目的:运用网络药理学研究和分子对接技术,探讨程氏萆薢分清饮治疗慢性前列腺炎(CP)的潜在机制.方法:借助TCMSP数据库筛选萆薢分清饮的活性成分及对应蛋白靶点,并利用Uniprot数据库确定基因靶点简称,通过Cytoscape3.7.2软件构建"中药-有效成分-靶点"作用网络.借助GeneCards和OMIM数据库筛选CP的疾病靶点,取交集后得到萆薢分清饮和CP的共同靶点,利用STRING数据库构建萆薢分清饮治疗慢性前列腺炎的蛋白互作网络(PPI)并进行拓扑分析.通过Metascape数据库进行GO功能富集分析和KEGG通路富集分析,最后进行分子对接验证.结果:筛选出萆薢分清饮有效成分150个,对应靶点122个,CP疾病靶点1067个,共同靶点基因117个,PPI网络分析表明萆薢分清饮治疗CP的关键靶点基因包括AKT1、TP53、IL6、MAPK8、MAPK1、VEGFA、TNF、JUN等.GO分析和KEGG分析表明核心靶点参与影响细胞代谢、凋亡,缓解疼痛等多种生物过程,作用于癌症、TNF、PI3K-Akt、HIF-1、细胞周期性代谢等多种信号通路.分子对接显示核心化合物与靶点具有良好的对接活性.结论:本研究从网络药理学和分子对接角度初步揭示萆薢分清饮治疗慢性前列腺炎涉及多靶点,多通路作用机制,预测了萆薢分清饮治疗慢性前列腺炎的潜在机制,为后续临床应用提供理论借鉴依据.

目的:观察腹针、艾灸联合盆底肌训练治疗女性压力性尿失禁(SUI)的临床疗效.方法:180例女性SUI患者随机分为对照组、艾灸组和腹针联合艾灸组,每组60例.对照组予常规盆底肌训练,艾灸组在此基础上加用艾灸关元穴治疗,腹针联合艾灸组在艾灸组治疗的基础上加用腹针治疗(针刺中脘、下脘、关元、气海、气穴),3组疗程均为12周.观察并比较3组患者治疗前与治疗8、12周后国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分、尿失禁生活质量问卷(I-QOL)评分、72 h尿失禁次数及1 h尿垫试验漏尿量,于治疗12周后评估临床疗效.结果:腹针联合艾灸组总有效率为93.3％,明显高于对照组的68.3％(P<0.05)和艾灸组的81.7％(P<0.05);艾灸组总有效率明显高于对照组(P<0.05).治疗8、12周后艾灸组和腹针联合艾灸组ICI-Q-SF评分、I-QOL评分均较治疗前明显改善(P<0.05),治疗12周后对照组上述指标较治疗前明显改善(P<0.05);治疗8、12周后腹针联合艾灸组、艾灸组上述指标改善程度明显优于同期对照组(P<0.05),腹针联合艾灸组I-QOL评分明显低于同期艾灸组(P<0.05);治疗12周后腹针联合艾灸组ICI-Q-SF评分明显低于艾灸组(P<0.05).治疗第8、12周时3组患者72 h尿失禁次数及1 h尿垫试验漏尿量均较治疗前明显降低(P<0.05),腹针联合艾灸组上述指标明显低于同期其他2组(P<0.05);治疗12周时艾灸组上述指标明显低于对照组(P<0.05).结论:在盆底肌训练基础上加用腹针、艾灸治疗可明显改善女性SUI患者生活质量,减少漏尿次数及漏尿量,疗效显著优于单用盆底肌训练和盆底肌训练联合艾灸.

[目的]探讨中药坐浴联合坦洛新及前列腺按摩对于Ⅲb型前列腺炎(CP)的临床疗效.[方法]选择2018年10月至2019年5月本院泌尿外科门诊收治的70例Ⅲb型CP患者,根据随机数表法将其分为观察组(中药坐浴联合口服坦洛新,并给予经直肠前列腺按摩治疗)和对照组(温水坐浴联合口服坦洛新,并给予经直肠前列腺按摩治疗),每组各35例.统计两组患者治疗后慢性前列腺炎症状评分(NIH-CPSI)、中医辨证积分改善情况,并比较治疗后两组患者的卵磷脂小体(SPL)计数转为正常比率以及临床医治有效率.[结果]观察组临床疗效有效率为88.6％(31/35),高于对照组的68.6％(24/35),差异有统计学意义(P<0.05).治疗后两组患者NIH-CPSI生活质量评分及其总评分均较治疗前改善,且观察组优于对照组,差异有统计学意义(P<0.05).治疗后两组中医辨证积分均下降,观察组低于对照组,差异有统计学意义(P<0.05).治疗后,观察组前列腺液(ESP)中SPL计数恢复正常25例(71.4％),对照组恢复正常16例(45.7％),差异有统计学意义(P<0.05).治疗3个月后进行随访,观察组复发率为9.4％(3/32),低于对照组的20.8％(5/24),差异有统计学意义(P<0.05).[结论]中药坐浴联合坦洛新、前列腺按摩对于Ⅲb型CP患者(湿热瘀滞证),可较好地改善患者的生活质量,具有临床效果显著,并副作用轻微,安全性高等优点,值得临床借鉴.

