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JAMA Intern Med:行为联合药物治疗用于改善男性膀胱过度活动

2020-01-20 MedSci MedSci原创

研究认为,行为疗法和药物疗法可有效地改善男性膀胱过度活动症状

男性膀胱过度活动(OAB)症状患者接受一线行为或药物治疗后通常不能治愈。近日研究人员考察了行为联合药物治疗OAB的效果。

OAB患者随机接受6周的单独行为治疗,单独药物治疗或联合治疗,随后所有患者接受6周的联合治疗。行为疗法包括盆底肌肉训练、冲动抑制训练和延迟排尿。药物治疗包括M受体抑制剂(托特罗定片,4mg)和α-阻滞剂(坦索洛新,0.4mg)。研究终点为在每6周的治疗阶段之前和之后的7天膀胱日记记录的排尿频率(主要结果)和其他症状(即急迫、急迫性尿失禁和夜尿症)的减少。其他次要结果包括整体改善和满意度评分、膀胱过度活动问卷评分和国际前列腺症状评分。

204名患者,平均年龄64.1岁,183人完成治疗。从基线检查到6周随访,3组患者每24小时平均排尿量均显著减少(行为疗法:11.7 vs 8.8;百分比变化,24.7%;药物治疗:11.8vs10.3;百分比变化,12.7%;联合治疗:11.8 vs8.2;百分比变化,30.5%)。意向分析表明,联合治疗组的治疗后平均排尿频率明显低于单纯药物治疗组(8.2 vs 10.3),但与单纯行为治疗组相比无显著性差异(8.2 vs 8.8)。在12周的随访中,在所有组接受联合治疗后,患者每24小时平均排尿量显著改善(行为治疗:11.7vs 8.0;百分比变化,31.6%;药物治疗:11.8 vs8.6;百分比变化,27.1%;联合治疗:11.8 vs8.0;百分比变化,32.2%)。

研究认为,行为疗法和药物疗法可有效地改善男性膀胱过度活动症状。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=378412, encodeId=261f3e8412e8, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 22 22:43:05 CST 2020, time=2020-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610199, encodeId=b1081610199a3, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Jan 22 10:12:00 CST 2020, time=2020-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035882, encodeId=9b72103588219, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 20 22:12:00 CST 2020, time=2020-01-20, status=1, ipAttribution=)]
    2020-01-22 1209e435m98(暂无昵称)

    学习了,谢谢分享

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  3. [GetPortalCommentsPageByObjectIdResponse(id=378412, encodeId=261f3e8412e8, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jan 22 22:43:05 CST 2020, time=2020-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610199, encodeId=b1081610199a3, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Jan 22 10:12:00 CST 2020, time=2020-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035882, encodeId=9b72103588219, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Jan 20 22:12:00 CST 2020, time=2020-01-20, status=1, ipAttribution=)]
    2020-01-20 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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