坦索罗辛联合索利那新对改善良性前列腺增生致顽固性下尿路症状的疗效观察

Tamsulosin Combined with Solifenacin Improved the Intractable LUTS Caused by BPH Patients Significantly

目的研究应用α受体阻滞剂坦索罗辛联合M受体阻滞剂索利拉新与单用α受体阻滞剂坦索罗辛对改善下尿路症状的疗效及安全性的差异。方法门诊108例前列腺增生有顽固性下尿路症状(lower urinary tract symptoms,LUTS)分别使用坦索罗辛(tamsulosin)和坦索罗辛配伍索利那新(solifenacin)治疗,进行对比观察。随机分为坦索罗辛联合索利拉新组55例(坦索罗辛0.2mg,1次/日,索利拉新5mg,1次/日),坦索罗辛组53例(坦索罗辛0.2mg,1次/日),均口服治疗4周。治疗前后分别进行国际前列腺储尿期症状评分(储尿期IPSS)、生活质量评分(QOL)和最大尿流率(Qmax)检测,评价两者对LUTS的治疗效果。结果坦索罗辛组IPSS、QOL评分分别由治疗前17.21±4.10、4.68±0.70,下降至15.82±5.50、4.50±0.70;Qmax由治疗前12.30±6.10ml/s,增加至14.20±8.51ml/s,其与治疗前相比差异不显著(P>0.05);坦索罗辛联合索利拉新组IPSS,QOL评分分别由治疗前18.43±5.11、4.55±0.92,下降至13.56±5.61、3.84±0.90,Qmax由治疗前11.40±6.90ml/s,增加至16.60±8.30ml/s,与治疗前相比差异明显(P<0.01)。联合用药组在同单纯使用坦索罗辛一样,均未见明显不良反应与严重合并症。结论坦索罗辛联合索利拉新治疗顽固性下尿路症状,特别是单一应用高选择性α受体阻滞剂如坦索罗辛治疗效果不佳者,可以明显改善下尿路症状,且无严重的并发症和不良反应发生,能有效地提高患者的生活质量。

Objective To study the efficacy and safety of using α receptor blocker （Tamsulosin） combined with M receptor blocker （Solifenacin） in improving the Lower Urinary Tract Symptoms （LUTS） caused by benign prostatic hyperplasia （BPH） comparing with u- sing Tamsulosin singly. Methods We studied 108 Patients with complaints of intractable LUTS caused by BPH in random. 108 Patients were divided at random into two groups. Patients in the group of Tamsulosin combined with Solifenacin （55 cases） received a 4 - week course of once daily 0. 2mg tamsulosin and 5mg Solifenacin, while patients in the group of Tamsulosin （53 cases） received a 4 -week course of once daily 0.2mg tamsulosin singly. All patients were assessed using International Prostate Symptom Score （IPSS） , quality of life （QOL） Questionnaire and Qmax. Results Total IPSS and QOL decreased from 17.21±4.10,4.68±0.70 to 15.82±5.50,4.50±0.70 respectively in the group of Tamsulosin, and Qmax increased from 12.30±6.10ml/s to 14.20±8.51ml/s （P 〉 0. 05 ）. In the group of Ta- msulosin combined with Solifenacin, total IPSS and QOL significantly decreased from 18.43±5.11,4.55±0.92 to 13.56±8.61,3.84±0.90 respectively, and in the group of Tamsulosin, Qmax increased from 11.40±6.90ml/s to 16.60±8.30ml/s（ P 〈 0.01 ）. Both groups showed no abvious side - effect and serious complications. Conclusion Combination of Tamsulosin and Solifenacin improved the intracta- ble LUTS caused by BPH,significantly and safely, especially a for the patients with single application of high - selective α - blockers such as tamsulosin poor treatment. It could significantly improve lower urinary tract symptoms and the patient＇s quality of life, and without seri- ous complications and side effects.