坦洛新联合托特罗定治疗逼尿肌不稳定前列腺增生的研究

Tamsulosin Combined with Tolterodined in the Treatment of Bladder Outlet Obstruction with Detrusor Instability

目的:评价坦洛新联合托特罗定治疗前列腺增生(BPH)并逼尿肌不稳定的有效性及安全性。方法:采用随机分组法将80例患者随机分为2组各40例,联合用药组口服坦洛新0.2mg/次(1次/d)+托特罗定2mg/次(2次/d),对照组口服坦洛新0.2mg/次(1次/d),持续4周。比较2组治疗前、后平均IPSS、SSS、QOL评分以及尿流率、残余尿。结果:2组均无因药物副作用中途退出者。治疗前,联合用药组和对照组平均IPSS评分、SSS评分、QOL评分、尿流率以及残余尿量差别无统计学意义(P>0.05);治疗后2组平均IPSS、SSS、QOL评分分别为(11.3±1.9)分、(5.2±0.7)分(、1.9±0.4)分和(15.1±2.3)分、(9.8±2.4)分、(3.9±1.2)分,差别有统计学意义(P<0.01);平均尿流率和残余尿差别无统计学意义(P>0.05)。结论:坦洛新联合托特罗定可改善BPH逼尿肌不稳定患者的下尿路症状和生活质量。对于轻至中度膀胱出口梗阻(BOO)患者,应用托特罗定较安全。

Objective：To evaluate the effect and safety of tamsulosin combined with Tolterodine in the treatment of bladder outlet obstruction with detrusor instability.Methods：80 patients of BPH with LUTS were identified urodynamically mild ormoderate BOO with DI.The patients were randomized into 2 groups.The study group was given tamsulos 0.2mg/d plus Tolterodine 5mg twice/d,and the control group was given tamsulosin 0.2mg/d.Reevaluation with IPSS,SSS,QOL,urine flow rate and residual volume were done after 4 weeks.Results：No patients withdrew because of side effect.The mean IPSS,SSS,QOL scores,average urine flow and residual urine pre-treatment in study and control groups were not significant difference（P0.05）.IPSS,SSS,QOL score post-therapy in 2 groups were（11.3±1.9）、（5.2±0.7）、（1.9±0.4）and（15.1±2.3）、（9.8±2.4）、（3.9±1.2）with significant difference（P0.01）.The mean urine flow and residual volume of 2 groups were not significant difference（P0.01）.It suggested combination therapy can improve the patients LUTS scores with no significantly effecting to patients＇urination.Conclusion：Combination therapy of tamsulosin plus Tolterodine can improve LUTS and QOL for patients of BOO with DI.For patients with mild and moderate BOO a suitable dosage of Tolterodine is safe.