甲磺酸多沙唑嗪对BPH患者夜尿症状的临床疗效观察

发布时间：2018-07-23 12:51

【摘要】：良性前列腺增生，也称前列腺增生症，过去被称为前列腺肥大，好发于中老年男性，是泌尿外科常见的渐进性慢性疾病。夜尿增多作为储尿期下尿路症状之一，被认为是BPH患者最早出现和最常见的症状，可严重影响患者正常睡眠，使之出现精神疲倦，生活质量下降，，严重者可出现神经衰弱，并使机体抵抗力下降，同时，器质性病变发生率升高。因此，夜尿症状的有效治疗对良性前列腺增生患者的日常生活及健康水平，具有十分的重要意义，在临床工作中，应重视夜尿症状的治疗。目的：针对客观存在夜尿症状并认为夜尿症状的存在影响其生活质量的良性前列腺增生患者，观察该患者应用甲磺酸多沙唑嗪后，夜尿症状的改善情况及治疗过程中的安全性。方法：51例经B超证实存在前列腺增生，并具有夜尿症状的患者入选，入选患者均在入选前完成7d排尿日记，涉及夜尿症状的记录指标主要有夜尿次数，夜间尿量、夜间首次排尿距睡眠时间及生活质量评分。入选患者随机分为两组，治疗组患者25例，对照组患者26例。所有入选患者均被告知睡前限制水分摄入及避免刺激性饮食。治疗组患者，予以甲磺酸多沙唑嗪控释片（可多华）4mg口服，1/晚；对照组患者，仅睡前限制水分摄入并避免刺激性饮食。4周后，再次应用7d排尿日记，记录两组患者夜尿情况。治疗过程中，密切观察治疗期间，患者血压变化及有无头晕、眩晕、体位性低血压等不良反应出现。使用SPSS21.0统计学软件对治疗前后所得的实验数据进行统计学分析，对符合正态分布的数据进行t检验，不符合正态分布的数据行秩和检验。比较两组患者的夜尿次数、夜尿量、夜间首次排尿距睡眠时间、夜尿系数、生活质量评分。若P＜0.05，认为差异具有统计学意义。结果：经过4周的治疗后，客观评价指标显示，治疗组患者夜尿症状的改善明显优于对照组，平均夜尿次数下降，夜间首次排尿距睡眠时间延长，治疗组平均夜尿次数由3.3±0.8降至1.8±0.5，首次夜尿距睡眠时间由120±21min延长至164±18min。而对照组上述指标改变不明显，平均夜尿次数为3.5±0.9次，4周后平均夜尿次数为3.2±0.7次，首次夜尿距睡眠时间为124±27min，4周后该指标为126±24min；经过4周治疗，多沙唑嗪组患者的生活质量评分（QOL评分）较对照组改善（采用秩和检验）；但在夜尿指数及夜间尿量上，两组患者无明显差异。 51例良性前列腺增生患者均顺利完成实验，用药过程中，无头晕、体位性低血压等严重不良反应出现。结论：甲磺酸多沙唑嗪可通过减少夜尿次数，改善前列腺增生患者的夜尿症状，使患者生活质量提高。甲磺酸多沙唑嗪治疗良性前列腺增生患者的安全性较好，副作用轻微。
[Abstract]:Benign prostatic hyperplasia, also known as prostatic hyperplasia, used to be called prostatic hypertrophy, which usually occurs in middle-aged and aged men and is a common progressive chronic disease in urology. As one of the lower urinary tract symptoms in the period of urine storage, nocturia is considered to be the earliest and most common symptom in patients with BPH. It can seriously affect patients' normal sleep, cause mental fatigue, decline in quality of life, and neurasthenia in severe patients. At the same time, the incidence of organic diseases increased. Therefore, the effective treatment of nocturnal urine symptoms is of great significance to the daily life and health level of patients with benign prostatic hyperplasia. In clinical work, attention should be paid to the treatment of nocturnal urine symptoms. Objective: to investigate the improvement and safety of night urine symptoms in patients with benign prostatic hyperplasia (BPH) who objectively exist nocturnal urine symptoms and believe that nocturnal urine symptoms affect their quality of life. Methods Fifty-one patients with benign prostatic hyperplasia (BPH) and nocturnal urine symptoms were enrolled in the study. All the patients were included in the diaries of voiding for 7 days before the inclusion. The main indexes of nocturnal urine symptoms were the number of nocturnal urine and the nocturnal urine volume. Nocturnal first urination distance sleep time and quality of life score. The patients were randomly divided into two groups: treatment group (n = 25) and control group (n = 26). All patients were told to limit water intake and avoid an irritating diet before bed. In the treatment group, doxazosin mesylate controlled release tablet (doxoxazone) 4mg was given orally for 1 / night, while in the control group, after only limiting water intake before bedtime and avoiding irritating diet for 4 weeks, the diaries of urination were used again for 7 days to record the nocturnal urine in the two groups. During the course of treatment, the changes of blood pressure, dizziness, dizziness and postural hypotension appeared. SPSS21.0 software was used to analyze the experimental data before and after treatment. T test was carried out on the data according to normal distribution, and rank sum test was performed on data that did not accord with normal distribution. The number of nocturnal urine, nocturnal urine volume, nocturnal first voiding time from sleep, nocturnal urine coefficient and quality of life score were compared between the two groups. If P < 0.05, the difference was statistically significant. Results: after 4 weeks of treatment, the objective evaluation index showed that the improvement of nocturnal urine symptoms in the treatment group was significantly better than that in the control group, the average number of nocturnal urine decreased, and the length of nocturnal first urination distance to sleep was prolonged. In the treatment group, the average nocturnal urine frequency decreased from 3.3 卤0.8 to 1.8 卤0.5, and the sleep time from the first night urine to sleep was prolonged from 120 卤21min to 164 卤18 mins. The average nocturnal urine frequency was 3.2 卤0.7 after 4 weeks in the control group, and it was 126 卤24 mins after 4 weeks of first night urination, 124 卤27mins after 4 weeks of sleep, after 4 weeks of treatment, the average nocturnal urine frequency was 3. 5 卤0. 9 times in the control group and 126 卤24 mins in the control group after 4 weeks of treatment. The quality of life score (QOL) in the doxazosin group was better than that in the control group (rank sum test), but in the nocturnal urine index and nocturnal urine volume, There was no significant difference between the two groups. 51 patients with benign prostatic hyperplasia completed the experiment successfully. There were no serious adverse reactions such as dizziness and postural hypotension in the course of medication. Conclusion: doxazosin mesylate can improve the night urine symptoms and improve the quality of life of patients with prostatic hyperplasia by reducing the number of nocturnal urine. Doxazosin mesylate is safe in the treatment of benign prostatic hyperplasia with mild side effects.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R697.3

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