慢性盆腔疼痛综合征与中央型腰椎间盘突出症相关性的初步研究

摘要

目的：研究慢性骨盆疼痛综合征（CPPS）与中央型腰椎间盘突出症（CLIDH）的相关性，以探究CPPS可能的病因，并寻求有效的治疗方法。方法：按照入选标准对门诊CPPS患者行腰椎间盘（腰3～骶1）CT检查，CLIDH阳性患者行腰椎牵引联合中药治疗。治疗前后4周，分别记录美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）评分，包括疼痛症状、尿路症状和生活质量评分。结果：170例不明原因CPPS患者中141例（82.94％）存在CLIDH。治疗后NIH-CPSI 总分由（25.49±5.27）分下降到（14.16±4.61）分（P＜0.05），其中疼痛评分由（12.85±2.92）分下降到（7.82±2.65）分（P＜0.05），排尿症状评分由（4.45±2.74）分下降到（2.19±2.21）分（P＜0.05），生活质量评分由（8.20±1.78）分下降到（4.16±2.18）分（P＜0.05）。结论：CLIDH可能是造成大多数“不明原因CPPS”的重要病因之一，对此类CPPS患者行腰椎牵引和中药口服治疗，疗效明显，简便无创。这为临床诊断和治疗CPPS提供了一个新的思路和方法，值得临床推广和普及。%To study the correlation of chronic pelvic pain syndrome (CPPS)and central lum-bar disc herniation (CLIDH),and explore the cause of CPPS,seeking for effective therapeutic method.Methods:The CPPS outpatients,diagnosed according to inclusion criteria,were examined with lumbar intervertebral disc (lumbar sacral 3 to 1 )CT.The positive patients were given lumbar traction combined traditional Chinese medicine. Before and 4 weeks after treatment,NIH Chronic Prostatitis Symptom Index (NIH-CPSI)score were recorded,in-cluding pain,urinary symptoms and life quality scores.Results:In the 170 patients with unexplained CPPS,141 ones (82.94 %)had CLIDH. After treatment,the NIH-CPSI score decreased from (25.49 ±5.27)to (14.16 ±4.61)(P <0.05),in which the pain score decreased from (12.85 ±2. 92)to (7.82 ±2.65)(P<0.05),urination symptom score from (4.45 ±2.74)to (2.19 ±2.21)(P <0.05),life quality score from (8.20 ±1.78)to (4.16 ±2.18)(P<0.05).Conclusion:CLIDH will probably be an important cause of most"unexplained CPPS".For such CPPS patients,lumbar traction therapy and oral tradition Chinese medicine is of ob-vious curative effect,simple and noninvasive.It provides a new way of thinking and methods for clinical diagnosis and treatment of CPPS,which is worthy of promotion and popularization.