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体外冲击波调控免疫反应对ⅢB型CP/CPPS患者的疗效及其机制研究
Effect of extracorporeal shock wave therapy combined with tamsulosin on category ⅢB chronic prostatitis/chronic pelvic pain syndrome and the mechanis
- 第三军医大学学报 2017年39卷第14期 页码：1498-1502
- 作者机构：
1.610400 成都，金堂县第一人民医院(四川大学华西医院金堂医院)泌尿外科
2.400037 重庆，重庆市肿瘤医院泌尿外科
- 作者简介：
[ 林斌, E-mail: wuyuhang012@126.com LIN Bin, E-mail: wuyuhang012@126.com
- 基金信息：
DOI：10.16016/j.1000-5404.201611236
中图分类号： R392.32; R454.4; R697.33收稿：2016-11-28，
修回：2016-12-27，
纸质出版：2017-07-30
- 稿件说明：
移动端阅览
林斌, 张兴艳, 王亮. 体外冲击波调控免疫反应对ⅢB型CP/CPPS患者的疗效及其机制研究[J]. 第三军医大学学报, 2017,39(14):1498-1502.
Bin LIN, Xingyan ZHANG, Liang WANG. Effect of extracorporeal shock wave therapy combined with tamsulosin on category ⅢB chronic prostatitis/chronic pelvic pain syndrome and the mechanis[J]. Journal of Third Military Medical University, 2017, 39(14): 1498-1502.
林斌, 张兴艳, 王亮. 体外冲击波调控免疫反应对ⅢB型CP/CPPS患者的疗效及其机制研究[J]. 第三军医大学学报, 2017,39(14):1498-1502. DOI： 10.16016/j.1000-5404.201611236.
Bin LIN, Xingyan ZHANG, Liang WANG. Effect of extracorporeal shock wave therapy combined with tamsulosin on category ⅢB chronic prostatitis/chronic pelvic pain syndrome and the mechanis[J]. Journal of Third Military Medical University, 2017, 39(14): 1498-1502. DOI： 10.16016/j.1000-5404.201611236.
摘要
目的
2
探讨体外冲击波治疗(extracorporeal shock wave therapy，ESWT)对ⅢB型慢性前列腺炎(CP)/慢性盆腔疼痛综合征(CPPS)患者免疫反应的影响，并观察其疗效。
方法
2
收集2014年1月至2016年9月于我院就诊的120例CP/CPPS患者，采用随机数字表法分为试验组与对照组，各60例。对照组给予坦索罗辛治疗，试验组予ESWT+坦索罗辛治疗，两组均治疗4周。治疗后收集两组患者慢性前列腺炎症状评分(NIH-CPSI)，国际前列腺症状评分(IPSS)，前列腺液中TNF-α、IL-6、卵磷脂小体及外周血中CD3
+
、CD4
+
、CD8
+
、CD4
+
CD25
+
、TGF-β1、CD4
+
CD25
+
Foxp3
+
的表达变化。
结果
2
治疗4周后，与对照组相比，试验组总体有效率明显提高(63.3%
vs
93.3%，
P
<
0.05)；NIH-CPSI评分(13.12± 1.71
vs
23.16±1.33) 和IPSS评分(8.23±2.28
vs
13.14±2.69) 明显降低。在炎症和免疫影响方面，与对照组相比，试验组前列腺液中卵磷脂小体明显升高，炎性因子TNF-α、IL-1β水平明显降低；外周血中CD3
+
、CD4
+
、CD8
+
、CD4
+
CD25
+
、TGF-β1、CD4
+
CD25
+
Foxp3
+
表达均明显提高。
结论
2
ESWT治疗ⅢB型CP/CPPS安全有效，其可能的作用机制与提高患者的免疫功能、降低前列腺局部炎症应答有关。
Abstract
Objective
2
To investigate the effect of extracorporeal shock wave therapy (ESWT) combined with tamsulosin on category ⅢB chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and explore the possible mechanisms.
Methods
2
A total of 120 patients with category ⅢB CP/CPPS were randomized into ESWT group and control group (
n
=60) to receive treatments with ESWT plus tams
ulosin and tamsulosin alone
respectively. After 4 weeks of treatment
the improvements of clinical symptoms (NIH-CPSI and IPSS score)
levels of tumor necrosis factor-α (TNF-α)
interleukin-6 (IL-6) and lecithin bodies in the prostatic fluid
and levels of CD3
+
CD4
+
CD8
+
CD4
+
CD25
+
CD4
+
CD25
+
Foxp3
+
cells and transforming growth factor (TGF)-β1 in the peripheral blood were determined.
Results
2
After 4 weeks of treatment
the patients in ESWT group showed a significantly higher overall response rate than those in the control group (93.3%
vs
63.3%
P
<
0.05) with and significantly decreased scores of NIH-CPSI (13.12±1.71
vs
23.16±1.33) and IPSS (8.23±2.28
vs
13.14±2.69). Compared with those in the control group
the content of lecithin body was significantly increased and the levels of inflammatory factors TNF-α and IL-1 were significantly decreased in ESWT group; the contents of CD3
+
CD4
+
CD8
+
CD4
+
CD25
+
CD4
+
CD25
+
Foxp3
+
cells and TGF-β1 level in peripheral blood were significantly increased in ESWT group.
Conclusion
2
ESWT combined with tamsulosin is safe and effective for treatment of category ⅢB CP/CPPS possibly by improving the immune function and reducing the local inflammatory response in the prostate.
关键词
Keywords
references
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