To explore the safety and efficacy of the selective 5-serotonin and
norepinephrine reuptake inhibitor
duloxetine hydrochloride and
alpha-adrenergic receptor blocker (alpha-blocker)
doxazosin mesylate-controlled
tablets in the treatment of
pain disorder in chronic
prostatitis/chronic
pelvic pain syndrome (CP/CPPS).In all, 150 patients were enrolled and 126 patients completed the study (41 patients in the
doxazosin group, 41 patients in the
sertraline group, and 44 patients in the
duloxetine group). This was an open randomized 6-month study. CP/CPPS patients who met the diagnostic criteria were randomized into 3 groups. The patients in the
duloxetine group received
doxazosin 4 mg +
duloxetine 30 mg once a day, and the dosage of
duloxetine was increased to 60 mg after a week. The patients in the
doxazosin group received
doxazosin 4 mg once a day. The patients in the
sertraline group received
doxazosin 4 mg +
sertraline 50 mg once a day. National Institutes of Health Chronic
Prostatitis Symptom Index (NIH-CPSI) score, the short-form McGill
Pain questionnaire (SF-MPQ), and the hospital anxiety and depression scale (HAD) were applied for evaluations during follow-up of 1, 3, and 6 months
after treatment.There were slight positive significant correlations between NIH-CPSI scores and HAD scores, moderate positive significant correlations between the quality of life (QOL) and SF-MPQ, and slight positive significant correlations between HAD and QOL. The effective rate in the
doxazosin group was 4.88%, 19.51%, and 56.10% after 1, 3, and 6 months, respectively (P < 0.05). The SF-MPQ score in the
doxazosin group decreased to 1.80 ± 1.29, 2.66 ± 1.57, and 3.24 ± 1.67 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the
doxazosin group decreased to 2.24 ± 2.17, 4 ± 2.11, and 4.90 ± 2.62 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the
sertraline group was 9.76%, 36.59%, and 63.41% after 1, 3, and 6 months, respectively. The SF-MPQ score in the
sertraline group decreased to 1.76 ± 1.28, 3.07 ± 2, and 3.93 ± 2.53 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the
sertraline group decreased to 3.56 ± 4.11, 5.73 ± 5.26, and 7.27 ± 6.50 after 1, 3, and 6 months, respectively (P < 0.05). The effective rate in the
duloxetine group was 36.36%, 88.64%, and 88.64% after 1, 3, and 6 months, respectively. The SF-MPQ score in the
duloxetine group decreased to 3.61 ± 2.54, 6.05 ± 3.66, and 7.41 ± 4.26 after 1, 3, and 6 months, respectively (P < 0.05). The HAD score in the
duloxetine group decreased to 3.14 ± 3.28, 6.93 ± 3.90, and 9.43 ± 4.67 after 1, 3, and 6 months, respectively (P < 0.05). There were significant differences in the reduction of the NIH-CPSI score and the SF-MPQ score between the
duloxetine group and the
sertraline group and between the
duloxetine group and the
doxazosin group (P < 0.01). There were significant differences in the reduction of the HAD score at 3 months between the
duloxetine group and the
doxazosin group, and there were significant differences in the reduction of the HAD score at 6 months among the groups (P < 0.05). The incidence rates of adverse reactions in the
duloxetine group, the
sertraline group, and the
duloxetine group were 29.5%, 17%, and 7.3%, respectively, with adverse events ranging from mild to moderate.There was a clear relationship between the extent of
pain and mental factors in CP/CPPS with the main symptom of
pain.
Doxazosin combined with
duloxetine exhibited good safety and efficacy in the treatment of
pain disorder in CP/CPPS.