目的:观察盆底肌功能训练联合艾灸关元穴治疗女性压力性尿失禁的临床疗效。方法:选取2017年3月至2018年3月北京中医药大学第三附属医院收治的女性压力性尿失禁患者60例作为研究对象,按照随机数字表法分为A、B、C 3组,每组20例。A组采用盆底肌功能训练,B组采用艾灸关元穴,C组采用盆底肌功能训练联合艾灸关元穴。评价3组患者治疗前、治疗8周后国际尿失禁咨询委员会尿失禁问卷简表（ICI-Q-SF）评分、盆底肌肌力的变化,评价3组患者治疗后临床疗效,同时随访6个月后3组患者ICI-Q-SF评分、盆底肌肌力、临床疗效,观察盆底肌功能训练联合艾灸关元穴对女性压力性尿失禁疗效的影响。结果:治疗前3组患者ICI-Q-SF评分、盆底肌肌力差异均无统计学意义（P＞0.05）,治疗后3组患者ICI-Q-SF评分均有所下降（P＜0.05）,盆底肌肌力均有所提高,并且C组效果明显高于A、B组（P＜0.05）,6个月后随访ICI-Q-SF评分、盆底肌肌力、临床疗效C组效果明显高于A、B组（P＜0.05）。结论:盆底肌功能训练联合艾灸关元穴是治疗女性压力性尿失禁的有效方法,值得临床推广。

目的 探讨温肾排石汤辅助经皮肾镜碎石取石术(PCNL)治疗复杂性肾结石的疗效.方法 将84例复杂性肾结石患者随机分为研究组和对照组,每组42例.对照组采用PCNL手术治疗.观察组在对照组治疗的基础上给予温肾排石汤治疗.对比2组的结石清除情况,检测2组治疗前后尿血红蛋白、β2-微球蛋白(β2-MG)、胱抑素C(CysC)、中性粒细胞明胶酶相关载脂蛋白(NGAL)及血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、IL-1β的水平.结果 观察组清石率明显高于对照组(P<0.05);治疗后,2组尿血红蛋白、β2-MG、CysC、NGAL水平和CRP、IL-6、TNF-α、IL-1β水平均显著降低(P均<0.05),观察组尿血红蛋白、β2-MG、CysC、NGAL水平和CRP、IL-6、TNF-α、IL-1β水平均显著低于对照组(P均<0.05).结论 温肾排石汤辅助PCNL治疗复杂性肾结石疗效确切,能改善肾功能,可能与减轻炎症反应有关.

Objective:To assess the clinical efficacy of Er-Xian-Jie-Du decoction application therapy on male asthenospermia.Methods:70 cases of male asthenospermia were randomized into a treatment group and a control group,with 35 patients respectively.The treatment group was given orally Er-Xian-Jie-Du decoction,with one packet for two times each day in the morning and evening.The control group was given levocarnitine oral solution,with one bottle each time,once daily.The treatment course lasted one month.The efficacy and sperm motility were observed after treatment.Results:The sperm motility of a level and (a + b) level in both groups was significantly increased after treatment (P ＜ 0.01).The therapy of treatment group had a significant effect compared with that of the control group (P ＜ 0.05).Compared with that of the control group,the sperm motility of a level and (a + b) level had a difference in the treatment group before and after treatment with a statistical significance (P ＜ 0.01).Conclusion:The therapy of Er-Xian-Jie-Du decoction application for male asthenospermia is effective.

