生物反馈电刺激联合托特罗定治疗膀胱过度活动症合并轻度认知障碍:前瞻性随机对照研究

Biofeedback Electrical Stimulation Combined With Tolterodine in the Treatment of Overactive Bladder Combined With Mild Cognitive Impairment: a Prospective Randomized Controlled Study

目的探讨生物反馈电刺激联合托特罗定治疗膀胱过度活动症(overactive bladder,OAB)合并轻度认知障碍(mild cognitive impairment,MCI)的效果。方法选择2017年5月~2018年4月55例OAB合并MCI患者,随机分为联合治疗组27例(口服酒石酸托特罗定缓释片及生物反馈电刺激治疗)和托特罗定组28例(口服酒石酸托特罗定缓释片),4周后比较治疗前后及治疗后2组间膀胱过度活动症症状评分(Overactive Bladder Symptom Score,OABSS)、膀胱过度活动症问卷(Overactive Bladder Questionnaire,OAB-q)、排尿日记、尿动力检查指标,评价2组治疗效果。结果2组治疗后OABSS及OAB-q得分均明显低于治疗前(P<0.05),联合治疗组治疗后的OABSS、OAB-q得分分别为(5.4±3.3)分、(45.4±4.1)分,明显低于托特罗定组治疗后的(7.6±3.5)分、(49.1±3.3)分(P<0.05)。2组治疗后白天平均排尿次数、平均夜尿次数、每日平均尿急次数、每日平均急迫性尿失禁次数、每次平均排尿量均有显著改善(P<0.05),联合治疗组的白天平均排尿次数、每日平均尿急次数、每次平均排尿量分别为(6.1±1.6)次、(1.1±1.0)次、(239.1±14.3)ml,明显优于托特罗定组的(7.5±1.8)次、(1.7±1.1)次、(202.4±13.1)ml(P<0.05)。联合治疗组治疗后的初始尿意容量、最大膀胱测量容量分别为(153.1±33.4)ml、(274.1±42.0)ml,明显优于托特罗定组的(133.0±36.2)ml、(243.4±47.7)ml(P<0.05)。结论生物反馈电刺激联合托特罗定可以有效地改善OAB合并MCI患者的排尿功能障碍症状,提高生活质量。

Objective To investigate the therapeutic effect of biofeedback electrical stimulation combined with tolterodineon for overactive bladder (OAB) combined with mild cognitive impairment (MCI).Methods A total of 55 eligible patients,diagnosed with OAB combined with MCI from May 2017 to April 2018,were randomly divided into two groups:27 were in the combined treatment group (treated with tolterodine tartrate sustained release tablets and received biofeedback electrical stimulation treatment at the same time) and 28 were in the tolterodine group (treated with tolterodine tartrate sustained release tablets).After 4 weeks,the therapeutic effects of two groups were evaluated by comparing the scores of Overactive Bladder Symptom Score (OABSS),Overactive Bladder Questionnaire (OAB-q),urination diary indexes,and urodynamic examination indexes before and after treatment.Results The OABSS and OAB-q scores of the two groups after treatment were significantly decreased than those before treatment (P<0.05).The OABSS and OAB-q scores of combined treatment group after treatment were (5.4±3.3) points and (45.4± 4.1) points,respectively,which were obviously lower than those scores of tolterodine group after treatment,which were (7.6± 3.5) points and (49.1±3.3) points,respectively (P<0.05).The average number of micturition during the day,average number of micturition at night,average number of urinary urgency per day,average number of urge incontinence per day,average urine volume per micturition of the two groups were significantly improved (P<0.05).The average number of micturition during the day,average number of urinary urgency per day,and average urine volume per micturition of combined treatment group after treatment were (6.1±1.6) times,(1.1±1.0) times,and (239.4±14.3) ml,respectively,which were significantly better than those of tolterodine group,which were (7.5±1.8) times,(1.7±1.1) times,and (202.4±13.1) ml,respectively (P<0.05).The volume at first desire (VFD),maximum cystometric capacity (MCC) of the combined treatment group after treatment were (153.1±33.4) ml and (274.1± 42.0) ml,which were significantly better than those of tolterodine group,which were (133.0±36.2) ml and (243.4± 47.7) ml,respectively (P<0.05).Conclusion Biofeedback electrical stimulation combined with tolterodine can effectively improve the urinary dysfunction symptoms and the quality of life in patients with OAB combined with MCI.