中西医结合治疗膀胱过度活动症临床研究

Clinical Study on Overactive Bladder with Integrated Traditional Chinese and Western Medicine

目的观察中西医结合治疗膀胱过度活动症(OAB)的临床疗效。方法收集2014年9月至2015年9月成都中医药大学附属医院泌尿外科门诊及住院部符合条件的患者,将135例OAB患者按随机数字表法随机分为中医组、西医组和中西医组,每组45例。西医组予琥珀酸索利那新片治疗,中医组予以中药补肾导浊汤治疗,中西医组给予琥珀酸索利那新片及中药补肾导浊汤联合治疗,持续治疗6周。分别于治疗前及治疗后测量尿流率参数、排尿日记参数、生活质量评估量表(QOL)评分、OABSS量表评分、临床疗效及观察不良反应。结果各组治疗后最大尿流量(Qmax),平均尿流量(Qave)及尿量(Vvo)改善情况优于治疗前(P<0.05);西医组治疗后各指标改善情况优于中医组(P<0.05);中西医组治疗后各指标改善情况优于西医组(P<0.05)。西医组治疗后排尿日记参数、OABSS量表评分及QOL评分优于中医组(P<0.05);中西医组治疗后各指标改善情况优于西医组(P<0.05)。中西医结合治疗OAB优于单纯西医、中医治疗(P<0.05)。同时,根据OABSS量表评分将患者分为轻度、中度及重度进行亚组分析,轻度OAB患者治疗后,中医组与西医组、中西医组治疗疗效相当(P>0.05);中度OAB患者治疗1个疗程后,中西医组治疗优于中医组、西医组(P<0.05);治疗2、3个疗程后,中医组与西医组疗效相当(P>0.05),西医组疗效优于中西医组(P<0.05);重度OAB患者治疗1、2、3个疗程后,中西医组优于中医组、西医组(P<0.05)。治疗过程中,各组均未出现明显不良反应。结论应采取不同的治疗方案治疗轻度、中度及重度OAB;轻、中度OAB患者首选中医治疗;重度OAB首选西医治疗或中西医联合治疗。

Objective To investigate clinical curative effect on overactive bladder with integrated traditional Chinese and western medicine. Methods 135 OAB patients from outpatient and inpatient department of urology in the affiliated hospital of Traditional Chinese medicine from Sept. 2014 to Sept. 2015 were randomly divided into the traditional Chinese Medicine( TCM) group,the Western Medicine( WM) group and the TCM + WM group with 45 cases in each group. The TCM group was given Chinese medicine for invigorating the kidney and removing turbid. The WM group was given Solifenacin succinate and TCM + WM group was given traditional Chinese Medicine and Western Medicine. Course of disease was 6 weeks. Before and after treatment,urine flow rate parameters,micturition diary parameters,quality of life assessment scale( QOL)score,OABSS scale score,efficiency and adverse reactions were observed. Results After treatment,maximum urinary flow( Qmax),mean urinary flow( Qave) and urine volume( Vvo) of three group were better than before treatment,the difference was statistically significant( P < 0. 05); After treatment,the indexes of the WM group were better than the TCM group( P < 0. 05),and the results of the TCM + WM group were better than those of the WM group( P < 0. 05). After treatment,the WM group in the urinary diary parameters,OABSS scale score and QOL score were superior to the TCM group( P < 0. 05). The results of the TCM + WMgroup were better than WM group( P < 0. 05),the TCM + WM group was better than the WM group( P <0. 05),and was superior to the TCM group( P < 0. 05). The OABSS basis weight scale score of the patients were divided into mild,moderate and severe subgroup analysis. Patients with mild OAB in treatment of WM,TCM and WM treatment,the difference was not statistically significant( P > 0. 05); After 1 course,patients with moderate OAB in the TCM + WM group was superior to TCM and WM( P < 0. 05); After 2,3 courses,the WM group was better than TCM + WM( P < 0. 05). After 1 and 2 courses,patients with severe OAB in the TCM + WM group was superior to TCM and WM( P <. 05); Meanwhile,TCM + WM were superior to the TCM group,the WM group( P < 0. 05). During the treatment,there were no significant adverse reactions in each group. Conclusion Different OAB should be in different treatment measures of mild,moderate and severepatients. Mild and moderate OAB patients should be in the first choice of TCM treatment and severe OAB patients should be in the first choice of WM or TCM and WM.