高敏对前列腺光选择性汽化术后下尿路症状的疗效:一项多中心病例对照研究

R. Lombardo, Destefanis, Varvello, Oriti, Tuccio, Ruggera, D. Rienzo, C. DeNunzio
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摘要

目的:在一项多中心随机对照研究中,评价高生物利用度姜黄素复合物对下尿路症状和良性前列腺增大(LUTS/BPE)患者行前列腺光选择性汽化(PVP)治疗后下尿路症状的疗效。材料与方法:纳入了一系列连续的LUTS-BPE患者进行PVP治疗。患者以2:1的比例随机分配到口服高生物利用度姜黄素复合物(Qurmin®,Naturneed,意大利),每天两次,持续10天,然后每天一次,持续20天,术后或未治疗。收集所有患者的临床和人口学特征。术前、拔管后第1天、第15天和第30天分别采用国际前列腺症状评分(IPSS)、美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)和疼痛急迫频率(PUF)问卷对患者进行评估,以评估治疗效果。结果:106例患者随机分为姜黄素复合治疗组(71/106:67%)和不治疗组(35/106:33%)。术前年龄、PV、IPSS差异无统计学意义;记录Qmax、NIH-CPSI、PUF。与第1天相比,两组患者在第15天和第30天的IPSS、NIH-CPSI和PUF评分均有改善(p< 0.01)。第15天,积极治疗组患者在泌尿系统症状(Δ15-1 IPSS评分:6,0±7,6 vs 3,1±4,6,p= 0.001)和疼痛(Δ15-1 PUF疼痛:1,7±4,2 vs -0,8±4,1,p= 0.001)方面有较好的改善。同时,在第30天,积极治疗组患者在泌尿系统症状(Δ30-1 IPSS评分:9,0±7,6比6,2±6,4,p= 0.001)和疼痛(Δ30-1 PUF疼痛:3,3±5,3比1,6±4,5,p= 0.001)方面均有较好的改善。在NIH-CPS改善方面,两组间无显著差异。治疗组无不良事件或副作用记录。结论:PVP后接受高生物利用度姜黄素复合物治疗的患者与未接受治疗的患者相比,症状和疼痛的改善明显更好。进一步的研究将证实我们的结果。
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Efficacy of Qurmin on Post-Operative Lower Urinary Tract Symptoms After Photoselective Vaporization of the Prostate: A Multicentre Case-Control Study
Objective: To evaluate the efficacy of highly bioavailable curcumin complex on postoperative lower urinary symptoms in patients treated with photoselective vaporization of the prostate (PVP) for lower urinary tract symptoms and benign prostatic enlargement (LUTS/BPE) in a multicentre randomized controlled study. Materials and Methods: A consecutive series of patients with LUTS-BPE undergoing PVP were enrolled. Patients were randomized in a 2:1 ratio to oral highly bioavailable curcumin complex (Qurmin®, Naturneed, Italy), twice a day for 10 days then once daily for 20 days postoperatively or no treatment. Clinical and demographic characteristics of all patients were collected. Patients were evaluated preoperatively, on day 1 (after catheter removal), on day 15 and on day 30 using the International Prostate Symptom Score (IPSS), National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and Pain Urgency Frequency (PUF) questionnaires to assess the efficacy of the treatment. Results: Overall 106 patients were randomized to curcumin complex treatment (71/106:67%) or no treatment (35/106:33%). Preoperatively no significant differences in terms of age, PV, IPSS; Qmax, NIH-CPSI and PUF were recorded. Patients in both groups presented improvements in terms of IPSS, NIH-CPSI and PUF scores on day 15 and on day 30 when compared to day 1 (p<0,01). On day 15 patients on active treatment group presented a better improvement in terms of urinary symptoms (Δ15-1 IPSS score: 6,0 ± 7,6 vs 3,1 ± 4,6, p=0,001) and pain (Δ15-1 PUF pain : 1,7 ± 4,2 vs -0,8 ± 4,1, p=0,001). As well on day 30 patients on active treatment group presented a better improvement in terms of urinary symptoms (Δ30-1 IPSS score: 9,0 ± 7,6 vs 6,2 ± 6,4, p=0,001) and pain (Δ30-1 PUF pain: 3,3 ± 5,3 vs 1,6 ± 4,5, p=0,001). No significant differences in terms of NIH-CPS improvements were recorded between groups. No adverse events or side effects have been recorded in the treated group. Conclusions: Patients treated with highly bioavailable curcumin complex after PVP reported a significantly better improvement in symptoms and pain when compared to no treatment. Further studies should confirm our results.
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