摘要
目的:探讨及对比联合应用高选择性α受体阻滞剂(坦索罗辛)和M受体阻滞剂(托特罗定)及单用高选择性α受体阻滞剂治疗男性顽固性下尿路症状的临床疗效及安全性。方法:2009年4月至2009年12月期间收集我院184例顽固性下尿路症状(LUTS)的男性前列腺增生患者,病程4周至2年。所有患者均为应用高选择性α受体阻滞剂(坦索罗辛)0.2 mg,1次/d,治疗1周后LUTS症状无改善。入选病例随机分成2组,其中坦索罗辛组89例继续应用坦索罗辛0.2 mg,1次/d,治疗4周;联合治疗组95例联合应用高选择性α受体阻滞剂(坦索罗辛)和M受体阻滞剂(托特罗定),给予坦索罗辛0.2 mg 1次/d+托特罗定2 mg 2次/d,治疗4周。分组治疗前后分别进行国际前列腺症状储尿期症状评分(储尿期IPSS)、生活质量评分(QOL)和最大尿流率(Qmax)检测,评估治疗后LUTS症状的改善情况。结果:坦索罗辛组储尿期IPSS、QOL总体评分分别由治疗前的(13.23±4.39)、(4.23±1.27)分下降到治疗后的(12.21±4.07)、(3.53±0.9)分,Qmax由治疗前的(12.31±8.39)ml/s上升到治疗后的(14.12±8.62)ml/s,与治疗前相比差异均无显著性(P>0.05)。联合治疗组储尿期IPSS、QOL总体评分分别由治疗前的(14.45±5.31)、(4.45±0.79)分降到治疗后的(6.56±2.03)、(2.34±0.73)分,Qmax由治疗前的(11.41±9.21)ml/s上升到治疗后的(15.52±8.35)ml/s,与联合治疗前相比差异均有显著性(P<0.01)。184例患者均无严重并发症出现。结论:联合应用坦索罗辛和托特罗定能明显缓解男性顽固性下尿路症状,改善患者的生活质量。未见严重不良反应和急性尿潴留发生。
Objective:To evaluate and compare the clinical efficacy and safety of the highly selective α receptor antagonist tamsulosin and its combination with the M receptor antagonist tolterodine in the treatment of refractory lower urinary tract symptoms(LUTS) in patients with benign prostatic hyperplasia(BPH).Methods:We included in this study 184 BPH patients with refractory LUTS with the disease course of 4 weeks to 2 years,whose LUTS were not alleviated after a week's treatment with tamsulosin.The patients were randomly divided into Groups A and B,the former(n = 89) treated with tamsulosin at 0.2 mg qd and the latter(n = 95) given tolterodine at 2 mg bid in addition to tamsulosin medication,both for 4 weeks.Scores on IPSS,QOL and Qmax were obtained before and after the treatment,and the improvement of LUTS evaluated after the medication.Results:The tamsulosin group showed no significant differences before and after the treatment in the scores on IPSS(13.23 ± 4.39 vs 12.21 ± 4.07),QOL(4.23 ± 1.27 vs 3.53 ± 0.95) and Qmax([12.3 ± 8.39] ml/s vs [14.1 ± 8.62] ml/s)(P〈0.05),while the combination group exhibited significantly higher scores on IPSS and QOL and lower score on Qmax after the medication than before it(IPSS:14.45 ± 5.31 vs 6.56 ± 2.03,P〈0.05;QOL:4.45 ± 0.79 vs 2.34 ± 0.73,P〈0.05;Qmax:[11.4 ± 9.21] ml/s vs [15.5 ± 8.35] ml/s,P〈0.01).No severe complications were found in any of the cases.Conclusion:Combination of tamsulosin and tolterodine can significantly alleviate refractory LUTS and improve QOL without causing serious adverse events in BPH patients.
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2010年第9期790-793,共4页
National Journal of Andrology
关键词
良性前列腺增生
下尿路症状
药物治疗
benign prostatic hyperplasia
lower urinary tract symptom
medication