Chronic Prostatitis Collaborative Research Network

描述（由申请人提供）： 本申请建议斯坦福大学医学院泌尿系作为几个国家临床中心之一参与合作，为慢性前列腺炎/慢性骨盆疼痛综合征的研究开发可行的临床试验。主要研究者打算作为指导委员会成员全面参与随机对照临床试验的设计，并与其他国家中心PI合作促进其实施。斯坦福大学的研究小组将与进行间质性膀胱炎研究试验的中心平行工作。目前正在同时提交这项工作的申请。 虽然慢性盆腔疼痛的确切病理生理学和生物学基础，特别是与泌尿生殖系统功能障碍相关的慢性盆腔疼痛尚未阐明，但美国大量男性多年来继续遭受这种慢性疾病的不可估量的痛苦。多模式治疗作为唯一的管理方法存在，在大多数情况下，缺乏合理的科学依据。该项目的具体目标是利用最有经验和知识渊博的医生的临床经验来设计治疗方式的临床试验，这些试验可能会在该患者群体的许多亚组中提供有利的治疗反应。这些试验中的调查将从药物延伸到免费的整体治疗方法，代表参与中心选择的最佳想法。 斯坦福大学小组打算贡献关于利用神经行为疗法管理慢性前列腺炎/慢性骨盆疼痛综合征的经验和专业知识，并提议进行一项临床试验，通过渐进式放松练习对疼痛触发点进行有针对性的理疗肌筋膜释放。患有这种疾病的患者的心理生理学变幻莫测长期以来一直受到赞赏，但定义不清，值得一个新的面貌与专门的“动手”临床工作进行了几个研究人员同时进行，并与严格的临床研究设计。

DESCRIPTION (provided by applicant): This application proposes that Stanford University School of Medicine, Department of Urology, participate as one of several National Clinical Centers in a cooperative effort to develop feasible clinical trials for the study of chronic prostatitis/chronic pelvic pain syndrome. The Principal Investigator intends to participate fully as a member of the steering committee in designing randomized controlled clinical trials and facilitate carrying them out in collaboration with other national center Pl's. The investigative group at Stanford will work in parallel with the centers conducting trials for investigation of interstitial cystitis. A simultaneous application for that effort is being submitted. While the precise pathophysiology and biologic basis of chronic pelvic pain, particularly associated with genitourinary dysfunction, have not been elucidated, a large number of men in the United States continue to suffer immeasurably for many years with this chronic disorder. Multimodal therapy exists as the only management approach and, for the most part, lacks sound scientific justification. The specific aim of this project is to utilize clinical experience from the most experienced and knowledgeable physicians available to design clinical trials of treatment modalities that may provide a favorable therapeutic response among the many sub-groups of this population of patients. Investigation within these trials will stretch from pharmaceutical to complimentary holistic treatment methods, representing the best of ideas chosen by the participating centers. The Stanford Group intends to contribute experience and expertise with regard to managing chronic prostatitis/chronic pelvic pain syndrome utilizing a neurobehavioral therapy and proposes a clinical trial of targeted physiotherapeutic myofascial release of painful trigger points with progressive relaxation exercises. The psychophysiological vagaries among patients suffering from this disorder have long been appreciated, but poorly defined, and deserve a fresh look with a dedicated "hands on" clinical effort conducted by several investigators simultaneously and with rigorous clinical research design.