目的 探讨萆薢分清丸联合克拉霉素治疗ⅢA型前列腺炎的临床效果。方法 选取2018年6月—2019年12月天津市东丽区东丽医院收治的154例ⅢA型前列腺炎患者，随机分为对照组和治疗组，每组各77例。对照组口服克拉霉素片，0.25 g/次，2次/d。治疗组在对照组基础上口服萆薢分清丸，6 g/次，2次/d。两组均连续治疗4周。比较两组临床疗效，观察两组慢性前列腺炎症状指数（NIH-CPSI）评分、排尿日记相关指标、前列腺按摩液（EPS）中白细胞（WBC）数量及肿瘤坏死因子（TNF）-α、白介素（IL）-8、巨噬细胞炎性蛋白（MIP）-1α、基质金属蛋白酶（MMP）-9、C反应蛋白（CRP）水平的变化情况。结果 治疗后，治疗组总有效率是94.8%显著高于照组84.4%（P<0.05）。两组治疗后NIH-CPSI中各部分（疼痛或不适症状、排尿症状、生活质量3个部分）评分及总评分均显著低于本组治疗前（P<0.05）；但治疗组NIH-CPSI各评分比对照组的改善均更显著（P<0.05）。两组治疗后尿急次数、日间和夜间排尿次数均显著减少（P<0.05），但平均排尿量均显著增加（P<0.05）；且治疗后，治疗组以上排尿日记相关指标较同期对照组的改善均更显著（P<0.05）。治疗后，两组EPS中WBC数量、TNF-α、IL-8、MIP-1α、MMP-9和CRP水平均显著降低（P<0.05）；且治疗后，治疗组这些EPS检查指标较同期对照组显著更低（P<0.05）。结论 萆薢分清丸联合克拉霉素治疗ⅢA型前列腺炎具有确切的临床疗效，对患者的骨盆生殖区域疼痛或不适、排尿异常和生活质量均有明显改善作用，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Bixie Fenqing Pills combined with clarithromycin in treatment of type ⅢA prostatitis. Methods A total of 154 patients with type ⅢA prostatitis admitted to Dongli Hospital Dongli District from June 2018 to December 2019 were randomly divided into control group (n=77) and treatment group (n=77). The control group was po administered with Clarithromycin Tablets, 0.25 g/time, twice daily. The treatment group was po administered with Bixie Fenqing Pills on the basis of the control group, 6 g/time, twice daily. All patients were treated for 4 weeks. The clinical efficacy in two groups were compared, and the changes of NIH-CPSI score, indicators related to urination diary, WBC amount, TNF-α, IL-8, MIP-1α, MMP-9, and CRP in prostate massage fluid (EPS) were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 94.8%, which was significantly higher than that of the control group (84.4%) (P<0.05). The scores of pain or discomfort symptoms, urination symptoms, life quality and the total scores of NIH-CPSI scores in two groups after treatment were significantly lower than those before treatment (P<0.05). However, the improvement of NIH-CPSI scores in the treatment group was more significant than that in the control group (P<0.05). After treatment, the times of urination urgency, daytime and night urination were significantly reduced in both groups (P<0.05), but the average urination volume was significantly increased in both groups (P<0.05). After treatment, the improvement of urinary diary related indexes in the treatment group was more significant than that in the control group (P<0.05). After treatment, WBC amount, TNF-α, IL-8, MIP-1α, MMP-9, and CRP levels in EPS in both groups were significantly reduced (P<0.05). After treatment, these EPS indicators were significantly lower in the treatment group than in the control group (P<0.05). Conclusion Bixie Fenqing Pills combined with clarithromycin has definite clinical effect in treatment of type ⅢA prostatitis, and can improve pelvic pain or discomfort, urination abnormalities of the genital area and life quality of patients, which has a certain clinical application value.

R976

天津市卫生和计划生育委员会科研基金项目（2017KZ059）