| Objective:Chronic prostatitis is a common disease in urology.Its pathogenesis is still unclear.Clinical diagnosis is often subjective,laboratory and imaging methods are limited,and treatment is also difficult.The purpose of this study was to evaluate the diagnostic value of prostatic exosomal protein(PSEP)for type III prostatitis,promote its clinical application,and provide a new urine-based,clinically feasible and painless diagnostic method for chronic prostatitis.At the same time,PSEP test was used as the observation index to verify the curative effect of Jingtian Siwu Decoction on chronic prostatitis of type III Qi stagnation and blood stasis syndrome,and to explore the clinical guiding significance of Jingtian Siwu Decoction in the dialectical treatment of chronic prostatitis.Methods:1.Urine specimens were collected from patients visiting the Affiliated Hospital of Nanjing University of Chinese Medicine and the Third Clinical Medical College of Nanjing University of Chinese Medicine.According to the"Clinical Diagnostic Criteria of Chronic Prostatitis" in"Diagnostic and Therapeutic Guidelines for Prostatitis 2014 Edition",the patients were divided into three groups:type ? A,type ? B and control group,30 cases in each group.The urine samples collected from outpatient clinics were detected by PSEP kit,and the sensitivity?specificity?total coincidence rateof observation were used to evaluate the diagnostic value.The difference between PSEP kit and standard diagnosis was evaluated.2.According to the relevant criteria of the diagnostic guidelines for prostatitis,42 outpatients with type III prostatitis were selected and accorded with the syndrome of qi stagnation and blood stasis in TCM.Jingtian Siwu Decoction was given orally for a course of treatment.The NIH-CPSI score and the related contents of the quantified scale of clinical symptoms of TCM were used as evaluation indexes to compare the changes of each index.Combined with the changes of PSEP kit detection value before and after treatment,to evaluatethe curative effect·Result:1.The PSEP concentration of type ? A and type ? B prostatitis was significantly different from that of the normal group(P<0.01).The total sensitivity and specificity of PSEP kit for the diagnosis of type ? CP were 91.7%and 93.3%.The total coincidence rate between clinical diagnosis and standard diagnosis was 92.2%.The Kappa coefficient of consistency test between PSEP kit and clinical diagnosis standard was 0.829,greater than 0.75.It is consistent with the standard diagnosis of chronic prostatitis.The NIH-CPSI of patients with type 2 and type III prostatitis after one course of oral Jingtian Siwu Decoction was 18.45±3.3 7.Compared with NIH-CPSI before treatment,the difference was significant(P<0.01),and the indexes of perineal pain or discomfort frequency were also significantly different from those before treatment.Conclusion:1.The detection of PSEP reagent can accurately diagnose type ? prostatitis,but it is not sensitive to distinguish the subtypes of type ? prostatitis.2.Jingtian Siwu Decoction can improve the main indicators of patients with type ? prostatitis of qi stagnation and blood stasis.PSEP detection technology can more effectively evaluate the therapeutic effect. |
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