磺酸多沙唑嗪控释片组72例,根据病情选用抗生素及其他对症支持治疗。采用NIH慢性前列腺炎症状指数(CPSI)评分作为疗效评价指标,分析评定比较各组患者疗效及副作用。未使用α-AR阻滞剂的53例作为对照组。结果对照组患者治疗有效(CPSI减少≥5分)22例(41.5%),无效(CPSI减少＜5分)31例(58.5%)；治疗组有效199例(73.2%),无效73例(26.8%),2组比较差异有统计学意义(P＜0.01)。盐酸酚苄明组有效率55.6%,盐酸特拉唑嗪组78.2%,甲磺酸多沙唑嗪控释片组76.4%,盐酸哌唑嗪组71.6%。α-AR阻滞剂药物副作用主要有体位性低血压(盐酸哌唑嗪组23.2%、盐酸特拉唑嗪组17.9%、盐酸酚苄明组22.2%和甲磺酸多沙唑嗪控释片组8.3%)和射精障碍(仅盐酸酚苄明组51.9%)。因不良事件停止治疗的发生率依次为盐酸酚苄明(18.5%)、盐酸哌唑嗪(7.4%)、盐酸特拉唑嗪(5.1%)和甲磺酸多沙唑嗪控释片组(0)。结论α-AR阻滞剂是治疗CP/CPPS的基础用药之一,可以显著改善患者的NIH-CPSI评分,但在选择药物时应考虑某些制剂的副作用。
Objective To investigate the efficacy and side effects of α-adrenergic receptor (α-AR) blocker in the treatment of type Ⅲ prostatitis (chronic non-bacterial prostatitis / chronic pelvic pain syndrome, CP / CPPS) Methods 325 cases of CP / CPPS patients, mean age 33.2 years, mean duration of 2.4 years, divided into prazosin hydrochloride group 95 cases, terazosin hydrochloride group 78 cases, phenoxybenzamine hydrochloride group 27 cases and methanesulfonic acid sand Controlled release tablets group 72 cases, according to the condition of antibiotics and other symptomatic supportive treatment. NIH chronic prostatitis symptom index (CPSI) score as the evaluation index of efficacy, analysis and evaluation of the efficacy and side effects of each group. 53 cases without α-AR blocker served as control group. Results In the control group, 22 cases (41.5%) were ineffective (CPSI less than 5 points), 31 cases (58.5%) were effective (73.2%) and 73 cases (26.8% %), The difference between the two groups was statistically significant (P <0.01). The effective rate of phenoxybenzamine hydrochloride group was 55.6%, that of terazosin hydrochloride group was 78.2%, that of doxazosin mesylate controlled-release group was 76.4%, and that of prazosin hydrochloride group was 71.6%. The side effects of alpha-AR blockers were mainly orthostatic hypotension (23.2% in the prazosin hydrochloride group, 17.9% in the terazosin hydrochloride group, 22.2% in the phenoxybenzamine hydrochloride group, and doxazosin- Group 8.3%) and ejaculation disorder (only 51.9% of the phenoxybenzamine hydrochloride group). The incidence of discontinuation of treatment for adverse events was phenoxybenzamine hydrochloride (18.5%), prazosin hydrochloride (7.4%), terazosin hydrochloride (5.1%) and doxazosin mesylate controlled release tablets group 0). Conclusions Alpha-AR blockers are one of the primary agents in the treatment of CP / CPPS and can significantly improve the NIH-CPSI score in patients, but side effects of certain agents should be considered when choosing the drug.