OBJECTIVE: To evaluate the effect and safety of Kangfuyan Capsules () for treating pelvic inflammatory disease (PID) in patients with chronic pelvic pain (CPP) in a multicenter, randomized, controlled, double-blind, parallel-group clinical trial. METHODS: Totally, 240 PID patients with CPP were randomized into 2 groups using a computer generated random number at a 1:1 ratio from 10 hospitals in China between September 2014 and November 2015. Patients received either oral Kangfuyan Capsules or Gongyanping Capsules (, control); the regimen for both groups comprised 4 capsules (3 times daily) for 12 weeks, with follow-up visit 4 weeks after treatment. The visual analogue scale (VAS) scores, clinical responses, remarkable cure rates for each symptom, and quality of life scores were assessed at baseline, and after 1, 2, and 3 months. Adverse events were also recorded. RESULTS: The VAS scores were significantly lower (P<0.05), whereas the clinical responses, remarkable cure rates for lower abdominal pain, uterine tenderness, adnexal mass, and adnexal tenderness, and Health-related quality of life (EQ-5D) scores were higher in the Kangfuyan group than in the control group at 3 months (P<0.05). Common treatment-related adverse events included high hepatic enzyme levels, reduced hemoglobin levels, and elevated platelet counts, although all the adverse events were either mild or moderate in severity. CONCLUSION Compared with Gongyanping therapy, Kangfuyan therapy yielded markedly better analgesia effects for CPP caused by PID, with obvious long-term efficacy and good safety. (Registration No. ChiCTR190022732).
Capsules ; Chronic Pain/drug therapy* ; Double-Blind Method ; Humans ; Pelvic Pain/drug therapy* ; Quality of Life ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy and safety of essential oil treatment for type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type III CP/CPPS patients were assigned to the essential oil group (35 cases) or almond placebo oil control group (35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index (NIH-CPSI) and expressed prostatic secretions (EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. RESULTS: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations (P>0.05). In the essential oil group, pain between rectum and testicles (perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group (P<0.01). No serious adverse events occurred. CONCLUSION The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS. (Registration No. ChiCTR-IPR-14005448).
Adult ; Chronic Pain ; drug therapy ; Humans ; Male ; Oils, Volatile ; therapeutic use ; Pelvic Pain ; drug therapy ; Pilot Projects ; Prostatitis ; drug therapy ; Syndrome ; Treatment Outcome

Objective: To investigate the short- and long-term effects of triple acupuncture at the Qugu acupoint as an adjunctive therapy on type-Ⅲ chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS). METHODS: We equally randomized 90 CP/CPPS patients into a control and a treatment group, both treated with Levofloxacin Mesylate Tablets (0.5 g, tid) + Terazosin Hydrochloride Capsules (2 mg qd) for 4 weeks, while the latter group by triple acupuncture at the Qugu acupoint as an adjunctive therapy twice a week at the same time. Then, we followed up all the patients for 4 weeks, recorded the cases, time and rate of recurrence, obtained the scores in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), quality of life (QoL) and Zung Depression Scale (ZDS), and compared them between the two groups of patients. RESULTS: Compared with the controls, the patients of the treatment group showed significantly decreased NIH-CPSI scores in pain (8.6 ± 2.12 vs 6.2 ± 2.25, P <0.05), micturition (5.8 ± 1.22 vs 3.1 ± 1.10, P <0.05), and QoL (6.0 ± 1.33 vs 3.4 ± 1.71, P <0.05) and ZDS score as well (43.9 ± 4.53 vs 33.6 ± 3.20, P <0.01). The recurrence rate was markedly lower while the recurrence time remarkably longer in the treatment than in the control group (15.56 vs 35.56% and ［20.0 ± 2.72］ vs ［12.5 ± 3.47］ d, P <0.05). CONCLUSIONS As an adjunctive therapy, triple acupuncture at the Qugu acupoint can evidently ameliorate the clinical symptoms, enhance the curative effect of antibacterials, reduce the recurrence rate, and prolong the recurrence time in the treatment of CP/CPPS.
Acupuncture Points ; Acupuncture Therapy ; methods ; Anti-Bacterial Agents ; therapeutic use ; Chronic Disease ; Chronic Pain ; therapy ; Combined Modality Therapy ; Drug Therapy, Combination ; methods ; Humans ; Levofloxacin ; therapeutic use ; Male ; Pelvic Pain ; therapy ; Prazosin ; analogs & derivatives ; therapeutic use ; Prostatitis ; therapy ; Quality of Life ; Recurrence ; Syndrome ; United States ; Urological Agents ; therapeutic use

