α受体阻滞剂单用或联合M受体阻滞剂治疗良性前列腺增生患者夜尿增多的疗效评估

Comparison of alpha-blocker monotherapy with alpha-blocker and antimuscarinic add-on therapy for nocturia in patients with benign prostatic hyperplasia

目的探讨α受体阻滞剂单用或联合M受体阻滞剂用于治疗BPH患者夜尿增多症状的疗效及安全性。方法选择有明显夜尿增多症状的BPH患者54例,年龄40~68（53.4±12.1）岁。入选标准：前列腺体积≥20 ml,夜尿≥2次。随机分为对照组（28例）和试验组（26例）,两组临床指标比较无统计学差异（P〉0.05）。对照组单用α受体阻滞剂治疗,试验组26例行α受体阻滞剂联合M受体阻滞剂治疗,疗程均为4周,比较两组患者治疗前后的夜尿次数、膀胱过度活动症评分（OABSS）和生活质量评分（QOL）,并记录不良反应发生情况。结果对照组、试验组治疗后的夜尿次数、OABSS总分、QOL评分值与治疗前比较差异均有统计学意义（P〈0.05）;治疗后对照组与试验组间夜尿次数、OABSS总分、QOL评分值差异有统计学意义（P〈0.05）。结论α受体阻滞剂单用或联合M受体阻滞剂均能改善BPH患者的夜尿增多症状,联合应用疗效优于单用α受体阻滞剂。

Objective To evaluative the efficacy and safety of alpha-blocker monotherapy or alpha-blocker and antimuscarinic add-on therapy for nocturia in patients with benign prostatic hyperplasia. Methods 54 BPH patients with 2 or more episodes of nocturia were enrolled. The control group（28 patients） received alpha-blocker monotherapy（TamsuIosin 0.2 mg per day）, while the combined treatment group（26 patients） received alpha-blocker and antimuscarinic add-on therapy（TamsuIosin 0.2 mg per day plus solifenacin 5 mg per day）. The course was 4 weeks. Before and after 4 weeks treatment, the nocturnal frequency, OABSS, QOL and side effects were recorded and compared between the two groups. Results After 4 weeks treatment, nocturnal frequency, OABSS and QOL significantly decreased in two groups（P〈0.01）. Compared with the control group, the decrease in nocturnal frequency, OABSS and QOL were more significant in the combined treatment group（P〈0.05）. Conclusion Alpha-blocker monotherapy or alpha-blocker and antimuscarinic add-on therapy both decrease nocturnal frequency in patients with BPH, but the latter is more effective.