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北京市丰台中西医结合医院针灸科,北京100072
丁玉龙,副主任医师。E-mail: princezzbmw@163.com
收稿:2023-06-26,
网络首发:2024-02-07,
纸质出版:2024-04-12
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王怀玉,纪元,张朔,等.针刺治疗对慢性前列腺炎/慢性盆腔疼痛综合征患者生活质量的影响:随机对照试验[J].中国针灸,2024,44(4):411-417.
WANG Huaiyu,JI Yuan,ZHANG Shuo,et al.Effect of acupuncture on quality of life in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2024,44(04):411-417.
王怀玉,纪元,张朔,等.针刺治疗对慢性前列腺炎/慢性盆腔疼痛综合征患者生活质量的影响:随机对照试验[J].中国针灸,2024,44(4):411-417. DOI: 10.13703/j.0255-2930.20230626-k0003.
WANG Huaiyu,JI Yuan,ZHANG Shuo,et al.Effect of acupuncture on quality of life in patients with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2024,44(04):411-417. DOI: 10.13703/j.0255-2930.20230626-k0003.
目的
2
观察针刺治疗对慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)患者生活质量、疼痛及前列腺症状的影响及安全性。
方法
2
将70例CP/CPPS患者随机分为针刺组(35例,剔除1例)和假针刺组(35例,脱落3例)。针刺组于双侧中髎、会阳、肾俞、三阴交行常规针刺;假针刺组于双侧中髎、会阳、肾俞及三阴交旁开非经非穴点进行浅刺,不行手法,不引发得气感。两组均留针30 min,隔日1次,每周3次,治疗8周(24次)。于治疗前后及治疗结束后24周随访时,观察两组患者健康调查简表[SF-36,包括生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、一般健康状况(GH)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)8个维度,8个维度可概括为躯体健康总测量(PCS)和心理健康总测量(MCS)评分两方面]、盆腔疼痛视觉模拟量表(VAS)、美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)、国际前列腺症状(IPSS)评分,并评价两组安全性。
结果
2
治疗后及随访时,针刺组SF-36各维度评分及PCS、MCS评分较治疗前升高(
P
<
0.05,
P
<
0.01);治疗后,假针刺组RP、BP、SF 3个维度评分及PCS评分较治疗前升高(
P
<
0.05,
P
<
0.01)。治疗后,针刺组患者RP、BP、GH、MH 4个维度评分及PCS、MCS评分高于假针刺组(
P
<
0.05,
P
<
0.01);随访时,除PF、RE维度外,针刺组患者各维度评分及PCS、MCS评分均高于假针刺组(
P
<
0.05,
P
<
0.01)。治疗后及随访时,针刺组患者盆腔疼痛VAS、NIH-CPSI、IPSS评分较治疗前降低(
P
<
0.01);假针刺组治疗后盆腔疼痛VAS、NIH-CPSI评分及随访时NIH-CPSI评分较治疗前降低(
P
<
0.01)。治疗后和随访时,针刺组盆腔疼痛VAS、NIH-CPSI、IPSS评分低于假针刺组(
P
<
0.01,
P
<
0.05)。两组均未见明显不良反应,不良反应发生率比较差异无统计学意义(
P
>
0.05)。
结论
2
针刺治疗可有效提高CP/CPPS患者生活质量,降低疼痛程度,改善前列腺症状,远期疗效较好。
Objective
2
To observe the effect and safety of acupuncture on quality of life
pain
and prostate symptoms in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
Methods
2
Seventy patie
nts with CP/CPPS were randomly divided into an acupuncture group (35 cases
1 case was eliminated) and a sham acupuncture group (35 cases
3 cases dropped out). The patients in the acupuncture group were treated with routine acupuncture at bilateral Zhongliao (BL 33)
Huiyang (BL 35)
Shenshu (BL 23) and Sanyinjiao (SP 6)
while the patients in the sham acupuncture group were treated with shallow needling at non-meridian and non-acupoint points beside bilateral Zhongliao (BL 33)
Huiyang (BL 35)
Shenshu (BL 23) and Sanyinjiao (SP 6)
without manipulation to induce arrival of
qi
(
deqi
). Both groups retained the needles for 30 min
with one session every other day
three times a week
for a total of 8 weeks (24 sessions). Before and after treatment
and at the follow-up of 24 weeks after treatment completion
the scores of MOS 36-item short-form health survey (SF-36
including 8 dimensions of physical function [PF
]
role physical function [RP
]
bodily pain [BP
]
general health status [GH
]
vitality [VT
]
social function [SF
]
role emotional [RE
]
and mental health [MH
]
which can be summarized as physical component summary [PCS
]
and mental component summary [MCS
]
)
pelvic pain visual analogue scale (VAS)
National Institutes of Health chronic prostatitis symptom index (NIH-CPSI)
and international prostate symptom score (IPSS) were evaluated
and safety of both groups was assessed.
Results
2
After treatment and at the follow-up
the scores of each dimension and PCS
MCS scores of SF-36 in the acupuncture group were higher than those before treatment (
P
<
0.05
P
<
0.01); compared before treatment
the RP
BP
and SF scores and PCS score in the sham acupuncture group were increased after treatment (
P
<
0.05
P
<
0.01). After treatment
the acupuncture group had higher scores in RP
BP
GH
MH and PCS
MCS than those in the sham acupuncture group (
P
<
0.05
P
<
0.01); at the follow-up
except for PF and RE dimensions
the scores in each dimension and PCS
MCS scores in the acupuncture group were higher than those in the sham acupuncture group (
P
<
0.05,
P
<
0.01). After treatment and at the follow-up
pelvic pain VAS
NIH-CPSI
IPSS scores in the acupuncture group were lower than those before treatment (
P
<
0.01); in the sham acupuncture group
pelvic pain VAS
NIH-CPSI scores were lower after treatment
and NIH-CPSI score at the follow-up was lower compared with those before treatment (
P
<
0.01). After treatment and at the follow-up
pelvic pain VAS
NIH-CPSI
IPSS scores in the acupuncture group were lower than those in the sham acupuncture group (
P
<
0.01
P
<
0.05). No significant adverse reactions were observed in both groups
and the incidence rates of adverse reactions had no significant difference (
P
>
0.05).
Conclusion
2
Acupuncture could effectively improve the quality of life
reduce pain levels
alleviate prostate symptoms
and shows favorable long-term efficacy in patients with CP/CPPS.
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