不同α受体阻滞剂联合M受体阻滞剂治疗伴有下尿路症状的前列腺增生的疗效比较  

Which alpha-blocker is more appropriate in combination with antimuscarinics to treat LUTs/BPH

作　　者：韩雨[1] 曹延炜[1] 于芹超[1] 王晓[1] 岳德志 

机构地区：[1]青岛大学医学院附属医院泌尿外科,山东青岛266101

出　　处：《现代泌尿外科杂志》2014年第5期311-314,共4页Journal of Modern Urology

基　　金：辉瑞IIR项目资助(WS1877452)

摘　　要：目的比较不同α受体阻滞剂与M受体阻滞剂联合用药治疗合并下尿路症状(LUTs)的前列腺增生(BPH)的临床疗效。方法选取确诊为BPH的门诊患者220例,随机分为两组,其中一组给予坦索罗辛和酒石酸托特罗定缓释剂联合治疗(坦索罗辛组),另一组给予多沙唑嗪和酒石酸托特罗定缓释剂联合治疗(多沙唑嗪组),分别在用药0、6、12周时进行国际前列腺症状(IPSS)、生活质量指数(QOL)、最大尿流率(Qmax)的测定。结果 192例完成了实验。两组0周时各项指标比较均未见统计学差异。服药6周IPSS、Qmax两组之间差异无统计学意义(P>0.05),服药6周QOL、服药12周IPSS、Qmax、QOL两组相比,多沙唑嗪组优于坦索罗辛组(P<0.05)。两组患者在用药期间均无尿潴留、头痛、便秘、皮肤过敏等不良反应发生,3人出现轻微血压下降,可耐受并坚持服药。结论α受体阻滞剂与M受体阻滞剂联合用药能够有效缓解前列腺增生患者的下尿路症状,改善最大尿流率。服药12周多沙唑嗪与酒石酸托特罗定缓释胶囊联合组优于坦索罗辛与酒石酸托特罗定缓释胶囊联合组,联合用药时患者无明显不良反应发生。Objective To compare the clinical improvement in BPH/LUTs patients who received combined therapy of different alpha-blockers with anticholinergic agent. Methods A number of 220 cases diagnosed as BPH/LUTs were enrolled into a randomized open-labeled trial （each group n = 110）. Group A were treated with 0.2 mg tamsulosin and 4 mg tolterodine extended release （ER） per day. Group B received 4 mg doxazosin and 4rag tolterodine ER per day. Clinical parameter of Inter- national Prostate Symptom Score （IPSS）, Quality of life （QOL）, Qmax, postvoid residual volume （PVR） were recorded and compared in the 6th and 12th week. Results A total of 192 cases went through the trial. Baseline showed no differences be- tween the groups. After six-week treatment, the IPSS and Qmax showed no significant difference in the two groups. But the QOL reduced apparently in group B （P〈0.01）. In the 12th week,all indicators of group B were significantly better than those of group A （P〈0.05）. There was no acute urinary retention and other serious complications in both groups. Conclusions The combination of alpha-blocker and an anticholinergic can relieve LUTs effectively in patients with BPH. The combination of doxazosin and tolterodine is more effective than tamsulosin and tolterodine ER in a short term treatment.

关 键 词：良性前列腺增生 下尿路症状 Α受体阻滞剂 M受体阻滞剂 

分 类 号：R697.32[医药卫生—泌尿科学]