Saw palmetto fruit extract (SPE), as a herbal product, is widely used for the treatment of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Recent studies show that SPE also has some therapeutic effects on chronic prostatitis, prostate cancer, sexual dysfunction, and so on. This article presents an overview on the application of SPE in the treatment of BPH, prostate cancer, and chronic prostatitis/chronic pelvic pain syndrome, with a discussion on its action mechanisms.
Chronic Disease ; Fruit ; chemistry ; Humans ; Lower Urinary Tract Symptoms ; drug therapy ; Male ; Pelvic Pain ; drug therapy ; Plant Extracts ; therapeutic use ; Prostatic Diseases ; drug therapy ; Prostatic Hyperplasia ; drug therapy ; Prostatic Neoplasms ; drug therapy ; Prostatitis ; drug therapy ; Syndrome

OBJECTIVETo evaluate the clinical effects of Yuleshu oral mixture combined with conventional therapy on chronic prostatitis.

METHODSEighty-eight patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were equally randomized to a control and an experimental group to receive conventional therapy (oral antibiotics, alpha blockers, proprietary Chinese medicine for activating blood circulation and massage of the prostate) and conventional therapy combined with Yuleshu oral mixture respectively. Before and after treatment, the severity of symptoms and sexual function of the patients were evaluated using NIH-CPSI and IIEF-5, their anxiety, depression and other emotional problems assessed with Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Scale (HAMA), and the results subjected to statistical analysis.

RESULTSBoth the experimental and control groups showed significant improvement in prostatitis symptoms and sexual function after treatment as compared with the baseline (P < 0.01), even more significant in the former than in the latter group, especially in pain symptoms (7.89 +/- 2.82 vs 10.41 +/- 2.55, P < 0.01). Before and after treatment, the HAMA and HAMD score had no significant difference in the control, but there was significant difference in the experimental group. The experimental group exhibited remarkably higher scores after than before treatment on HAMA (24.30 +/- 5.07 vs 13.80 +/- 3.62, P < 0.01) and HAMD (23.81 +/- 5.01 vs 16.23 +/- 5.93, P < 0.01), but not the control group (P > 0.05).

CONCLUSIONYuleshu oral mixture can effectively relieve anxiety, depression and other psychological problems in CP/CPPS patients, and improve their clinical symptoms as well. Therefore, it is an effective drug for chronic prostatitis.

Adolescent ; Adrenergic alpha-Antagonists ; therapeutic use ; Adult ; Chronic Disease ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; Prostatitis ; drug therapy ; Treatment Outcome ; Young Adult

PURPOSE: The aim of this study is to explore non-steroid anti-inflammation drugs (NSAIDs) potency for pelvic floor muscle pain by measuring local concentration in a rat model. MATERIALS AND METHODS: We used nine NSAIDs, including nabumetone, naproxen, ibuprofen, meloxicam, piroxicam, diclofenac potassium, etodolac, indomethacin, and sulindac, and 9 groups of female Wister rats. Each group of rats was fed with one kind of NSAID (2 mg/mL) for three consecutive days. Thereafter, one mL of blood and one gram of pelvic floor muscle were taken to measure drug pharmacokinetics, including partition coefficient, lipophilicity, elimination of half-life (T1/2) and muscle/plasma converting ratio (Css, muscle/Css, plasma). RESULTS: Diclofenac potassium had the lowest T1/2 and the highest mean Css, muscle/Css, plasma (1.9 hours and 0.85+/-0.53, respectively). The mean Css, muscle/Css, plasma of sulindac, naproxen and ibuprofen were lower than other experimental NSAIDs. CONCLUSION: Diclofenac potassium had the highest disposition in pelvic floor muscle in a rat model. The finding implies that diclofenac potassium might be the choice for pain relief in pelvic muscle.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Butanones/therapeutic use ; Chronic Pain/*drug therapy ; Diclofenac/therapeutic use ; Female ; Muscles/drug effects ; Naproxen/therapeutic use ; Pelvic Floor/*pathology ; Pelvic Pain/*drug therapy ; Piroxicam/therapeutic use ; Rats ; Rats, Wistar ; Thiazines/therapeutic use ; Thiazoles/therapeutic use

BACKGROUNDAnalgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.

