桂枝茯苓汤加减联合坦索罗辛治疗Ⅲ型前列腺炎的疗效及对血清VCAM-1、MCP-1、NLRP3的影响OA
The therapeutic effect of modified Guizhi Fuling Decoction combined with tamsulosin in the treatment of type Ⅲ prostatitis and its effects on serum VCAM-1,MCP-1 and NLRP3
目的 探究桂枝茯苓汤加减联合坦索罗辛(TAM)治疗Ⅲ型前列腺炎(CP/CPPS)的疗效及对血清血管细胞黏附分子-1(VCAM-1)、单核细胞趋化蛋白-1(MCP-1)、NOD样受体蛋白3(NLRP3)的影响.方法 参照随机数字法将2023年2月～2025年11月南京中医药大学附属医院泌尿科收治的120例Ⅲ型CP/CPPS患者随机分为对照组(TAM治疗)和试验组(TAM联合桂枝茯苓汤治疗).比较2组的临床症状评分、尿动力学、前列腺液常规、炎症因子、血清因子、临床疗效.结果 最终2组各纳入60例.中医证候积分分别为(13.23±4.21)分和(11.62±3.76)分,美国国立研究院慢性前列腺炎症症状指数(NIH-CPSI)分别为(15.35±4.34)分和(13.68±4.16)分,最大尿流率(Qmax)分别为(21.36±6.96)mL·s-1 和(24.32±7.36)mL·s-1,平均尿流率(Qave)分别为(10.33±3.34)mL·s-1 和(11.96±3.79)mL·s-1,残余尿量(RUV)分别为(10.01±3.21)mL 和(8.84±2.27)mL,卵磷脂小体(SPL)分别为(5.63±1.45)个·HP-1和(6.41±1.64)个·HP-1,白细胞计数(WBC)分别为(9.36±3.08)个·HP-1 和(8.32±2.06)个·HP-1,白细胞介素-6(IL-6)分别为(1.52±0.48)μg·L-1 和(1.32±0.41)μg·L-1,白细胞介素-1β(IL-1β)分别为(12.97±4.16)ng·L-1 和(11.35±3.74)ng·L-1,γ-干扰素(IFN-γ)分别为(7.34±2.41)ng·L-1 和(6.48±2.09)ng·L-1,VCAM-1 分别为(43.63±9.33)ng·mL-1 和(39.97±9.02)ng·mL-1,MCP-1 分别为(98.96±14.95)pg·mL-1 和(92.63±14.12)pg·mL-1,NLRP3 分别为(12.15±3.95)ng·mL-1 和(10.65±3.32)ng·mL-1,在统计学上差异有意义(P＜0.05).试验和对照组总有效率分别为93.33％和78.33％,在统计学上差异有意义(P＜0.05).结论 桂枝茯苓汤加减联合TAM可有效改善Ⅲ型CP/CPPS患者症状和前列腺功能,提升尿流率,减轻炎症水平,降低血清VCAM-1、MCP-1、NLRP3 水平,疗效显著.
Objective To explore the therapeutic effect of modified Guizhi Fuling Decoction combined with tamsulosin(TAM)in the treatment of type Ⅲ prostatitis(CP/CPPS),and to investigate its effects on serum vascular cell adhesion molecule-1(VCAM-1),monocyte chemotactic protein-1(MCP-1),and NOD-like receptor family pyrin domain containing protein 3(NLRP3).Methods According to the random number method,120 patients with type Ⅲ CP/CPPS admitted from February 2023～November 2025 were admitted to the Urology Department of the Affiliated Hospital of Nanjing University of Chinese Medicine assigned into control group(received oral treatment with TAM)and the treatment group(received oral treatment with TAM and Guizhi Fuling Decoction).After 8 weeks of treatment,the clinical symptom scores,urodynamics,routine tests of prostatic fluid,inflammatory factors,serum factors,and clinical therapeutic effect were evaluated.Results Finally,60 cases were included in each group.TCM syndrome score was(13.23±4.21)scores and(11.62±3.76)scores,National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI)was(15.35±4.34)scores and(13.68±4.16)scores,maximum flow rate(Qmax)was(21.36±6.96)mL·s-1 and(24.32±7.36)mL·s-1,Average flow rate(Qave)was(10.33±3.34)mL·s-1 and(11.96±3.79)mL·s-1,Residual Urine Volume(RUV)was(10.01±3.21)mLand(8.84±2.27)mL,Small Particles of Lecithin(SPL)was(5.63±1.45)and(6.41±1.64),White Blood Cell Count(WBC)was(9.36±3.08)and(8.32±2.06),Interleukin-6(IL-6)was(1.52±0.48)μg·L-1 and(1.32±0.41)μg·L-1,Interleukin-1 β(IL-1 β)was(12.97±4.16)ng·L-1 and(11.35±3.74)ng·L-1,Interferon-γ(IFN-γ)was(7.34±2.41)ng·L-1 and(6.48±2.09)ng·L-1,VCAM-1 was(43.63±9.33)ng·mL-1 and(39.97±9.02)ng·mL-1,MCP-1 was(98.96±14.95)pg·mL-1 and(92.63±14.12)pg·mL-1,NLRP3 was(12.15±3.95)ng·mL-1 and(10.65±3.32)ng·mL-1,statistically significant difference(P＜0.05).The total effective rates of the treatment group and control drug group were 93.33％and 78.33％,statistically significant difference(P＜0.05).Conclusion The modified Guizhi Fuling Decoction combined with TAM can effectively alleviate the symptoms and prostate function of patients with type Ⅲ CP/CPPS,increase urine flow rate,reduce inflammatory levels,and lower levels of serum VCAM-1,MCP-1,and NLRP3.The therapeutic effect is remarkable.
余秋昊;赵浩宇;赵凯;武密山
澳门科技大学中医药学院||江苏省中医院(南京中医药大学附属医院)泌尿外科 江苏省 南京市 210029澳门科技大学中医药学院江苏省中医院(南京中医药大学附属医院)泌尿外科 江苏省 南京市 210029澳门科技大学中医药学院||澳门科技大学中药质量研究国家重点实验室 中国 澳门 999078
医药卫生
桂枝茯苓汤加减坦索罗辛Ⅲ型前列腺炎血管细胞黏附分子-1单核细胞趋化蛋白-1NOD样受体家族含pyrin结构域蛋白3
modified Guizhi Fuling Decoctiontamsulosintype Ⅲ prostatitisvascular cell adhesion molecule-1monocyte chemotactic protein-1NOD-like receptor family pyrin domain containing protein 3
《中国临床药理学杂志》 2026 (15)
2107-2112,6
江苏省高等学校基础科学(自然科学)研究面上省资助经费项目(编号:23KJB320011)
评论