Type III prostatitis (chronic prostatitis/chronic pelvic pain syndrome) accounts for about 90% of prostatitis diseases, mainly manifesting as long-term, recurrent pain or discomfort in the pelvic region, which can be accompanied by varying degrees of urinary symptoms, seriously affecting the patient’s quality of life, and can be divided into two types, A and B, each accounting for about 50%. The cause of type IIIB prostatitis is more complex and the pathogenesis has not been fully elucidated so far, so there is a lack of systematic and standardized treatment plan, mostly empirical treatment. In recent years, most domestic scholars tend to combine Chinese and Western medicine to treat the disease. We used Peach Kernel Cheng Qi Tang combined with Celecoxib to treat type IIIB prostatitis and achieved better clinical results. The results are reported below.
I. Clinical data
From March 2012 to October 2012, 68 patients diagnosed with type IIIB prostatitis in our urology outpatient clinic were randomly divided into 2 groups using the number table method, and 34 patients were included in each group. The final follow-up was completed in 64 patients, 1 case was lost in the combined medication group due to change of workplace, and 3 cases were lost in the western medication group due to patients changing their treatment midway. The actual evaluable patients were 33 cases in the combined medication group and 31 cases in the western medication group.
II. Inclusion criteria
① Age from 18 to 50 years old, with a disease duration of 3 months to several years.
②Long-term, recurrent pain or discomfort in the pelvic region.
③with urinary frequency, urgency, incomplete urination and other urinary discomfort symptoms.
④Prostate fluid (Expressed prostatic secretions, EPS) microscopy: 10 leukocytes/HP, normal or reduced lecithin vesicles.
⑤ negative bacterial culture of prostatic fluid or urine after massage.
(vi) NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) score ≥ 10.
(vii) Not taking any other medication for chronic prostatitis and affecting urination within 1 week.
⑧ Meet the criteria for identification of Qi stagnation and blood stasis in Chinese medicine. Among them, ②④⑤⑧ are necessary.
III. Exclusion criteria
(1) Those aged <18 years or >50 years.
(2) Those with positive bacterial culture or pathogenic microorganisms such as mycoplasma and chlamydia.
(3) Those with painful discomfort caused by other diseases such as varicocele and epididymitis.
(4) Those with severe liver or kidney insufficiency.
(5) Those who are allergic to this test drug.
IV. Drug administration method
The Western medicine group was given oral celecoxib 0.2g, qd, orally after breakfast for 4 weeks. In the combined drug group, peach kernel Cheng Qi Tang was added to the oral celecoxib. Chinese medicine composition:12g each of peach kernel and raw rhubarb, 6g each of licorice, cinnamon stick and mannitol, 1 dose daily, decoction in water, taken after morning and evening meal. The Chinese herbal tablets were provided by the hospital herbal pharmacy.
V. Observation index
NIH-CPSI scores (recorded once before treatment and once after 4 weeks of administration), including pain symptom score (category I), urinary symptom score (category II) and quality of life score (category III).
Evaluation criteria of efficacy
Clinical cure: the symptom score is reduced by more than 90%, the pressure pain on palpation of the prostate disappears, and the texture is restored or close to normal. Effective: 70%~89% reduction in symptoms, improvement in tenderness and texture on palpation. Effective: 30%-69% reduction in symptom score and improvement in palpation. Ineffective: 30% reduction or no change or worsening of symptom score, no improvement or worsening of palpation.
VII. Statistical treatment: The measurement data were described by ± s. The t-test for paired data was used to compare the NIH-CPSI scores before and after treatment between the two groups, and the χ2 test was used to compare the treatment effects between the two groups. p<0.05 was considered a significant difference. All data were analyzed using SPSS17.0 analysis software.
VIII. Results
(1) Comparison of clinical efficacy between the two groups
18 Both the western medicine group and the combined medicine group achieved better therapeutic effects, but the efficiency of the combined medicine group increased by about 10% compared with that of the western medicine group. The cure rate and apparent efficiency of the Western medicine group accounted for 48.4% of the efficiency, while the cure rate and apparent efficiency of the combined medicine group accounted for 80% of the efficiency, which was 31.6% higher than the former.
(2) NIH-CPSI scores of the two groups
(i) Pain symptom score, urinary symptom score and quality of life score were significantly improved in the western medicine group before treatment compared with after treatment, P<0.05.
(ii) There was significant improvement in both subscale scores and total scores in the combination drug group before treatment compared with after treatment, with a decrease of more than 10 points in total scores, P<0.05.
(③) The total score decreased significantly in the combined medication group compared with the western medication group after treatment, with statistical significance, P<0.05.
(3) Safety
Three cases in the combined medication group showed 3 times/day stools and one case showed nausea and discomfort; one case in the western medication group showed nausea and discomfort, all of which did not affect the continuation of medication.