OBJECTIVEThe aim of this study was to assess the effect of cinnamon on perineal pain and healing of episiotomy incision.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSIn this double-blind, randomized, placebo-controlled trial, 144 postpartum women were allocated into two groups, using stratified block randomization, 1 h after completion of episiotomy repair. They received cinnamon or placebo ointment, 2 mL every 12 h for 10 d.

MAIN OUTCOME MEASURESPerineal pain and wound healing were assessed using visual analogue scale (0-10) and Redness, Edema, Ecchymosis, Discharge, Approximation scale (0-15), respectively. General linear model was used to compare the groups on the outcomes adjusted for baseline values and stratified factors.

RESULTSFollow-up rate was 100% up to the 8 h time point in both groups, and 86% (62 of 72) in the cinnamon group and 85% (61 of 72) in the placebo group at day 10-11 after delivery. Pain score in the cinnamon group was significantly lower than that in the placebo group at (4±1) h (adjusted difference: -0.6, 95% confidence interval: -1.0 to -0.2) and (8±1) h (-0.9, -1.4 to -0.3) after intervention, and on the 10-11th day after delivery (-1.4, -2.0 to -0.7). Also the cinnamon group showed significantly more improvement than the control group in healing score at (8±1) h (-0.2, -0.4 to -0.04) and the 10-11th day after delivery (-1.6, -2.0 to -1.1).

CONCLUSIONCinnamon can be used for reducing perineal pain and improving healing of episiotomy incision.

Adult ; Analgesics ; administration & dosage ; Cinnamomum zeylanicum ; chemistry ; Delivery, Obstetric ; Female ; Humans ; Pain Measurement ; Pain, Postoperative ; drug therapy ; physiopathology ; Pelvic Pain ; drug therapy ; physiopathology ; Perineum ; surgery ; Plant Extracts ; administration & dosage ; Wound Healing ; drug effects ; Young Adult

OBJECTIVETo study the therapeutic effect and safety of Longjintonglin Capsule in the treatment of type III prostatitis (chronic prostatitis/chronic pelvic pain syndrome, CP/CPPS).

METHODWe selected 240 patients with type III prostatitis according to the diagnostic standards of the American National Institute of Health (NIH) and treated them with Longjintonglin Capsule orally 3 capsules once tid for 12 weeks. Based on the NIH chronic prostatitis symptom index (NIH-CPSI), traditional Chinese medicine (TCM) syndrome score, and leukocyte count in the expressed prostatic secretion (EPS), we evaluated the results of treatment.

RESULTSTotally 238 patients completed the treatment, including 108 IIIA and 120 III B prostatitis cases. Before and after 4, 8, and 12 weeks of treatment, the total NIH-CPSI scores were 23.12 ± 6.99, 18.22 ± 6.39, 14.12 ± 5.88, and 12.36 ± 6.04 (P < 0.01) in the IIIA prostatitis patients and 22.01 ± 6.28, 17.56 ± 5.89, 13.67 ± 5.18, and 11.45 ± 5.22 in the III prostatitis patients (P < 0.01), the TCM syndrome scores were 52.12 ± 13.08, 48.13 ± 12.11, 43.05 ± 11.19, and 40.78 ± 10. 59 in the former (P < 0.01) and 53.02 ± 12.12, 49.32 ± 12.78, 44.01 ± 11.79, and 39.67 ± 10.26 in the latter (P < 0.01), and the leukocyte counts were 26.09 ± 21.55, 23.02 ± 18.61, 18.25 ± 17.79, and 15.36 ± 16.38 in the IIIA cases (P < 0.01). Neither abnormalities in liver and renal function nor obvious adverse events were observed during the experiment.

CONCLUSIONLongjintonglin Capsule, with its advantages of safety, effectiveness, and no obvious adverse reactions in the treatment of type III prostatitis, deserves to be recommended for clinical application.

