电针治疗良性前列腺增生症的疗效评价

关键词：良性前列腺增生  电针/针灸疗法  随机对照试验

Keywords:benign prostatic hyperplasia  electroacupuncture/acupuncture  randomized controlled trial

摘要：

      目的：评价电针治疗良性前列腺增生症的疗效和安全性。方法：采用前瞻性多中心随机对照研究，选取符合纳入标准的良性前列腺增生患者175例，随机分成电针组87例，药物组88例；电针组取穴中髎、会阳，隔日1次，对照组口服盐酸特拉唑嗪（马沙尼）2mg,每晚1次；治疗时间4周，主要结局指标为国际前列腺症状评分（IPSS）、最大尿流率（Qmax）和残余尿（PVR）；次要结局指标为泌尿症状困扰积分（BS）、24h憋尿困难次数、夜尿次数和前列腺体积，并记录不良反应。结果:①治疗4周，电针组改善IPSS优于药物组（P<0.01），电针组提高Qmax及减少PVR优于药物组（P<0.05）。治疗后6个月随访，电针组改善IPSS、提高Qmax、减少PVR优于药物组（P<0.01）；治疗后18个月随访，电针组改善IPSS、提高Qmax、减少PVR优于药物组（P<0.01）。②治疗4周，电针组改善BS评分及减少24h憋尿困难次数明显优于药物组（P<0.01）；电针组减少夜尿次数优于药物组（P<0.05）。两组治疗前后前列腺体积比较差异无显著性意义。结论: 电针中髎、会阳可显著减低轻中度良性前列腺增生症患者IPSS、提高Qmax、减少PVR，疗效明显优于西药盐酸特拉唑嗪；在降低BS、减少24h憋尿困难次数及夜尿次数方面，疗效可能优于盐酸特拉唑嗪。

Abstract:

      Objective: To evaluate the effects of electroacupuncture on symptoms of benign prostatic hyperplasia (BPH). Method: One hundred and seventy-five patients of BPH were randomly divided into two groups, 87 in electronic acupuncture group and 88 in medicine(terazosin) group. The electroacupuncture group were treated with electroacupuncture on zhongliao(BL33)、huiyang(BL35), and medicine group received. Terazosin 2 mg daily at night for 4 weeks. International Prostatic Symptom Score(IPSS), maximal urinary flow rates(Qmax) and post-voided residual urine volume (PVR) were adopted as the primary outcome measures, while bother of score(BS)、times of difficulty for holding urine during 24-hours and urinating times at night and prostate volume were taken as secondary outcome measures. Result: ①After 4 weeks of treatmeuts, in electro acupuncture group the decrease of IPSS scores was significantly superior to that in medicine group（P<0.01）, the increase of Qmax、decrease of PVR were statistically better than that in medicine group（P<0.05）. Six monthes following up showed that the improvement of IPSS、Qmax and PVR in electro-acupuncture group were greater than that in medicine group（P<0.01）. Similar statistical differences were observed at 18 monthes follow-up. ②After 4 weeks of treatments, in electroacupancture group the decrease of BS scores and times of difficulties in holding urine during 24-hours were significantly superior to that in medicine group（P<0.01）,the decrease of urinating times at night were statistically better than that in medicine group（P<0.05）. There was no statistically difference in prostate volume before and after treatments in two groups.Conclusion:Therapeutic effects of electro acupuncture on bilateral zhongliao(BL33) and huiyang(BL35) for mild and moderate BPH are evidently better than that of Terazosin in relieving prostatic symptoms, improving Qmax and decreasing PVR; and possibly better in improving BS, reducing times of difficulties in holding urine during 24-hours and urinating times at night. The dominance of effects of electroacupuncture can last 6 months, or even 18 months in some cases.