中药癃闭舒胶囊对逼尿肌肌力弱所致排尿困难的治疗机制

Effecting Mechanism of Chinese Drug Longbishu Capsule on Patients with Weaken Detrusor

目的:探讨中药癃闭舒胶囊对逼尿肌肌力弱所致排尿困难患者的治疗机制。方法:将30例经尿动力学检查证实为逼尿肌肌力弱而未留置尿管患者随机分为两组,治疗组15例(1组),给予癃闭舒胶囊治疗,每天2次,治疗4周;对照组15例(2组),给予压腹排尿治疗4周。治疗前后均进行尿流率检查随访。又对30例经尿动力学检查证实为逼尿肌肌力弱而留置尿管患者随机分为两组,治疗组15例(3组),给予癃闭舒胶囊治疗;对照组15例(4组),未服药,4周后行尿动力学复查。结果:经4周治疗后,1组平均最大尿流率(Q_(max))自(14.1±1.0)ml/s升至(16.6±3.6)ml/s(P=0.042),2组Q_(max)自(11.1±2.6)ml/s降至(10.7±2.5)ml/s(P=0.209),两组平均Q_(max)改善值分别为(2.5±3.6)ml/s和(-0.3±0.9)ml/s(P=0.007)。3、4组患者最大逼尿肌压力(Pdet.max)平均改善值分别为(2.401±1.607)kPa和(1.264±1.362)kPa,两组改善值比较差异有统计学意义(P=0.045)。结论:癃闭舒胶囊能明显改善逼尿肌肌力弱患者的尿流率,其作用机制之一是改善患者的逼尿肌肌力。

Objective： To study the effecting mechanism of Longbishu capsule on patients with dysuria due to weaken detrusor. Methods： 30 patients （without catheter） with weaken detusor diagnosed by urodynamics were randomly divided into two groups （n = 15 each）, Longbishu capsule was given twice daily in group 1 during 4 weeks, patients in group 2 void urine with adding pressure on abdomen. Uroflow was performed before and after treatment. Other 30 patients dwelling catheter with weaken detusor diagnosed by urodynamics were randomly divided into two groups （n= 15 each）, Longbishu capsule was given twice daily in group 3 during 4 weeks, patients in group 4 without drugs. Urodynamics was performed before and after treatment. Results： After 4 weeks, the Maximum flow rate （Qmax） in group 1 was increased to（16.6±3.6）ml/s from（14. 1±1.0）ml/s（P=0. 042）, the Qmax in group 2 was declined to （10.7±2.5）ml/s from （11.1±2.6）ml/s（P=0. 209）. The improvements of Qmax were （2.5±3.6）ml/s and （-0. 3±0. 9）ml/s respectively（P=0. 007）. After 4 weeks, the improvements of Pdet. max in group 3 and 4 were （2.401 ± 1. 607 ） kPa and （ 1. 264 ± 1. 362） kPa respectively（ P = 0. 045 ）. Conclusions： 4 weeks treatment of Longbishu capsule can increase the Q of patients with dysuria due to weaken detrusor through improving the pressure of detrusor.