目的 分析慢性细菌性前列腺炎通过前列腺汤和莫西沙星联合治疗的效果.方法 随机选取2016年11月至2017年11月所收治慢性细菌性前列腺炎患者60例进行研究,分为两组,每组30例,第一组患者通过前列腺汤和莫西沙星进行治疗,第二组患者采用莫西沙星进行治疗,比较患者治疗的效果和并发症情况.结果 第一组患者的效果优于第二组,差异显著(P<0.05);第一组患者并发症率低于第二组,差异显著(P<0.05).结论 慢性细菌性前列腺炎通过前列腺汤和莫西沙星联合治疗,效果显著,值得运用和推广.

The combined therapy of acupoint application of bushentongyu plaster and oral administration of tamsulosin hydrochloride capsules achieves the significant efficacy on senile female bladder neck obstruction as compared with the simple administration of tamsulosin hydrochloride capsules.

Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.

OBJECTIVE:To understand the effect of resiniferatoxin on neurogenic bladder by intravesical filling.METHODS:Twenty-four male spinal cord injury patients with an obviously low cystometric capacity, 2 incomplete cervical cord injury, 5 complete thoracic cord injury, 4 incomplete thoracic cord injury, 5 incomplete lumbar cord injury and 8 complete lumbar cord injury were examined. The age range was 24 - 58 years old and the course of disease 1 - 6 years. There were 0.0063 mg/4 ml RTX in each bottle, it was dissolved in 50 ml physiologic saline and was infused into bladder slowly, kept 30 min, then was discharged by intermittent catheterization (IC). During the process, the patients were requested to fill a micturition chart and conduct urodynamic examination before and after the infusion. We regulated that it was utility when the amount of increased maximal cystometric capacity (MCC) exceeded or was 100 ml, otherwise it was invalid.RESULTS:The urodynamic examination before intravesical filling and 1 week after intravesical filling showed that the average MCC were (210 ± 23) ml and (360 ± 30) ml respectively, the average bladder compliance were (17 ± 3) ml/cm H2O and (24 ± 5) ml/cm H2O, there were statistic difference between them (both P < 0.01). The overall effective rate was 62.5%. It lasted 1 - 4 months.CONCLUSION:Resiniferatoxin is effective to increase the cystometric capacity and booster the bladder compliance.

Objective To investigate the effects and indication of intermittent catheterization(IC) by relative safe bladder capacity(RSBC) to treat vesical-ureteral reflux(VUR).Methods There were 23 male complete SCI patients,aged between 7~45 years,including 15 patients without vesicao-ureteral reflux injuried 1~3 months as control group,3 patients in mild group affected only ureter,and 5 patients in severe group affected not only ureter but also the pelvis. All the patients were taken intermittent catheterrization according to their own RSBC companied with supersonic device. The times of IC per day is that the average total urine volume one day was divided by RSBC. The observation time is over 2 years. During the oberservation some medicine was used to enlarge some patients bladder capacity.Results There were no reflux in the control group; the reflux in the mild group improved a lot,some even disappeared,and there were no change in the severe group.Conclusion IC by RSBC is effective to prevent and cure vesical-ureteral reflux in some SCI patients.

OBJECTIVE:To investigate the differential diagnosis of type III prostatitis and interstitial cystitis so as to improve the efficiency of diagnosis and treatment of the two diseases.METHODS:Based on the clinical data of 4 cases of type III prostatitis and 3 cases of interstitial cystitis, we analyzed the characteristics of the two diseases in such aspects as clinical symptomatology, urodynamics, prostatic fluid microscopy, microbiology and treatment.RESULTS:The common clinical characteristics of type III prostatitis and interstitial cystitis were indisposition or pain in the subabdomen and/or pelvic floor, but their differences were quite obvious. In interstitial cystitis, longer urine accumulation could cause worse pain in the subabdomen, which could be relieved after micturation, and the bladder capacity was obviously decreased, but with normal prostatic fluid and negative result of microbial culture. It responded to behavior therapy, resiniferatoxin, sodium hyaluronate and water dilation of the bladder under anaesthesia. While type III prostatitis, with white blood cells > 10/HP or < or = 10/HP in the prostatic fluid and negative result of microbial culture, did not respond to the above therapeutic methods that were effective for interstitial cystitis.CONCLUSION:Type III prostatitis and interstitial cystitis, although clinically confusable, can be definitely differentiated from each other according to their characteristic causes and locations.

脊髓损伤患者如果平稳度过创伤期,在之后的恢复过程中对其生命影响最大的原因是尿路高压引发的肾积水.通常肾积水过程隐匿、漫长,通常需要以"年"计算.然而我们在实际临床工作中却遇到了5例脊髓损伤患者,他们的肾功能损害表现为在慢性损害过程的基础上突然出现急性的加重.现报道如下.