Administration, Oral ; Adult ; Capsules ; Chronic Pain ; drug therapy ; Drug Administration Schedule ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; Phytotherapy ; Prostatitis ; drug therapy ; Syndrome

OBJECTIVETo investigate the clinical features and prognosis of bone metastases in colorectal cancer patients.

METHODSThe clinical data of 104 cases of colorectal cancer with bone metastasis were collected and retrospectively analyzed.

RESULTSAmong all the 104 patients included, 45 (43.3%) patients had multiple bone metastases, and 59 (56.7%) patients had single bone metastasis. Pelvis (46.1%) was the most common site, followed by thoracic vertebrae (41.3%), lumbar vertebrae (40.4%), sacral vertebrae (29.8%) and ribs (29.8%). One hundred and two patients (98.1%) were complicated with other organ metastases. The median time from colorectal cancer diagnosis to bone metastasis was 16 months, and the median time from bone metastasis to first skeletal-related events (SREs) was 1 month. The most common skeletal-related events (SREs) were the need for radiotherapy (44.2%), severe bone pain (15.4%) and pathologic fracture (9.6%). The median survival time of patients with bone metastases was 10.0 months, and 8.5 months for patients with SREs. ECOG score, systemic chemotherapy and bisphosphonate therapy were prognostic factors by univariate analysis (all P < 0.05). ECOG score and systemic chemotherapy were independent prognostic factors by Cox multivariate analysis.

CONCLUSIONSBone metastasis in colorectal cancer patients has a poor prognosis and the use of chemotherapy and bisphosphonates may have a benefit for their survival.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; drug therapy ; radiotherapy ; secondary ; Colorectal Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Diphosphonates ; therapeutic use ; Female ; Follow-Up Studies ; Fractures, Bone ; etiology ; Humans ; Lumbar Vertebrae ; pathology ; Male ; Middle Aged ; Pain ; etiology ; Pelvic Bones ; pathology ; Prognosis ; Retrospective Studies ; Ribs ; pathology ; Sacrum ; pathology ; Spinal Cord Compression ; etiology ; Spinal Neoplasms ; drug therapy ; radiotherapy ; secondary ; Thoracic Vertebrae ; pathology ; Young Adult

BACKGROUNDCategory III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common syndrome of unclear etiology with significant impact on quality of life. Because the outcomes of multiple therapies for CP/CPPS have been far from approving, the possible psychological factors have been considered to play an important role in CP/CPPS. Based on this, we investigated the role of antidepressant drug (fluoxetine) in men with refractory CP/CPPS.

METHODSIn this study, 42 men diagnosed with refractory CP/CPPS without response to standard therapy (include multiple antibiotic courses and α-blockers) were referred for fluoxetine therapy. All patients received fluoxetine (20 mg/d) for three months and were clinically evaluated before (baseline), and after 4, 8 and 12 weeks of therapy. The evaluation included a National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) and a Beck depression inventory (BDI) questionnaire. Moreover, the subjective global assessment (SGA) was assessed at the 4th, 8th and 12th week of therapy.

RESULTSSignificant decreases were observed for total NIH-CPSI (28.55 to 9.29), NIH-CPSI pain (14.69 to 5.19), NIH-CPSI urinary (4.95 to 1.88), NIH-CPSI quality of life (8.83 to 2.20), and BDI (34.67 to 13.95) scores compared with baseline, all P values < 0.05. Twenty-nine (69.05%) reported marked improvement on the subjective global assessment and 33 (78.57%) had a greater than 50% decrease in NIH-CPSI at the end of therapy (12th week). At the same time, the Pearson correlation coefficient analysis demonstrated a positive correlation between BDI score and each CPSI score. No adverse events were reported in this study.

CONCLUSIONSFluoxetine appears to be a safe and effective treatment in improving symptoms in, and the quality of life of, men with difficult CP/CPPS. Moreover, amelioration of difficult CP/CPPS-related symptoms could be related to a decrease in depressive symptoms.

Adult ; Antidepressive Agents, Second-Generation ; adverse effects ; therapeutic use ; Chronic Disease ; Fluoxetine ; adverse effects ; therapeutic use ; Humans ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; Prostatitis ; drug therapy ; Quality of Life ; Treatment Outcome ; Young Adult