【摘要】：目的:觀察托特羅定、坦索羅辛以及兩藥的聯(lián)合用藥治療留置雙J管引起的下尿路癥狀(LUTS)的療效。方法:雙J管置入術(shù)后的患者共80例(男性50例,女性30例),隨機分到A、B、C、D四組,每組各20例。所有患者均于術(shù)后1周拔除尿管后開始服藥,A組給予口服坦索羅辛0.2mg日一次治療,B組給予口服托特羅定4mg日一次治療,C組給予口服坦索羅辛0.2mg日一次及托特羅定4mg日一次聯(lián)合用藥治療,D組為空白對照組,四組均給予相同的術(shù)前及術(shù)后的常規(guī)治療。所有患者出院后隨訪3周,3周后返院拔除雙J管時填寫生活質(zhì)量評分量表(QOL)、國際前列腺癥狀評分表(IPSS)及視覺模擬疼痛評分(VAS)。結(jié)果:1四組患者的一般資料(年齡、性別、置管方式)在不同組中差異無明顯統(tǒng)計學意義(P0.05),各癥狀評分(IPSS、QOL、VAS)與性別、年齡、置管方式的相關(guān)性無明顯統(tǒng)計學意義(P0.05)。2 A、B、C、D四組的VAS評分依次為2.43?0.47、2.02?0.43、1.20?0.56、2.87?0.57,多重比較結(jié)果顯示:坦索羅辛組、托特羅定組和聯(lián)合用藥組治療效果均優(yōu)于空白對照組(P0.05),托特羅定聯(lián)合坦索羅辛組治療效果優(yōu)于單一用藥組(P0.05),托特羅定組治療效果優(yōu)于坦索羅辛組(P0.05)。3 A、B、C、D四組的IPSS評分依次為41.13、43.08、12.63、65.18及QOL評分依次為40.40、36.65、19.70、65.25,多重比較結(jié)果顯示:托特羅定組與坦索羅辛組對比無顯著統(tǒng)計學差異(P0.05),聯(lián)合用藥組治療效果優(yōu)于坦索羅辛組、托特羅定組(P0.05)。4 A、B、C、D四組的梗阻癥狀評分依次為32.13、52.23、18.58、59.08及刺激癥狀評分依次為51.05、32.95、14.50、63.50,多重比較結(jié)果顯示:梗阻癥狀評分中坦索羅辛組、聯(lián)合用藥組治療效果優(yōu)于托特羅定組、空白對照組(P0.05),坦索羅辛組與聯(lián)合用藥組差異無明顯統(tǒng)計學意義(P0.05),托特羅定組與空白對照組差異無明顯統(tǒng)計學意義(P0.05);膀胱刺激癥狀中托特羅定組、聯(lián)合用藥組治療效果優(yōu)于坦索羅辛組、空白對照組(P0.05),托特羅定組與聯(lián)合用藥組差異無明顯統(tǒng)計學意義(P0.05),坦索羅辛組與空白對照組差異無明顯統(tǒng)計學意義(P0.05)。結(jié)論:1托特羅定、坦索羅辛及兩藥的聯(lián)合用藥均能改善雙J管留置術(shù)后引起的下尿路癥狀,且聯(lián)合用藥優(yōu)于單一用藥。2坦索羅辛主要改善雙J管置入術(shù)后引起的下尿路癥狀中的尿路梗阻癥狀,托特羅定主要改善雙J管置入術(shù)后引起的下尿路癥狀中的膀胱刺激癥狀。
[Abstract]:Objective: to observe the efficacy of Todrodine, tamsoloxine and two drugs in the treatment of lower urinary tract (LUTS) caused by indwelling double J tube. Methods: a total of 80 patients (50 males and 30 females) after double J tube implantation were randomly divided into four groups (20 cases in each group). All the patients began to take drugs one week after the removal of urinary catheter. Group A was given once a day of oral tansoroxine 0.2mg and group B was treated with oral tolterodine 4mg once a day. Group C was treated with oral tansoloxine 0.2mg once a day and toterodine 4mg once. Group D was treated as blank control group. All four groups were given the same routine treatment before and after operation. All patients were followed up for 3 weeks after discharge and returned to hospital 3 weeks later to complete the quality of Life scale (IPSS) and Visual Analog pain scale (VAS).) when removing double J tubes. Results: (1) there was no significant difference in the general data (age, sex, catheterization) among the four groups (P0.05). The scores of symptoms (IPSS,QOL,VAS) and gender, age were not significantly different among the four groups (P0.05). There was no significant correlation between catheterization and catheterization (P0.05). 2 the VAS score of group D was 2.43 鹵0.47 鹵2.020.42 鹵0.43 鹵1.200.66 鹵2.87 / 0.57, respectively. The results of multiple comparison showed that the therapeutic effect of tansoloxine group, toterodine group and combined drug group were better than that of blank control group (P0.05), the effect of tolterodine combined with tamoxoroxine group was better than that of single drug group (P0.05). The therapeutic effect of toterodine group was better than that of tansoloxine group (P0.05). The IPSS score of group D was 41.1383.0812.63n 65.18, and the QOL score of group D was 40.400.36.65,19.70,65.25, respectively. The results of multiple comparison showed that there was no significant difference between toterodine group and tamsoloxine group (P0.05). The therapeutic effect of combined drug group was better than that of tansoroxin group, and that of toterodine group (P0.05). In group D, the score of obstruction symptom was 32.13 ~ 52.23 ~ 18.58 ~ 59.08 and the score of irritation symptom was 51.05 ~ 32.95 ~ 14.50 ~ 63.50 respectively. The therapeutic effect of combined drug group was better than that of tolterodine group, blank control group (P0.05), tamsoloxine group and combined drug group had no significant difference (P0.05). There was no significant difference between tolterodine group and blank control group (P0.05). In the bladder irritation symptoms, the Totterodine group, the combined treatment group was better than the tansoroxine group, the blank control group (P0.05), the Totterodine group and the combined drug group had no significant difference (P0.05). There was no significant difference between tansoroxine group and blank control group (P0.05). Conclusion: (1) the combined use of tolterodine, tamsoloxine and two drugs can improve the symptoms of lower urinary tract after double J tube indwelling. 2 Tansoroxine mainly improved the symptoms of lower urinary tract obstruction caused by double J tube implantation, and Totterodine mainly improved the bladder irritation symptoms of lower urinary tract symptoms after double J tube placement.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R472

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