【摘要】：良性前列腺增生，也稱前列腺增生癥，過去被稱為前列腺肥大，好發(fā)于中老年男性，是泌尿外科常見的漸進(jìn)性慢性疾病。夜尿增多作為儲(chǔ)尿期下尿路癥狀之一，被認(rèn)為是BPH患者最早出現(xiàn)和最常見的癥狀，可嚴(yán)重影響患者正常睡眠，使之出現(xiàn)精神疲倦，生活質(zhì)量下降，，嚴(yán)重者可出現(xiàn)神經(jīng)衰弱，并使機(jī)體抵抗力下降，同時(shí)，器質(zhì)性病變發(fā)生率升高。因此，夜尿癥狀的有效治療對(duì)良性前列腺增生患者的日常生活及健康水平，具有十分的重要意義，在臨床工作中，應(yīng)重視夜尿癥狀的治療。 目的：針對(duì)客觀存在夜尿癥狀并認(rèn)為夜尿癥狀的存在影響其生活質(zhì)量的良性前列腺增生患者，觀察該患者應(yīng)用甲磺酸多沙唑嗪后，夜尿癥狀的改善情況及治療過程中的安全性。 方法：51例經(jīng)B超證實(shí)存在前列腺增生，并具有夜尿癥狀的患者入選，入選患者均在入選前完成7d排尿日記，涉及夜尿癥狀的記錄指標(biāo)主要有夜尿次數(shù)，夜間尿量、夜間首次排尿距睡眠時(shí)間及生活質(zhì)量評(píng)分。入選患者隨機(jī)分為兩組，治療組患者25例，對(duì)照組患者26例。所有入選患者均被告知睡前限制水分?jǐn)z入及避免刺激性飲食。治療組患者，予以甲磺酸多沙唑嗪控釋片（可多華）4mg口服，1/晚；對(duì)照組患者，僅睡前限制水分?jǐn)z入并避免刺激性飲食。4周后，再次應(yīng)用7d排尿日記，記錄兩組患者夜尿情況。治療過程中，密切觀察治療期間，患者血壓變化及有無頭暈、眩暈、體位性低血壓等不良反應(yīng)出現(xiàn)。使用SPSS21.0統(tǒng)計(jì)學(xué)軟件對(duì)治療前后所得的實(shí)驗(yàn)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析，對(duì)符合正態(tài)分布的數(shù)據(jù)進(jìn)行t檢驗(yàn)，不符合正態(tài)分布的數(shù)據(jù)行秩和檢驗(yàn)。比較兩組患者的夜尿次數(shù)、夜尿量、夜間首次排尿距睡眠時(shí)間、夜尿系數(shù)、生活質(zhì)量評(píng)分。若P＜0.05，認(rèn)為差異具有統(tǒng)計(jì)學(xué)意義。 結(jié)果：經(jīng)過4周的治療后，客觀評(píng)價(jià)指標(biāo)顯示，治療組患者夜尿癥狀的改善明顯優(yōu)于對(duì)照組，平均夜尿次數(shù)下降，夜間首次排尿距睡眠時(shí)間延長，治療組平均夜尿次數(shù)由3.3±0.8降至1.8±0.5，首次夜尿距睡眠時(shí)間由120±21min延長至164±18min。而對(duì)照組上述指標(biāo)改變不明顯，平均夜尿次數(shù)為3.5±0.9次，4周后平均夜尿次數(shù)為3.2±0.7次，首次夜尿距睡眠時(shí)間為124±27min，4周后該指標(biāo)為126±24min；經(jīng)過4周治療，多沙唑嗪組患者的生活質(zhì)量評(píng)分（QOL評(píng)分）較對(duì)照組改善（采用秩和檢驗(yàn)）；但在夜尿指數(shù)及夜間尿量上，兩組患者無明顯差異。 51例良性前列腺增生患者均順利完成實(shí)驗(yàn)，用藥過程中，無頭暈、體位性低血壓等嚴(yán)重不良反應(yīng)出現(xiàn)。 結(jié)論：甲磺酸多沙唑嗪可通過減少夜尿次數(shù)，改善前列腺增生患者的夜尿癥狀，使患者生活質(zhì)量提高。甲磺酸多沙唑嗪治療良性前列腺增生患者的安全性較好，副作用輕微。
[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 鹵0.8 to 1.8 鹵0.5, and the sleep time from the first night urine to sleep was prolonged from 120 鹵21min to 164 鹵18 mins. The average nocturnal urine frequency was 3.2 鹵0.7 after 4 weeks in the control group, and it was 126 鹵24 mins after 4 weeks of first night urination, 124 鹵27mins after 4 weeks of sleep, after 4 weeks of treatment, the average nocturnal urine frequency was 3. 5 鹵0. 9 times in the control group and 126 鹵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.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R697.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 黃雙;王保軍;孫圣坤;郝通利;張旭;;去氨加壓素治療前列腺增生患者夜尿增多的臨床研究[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2013年18期

2 吳翔;張孜瑋;林燕輝;高祥勛;;體檢人群代謝因素與前列腺增生的相關(guān)性分析:肥胖是其獨(dú)立危險(xiǎn)因素[J];現(xiàn)代泌尿外科雜志;2013年03期

3 左立;李壽春;鄒建綱;周忠興;吳小鵬;陸曙炎;;COX-2抑制劑治療良性前列腺增生癥引起夜尿癥的臨床研究[J];上海醫(yī)藥;2012年23期

4 關(guān)志忱;;夜尿癥的臨床研究進(jìn)展[J];北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2010年04期

5 吳們;鄭少斌;;坦索羅辛對(duì)BPH患者夜尿影響的觀察(附36例報(bào)告)[J];臨床泌尿外科雜志;2009年10期

6 劉艷波;沈維高;趙雪儉;;堿性成纖維細(xì)胞生長因子在前列腺癌和良性前列腺增生組織中表達(dá)的意義[J];中國老年學(xué)雜志;2007年14期

本文編號(hào)：2139469