中国11城市老年科门诊良性前列腺增生患者药物治疗的现状及分析

Current status and analysis of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China

目的了解中国老年科门诊良性前列腺增生药物治疗的现状，并对其进行总结和分析。方法2008年2月至2008年9月在全国11个中心城市的34个老年科门诊进行调研，首先对在调查时间内前来老年科门诊就诊的全部男性患者进行有关良性前列腺增生的病史询问，然后从中选取1000例正在进行良性前列腺增生药物治疗的患者填写详细的调查问卷并进行相关检查。结果在1000名被调查者中，共收到有效问卷774份，其中国际前列腺症状评分（IPSS）偏高且前列腺体积偏大者比例较高。在良性前列腺增生患者的药物治疗方面，联合药物治疗（5α还原酶抑制剂＋α受体阻滞剂）的比例最高，达45．48％，以下依次是α受体阻滞剂（36．30％）、5α还原酶抑制剂（13．05％）和其他药物（主要是中成药和植物制剂，5．17％）。结论当前，我国老年科门诊在良性前列腺增生的药物治疗方面，还存在着只重视症状的改善而轻视疾病进展的倾向，和当前的国际、国内的治疗指南以及众多的随机、对照研究的结论相比还存在着一定的差距。

Objective To realize and analyze the current status of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China. Methods The informations were gathered from 34 clinics for elderly located in 11 Chinese cities from February 2008 to September 2008. First, all male patients who visited the clinic were inquired about their history of benign prostatic hyperplasia , and then 1000 benign prostatic hyperplasia patients who were receiving medical treatment were selected to finish a detailed questionnaire and to get several examinations for benign prostatic hyperplasia. Results Among the 1000 patients, 774 completely finished the questionnaire, patients with middle or severe international prostate symptom score （IPSS） and with high volume of prostate occupied a large proportion. Medical treatments included the combined therapy of α-blockers plus 5a reduetase inhibitors （45.48%）,α-blockers （36.30%）, 5α reductase inhibitors （13.05%） and other medicines （including phytotherapeutic agents and traditional medicines, 5.17%）. Conclusions Nowadays in China, as to the prescription for benign prostatic hyperplasia in the clinic for elderly presents, doctors only concentrate on the improvement of symptoms, whereas ignore the progression of the disease. There is still a considerable gap between real medical treatment and international guidelines. Therefore, improvements of medical treatment are still needed in the future clinical practice.