屈他维林联合托特罗定治疗经尿道前列腺电切术后膀胱痉挛的疗效观察

Clinical observation of drotaverine combined with tolterodine in treatment of bladder spasm after trans-urethral resection of prostate

目的探讨屈他维林联合托特罗定治疗经尿道前列腺电切术后膀胱痉挛的临床疗效。方法选取2016年6月—2017年6月在河北省沧州中西医结合医院治疗的经尿道前列腺电切术后后膀胱痉挛患者82例,随机将患者分为对照组(41例)和治疗组(41例)。对照组口服酒石酸托特罗定片,2 mg/次,2次/d。治疗组在对照组基础上口服盐酸屈他维林片,80 mg/次,3次/d。两组均在拔出尿管3 d后停药。观察两组患者临床疗效,比较治疗前后两组患者膀胱痉挛次数和持续时间以及膀胱过度活动症评分(OABSS)评分、膀胱状况感知量表(PPBC)评分、视觉模拟评分法(VAS)评分和生活质量(QOL)评分。结果治疗后,对照组和治疗组临床有效率分别为80.49%和97.56%,两组比较差异具有统计学意义(P<0.05)。治疗2、3 d后,两组膀胱痉挛次数和持续时间均较治疗前显著减少,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后,治疗组膀胱痉挛次数和持续时间比同时期对照组均显著减少,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者OABSS评分、PPBC评分、VAS评分和QOL评分均明显降低;同组比较差异具有统计学意义(P<0.05);且治疗组上述相关评分明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论屈他维林联合托特罗定治疗经尿道前列腺电切术后膀胱痉挛可显著改善患者临床症状,减轻患者疼痛,具有一定的临床推广应用价值。

Objective To investigate the clinical curative effect of drotaverine combined with tolterodine in treatment of bladder spasm after trans-urethral resection of prostate. Methods Patients（82 cases） with bladder spasm after trans-urethral resection of prostate in Cangzhou Hospital of Integrated TCM-WM·Hebei from June 2016 to June 2017 were randomly divided into control（41 cases） and treatment（41 cases） groups. Patients in the control group were po administered with Tolterodine Tartrate Tablets, 2 mg/time, twice daily. Patients in the treatment group were po administered with Drotaverine Hydrochloride Tablets on the basis of the control group, 80 mg/time, three times daily. Patients in two groups were treated until pulling out the urethral catheter for 3 d. After treatment, the clinical efficacy was evaluated, the frequency and duration of bladder spasm, the OABSS, PPBC, VAS, and QOL scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 80.49% and 97.56%, respectively, and there were differences between two groups（P〈0.05）. After treatment for 2 and 3 d, the frequency and duration of bladder spasm in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, the frequency and duration of bladder spasm in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the OABSS, PPBC, VAS and QOL scores in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And these scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Drotaverine combined with tolterodine in treatment of bladder spasm after trans-urethral resection of prostate can improve clinical symptoms and relieve the pain of patients, which has a certain clinical application value.