DOI: https://doi.org/10.30841/2307-5090.3 (58).2016.104392

Комбинированное лечение больных хроническим абактериальным простатитом с депрессивным синдромом

І. І. Горпинченко, К. Р. Нуріманов, В. С. Савченко, Т. В. Порошина, О. А. Недогонова, Г. М. Драннік

Аннотация


Хронический абактериальный простатит (ХАП) – наиболее распространенный вариант хронического воспаления предстательной железы, в патогенезе которого важную роль играют нарушения нервной системы, в частности депрессия.

Цель исследования: оценивание эффективности ингибитора обратного захвата серотонина (сертралина) в комбинированном лечении больных ХАП во взаимосвязи с содержанием провоспалительных и противовоспалительных цитокинов в эякуляте.

Материалы и методы. В исследовании приняли участие 64 пациента с ХАП в возрасте от 19 до 38 лет. Пациенты основной группы (n=32) получали ректальную электростимуляцию (10 сеансов через день) в комбинации с пероральным приемом сертралина (50–200 мг/день) в течение 1 мес. Пациенты контрольной группы (n=32) получали только физиотерапию. 

Для оценивания симптомов хронического простатита использовали анкету NIH- CPSI. Симптомы депрессии изучали с помощью анкеты PHQ-9. Концентрацию цитокинов в эякуляте определяли иммуноферментным методом.

Результаты. Во время лечения наблюдали уменьшение симптомов хронического простатита и депрессии, статистически значимое (р<0,05) уменьшение концентрации противовоспалительных цитокинов эякулята (ИЛ-1в, ИЛ-8, ТНФ-б) в основной и контрольной группах. Значимое увеличение концентрации противовоспалительных цитокинов эякулята (ИЛ-10, ТФР-в) наблюдали только у пациентов основной группы. Клиническая эффективность в отношении симптомов хронического простатита в основной группе была значимо больше (р<0,05) чем в контрольной группе и составила 84% против 63%, а в отношении симптомов депрессии – 63 та 34% соответственно.

Заключение. Полученные результаты демонстрируют эффективность (84%) комбинации физиотерапии и антидепрессанта (сертралин) в лечении больных ХАП, а также показывают роль нервно-иммунной регуляции, и ее нарушений (в частности, депрессивных нарушений) в патогенезе ХАП.


Ключевые слова


хронический абактериальный простатит; синдром хронической тазовой боли; депрессия; цитокины; физиотерапия; сертралин

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Литература


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