摘要:慢性前列腺炎是一种常见且严重影响生存质量的疾病,给患者带来巨大的经济负担。由于慢性前列腺炎的 规范化诊疗方案尚未达成一致,中国中医药信息学会男科分会于2020年制定《慢性前列腺炎中西医结合多学科诊 疗指南》(以下简称 《指南》)。本文结合国内外最新研究进展,对该 《指南》 进行解读,并对最新的慢性前列腺 炎诊疗方法进行阐述。
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王子龙,玄绪军. 《慢性前列腺炎中西医结合多学科诊疗指南》解读[J]. 泌尿外科杂志(电子版),2021,13(4):10-14. DOI:10.3969/j.issn.1674-7410.2021.04.003
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慢性前列腺炎是男性泌尿生殖系统中最常见 的有症状性前列腺炎综合征,人群发病率为 4.5%~ 9.0%,具有较高的复发率[1] 。慢性前列腺炎不仅表现 为尿频、会阴部疼痛、尿潴留等症状,还会导致患 者性功能障碍,影响患者的生活质量[2] 。然而,由于 慢性前列腺炎的发病机制和临床表现复杂多样,尚 未对规范化诊疗方案达成一致。中西医结合多学科 诊疗 (multiple disciplinary team,MDT) 是将中西 医诊疗优势与基础临床各学科高度结合改善临床治 疗方案,从而促进慢性前列腺炎的诊断和治疗[3] 。因 此,2020年经过中国中医药信息学会男科分会专家 反复研讨,最终制定 《慢性前列腺炎中西医结合多 学科诊疗指南》(以下简称 《指南》) [4] 。本文结合 国内外最新临床研究,对该 《指南》 进行初步解读。
1 病因
1.1 盆底肌功能失调
1.2 感染与免疫因素
1.3 精神心理因素
2 临床表现与诊断
3 治疗
3.1 中草药治疗
3.2 针灸治疗
3.3 中西医结合治疗
3.4 对症治疗
3.5 盆底肌功能康复治疗
3.6 多学科诊疗
3.7 手术治疗
4 结论与展望
4 结论与展望
尽管目前慢性前列腺炎的诊断治疗方法尚未达 成一致,但中西医结合 MDT 是制定诊疗方案的基 础[4] 。应定期评估患者的身心状况,并筛查患者可能 出现的心理障碍。目前对该疾病制定治疗方案的核 心是在患者与医务人员之间建立协作信任的关系, 从而促进开放式沟通,并帮助患者制定最佳治疗计 划[36] 。因此,应用生物-心理-社会医学模式制定中 西医结合 MDT计划,可通过个体化治疗带来最佳的 治疗效果。
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