坦索罗辛联合索利那新在治疗轻中度良性前列腺增生合并膀胱过度活动症中的疗效分析

目的:探讨坦索罗辛联合索利那新在治疗轻中度BPH合并膀胱过度活动症(OAB)中的有效性及安全性。方法:选取在我院诊治的轻中度良性BPH合并OAB患者166例,分为轻度梗阻症状组(88例)(联合用药组48例及坦索罗辛组40例)和中度梗阻症状组(78例)(联合用药组36例及坦索罗辛组42例)。坦索罗辛组均服用坦索罗辛0.2mg,每日1次。联合用药组均口服坦索罗辛0.2mg,每日1次,索利那新5mg,每日1次,共12周。比较两组治疗前后国际前列腺症状评分(IPSS)、排尿期症状评分、储尿期症状评分、最大尿流率(Qmax)、残余尿量、膀胱过度活动症症状评分(OABSS)、尿常规检查、不良事件等。结果:在轻度梗阻症状组中,联合用药组治疗后在IPSS、储尿期症状评分、Qmax、OABSS明显优于治疗前(P0.05),而残余尿无明显变化(P0.05),坦索罗辛组治疗后仅IPSS较治疗前有所改善,而其他方面无明显变化(P0.05);而治疗后联合用药组IPSS(9.7±3.0)分vs(15.8±3.3)分]、储尿期症状评分(8.1±1.7)分vs(12.3±3.1)分]、Qmax(18.6±4.1)ml/s vs(14.2±2.3)ml/s]、OABSS(5.3±1.3)分vs(9.7±2.7)分]等方面明显优于坦索罗辛组(P均0.05),而残余尿、尿常规检查及不良事件无明显差异(P0.05);在中度梗阻症状组,联合用药组治疗后IPSS、排尿期症状评分、Qmax、OABSS明显优于治疗前,而残余尿无明显差异;坦索罗辛组治疗后IPSS、排尿期症状评分、Qmax、OABSS及残余尿较治疗前改善明显;联合用药组的OABSS优于坦索罗辛组(4.8±1.5)分vs(6.5±2.5)分,P0.05],而在IPSS、Qmax、排尿期症状评分、尿常规检查及不良事件等方面与坦索罗辛组无明显差异(P均0.05)。结论:坦索罗辛联合索利那新在治疗BPH轻中度梗阻症状合并OAB均有明显疗效,其疗效优于单用坦索罗辛,而不良反应无明显增加。

Efficacy of combination therapy of tamsulosin and solifenacin for mild and moderate benign prostatic hyperplasia with overactive bladder

To evaluate the efficacy and safety of the combination therapy of tamsulosin and solifenacin for mild and moderate benign prostatic hyperplesia （BPH） with overactive bladder （OAB）. Methods： We randomly divided 166 patients with BPH and concomitant OAB into a mild obstruction symptom group （ n = 88 ） and a moderate obstruction symptom group （ n = 78 ）, 48 of the former group treated with 0.2 mg tamsulosin ＋ 5 mg solifenaein and the other 40 with 0.2 mg tamsulosin; 36 of the latter grouotreated with O. 2 mg tamsulosin ＋ 5 mg solifenacin and the other 42 with O. 2 mg tamsulosin, all administered once daily for 12 weeks. We obtained the International Prostate Symptom Score （IPSS） , urine storage period symptom score （USPSS）, voiding symptom score （VSS）, Qmax, residual urine volume, OAB symptom score （OABSS） and adverse reactions, and compared them among different groups. Results ： Among the patients with mild obstruction symptoms, the combination of tamsulosin and solifenacin achieved remark- able improvement in IPSS, USPSS, Qmax and OABSS as compared with the baseline （ P 〈 0.05 ）, but made no significant difference in the residual urine volume （P 〉 O. 05 ） , while tamsulosin improved IPSS only （P 〈 0.05 ）. The combination therapy exhibited an obvious superiority over tamsulosin alone in improving IPSS （9.7 ± 3.0 vs 15.8 ± 3.3 ）, USPSS （ 8.1 ± 1.7 vs 12.3 ± 3.1 ）, Qmax （18.6 ± 2.3] ml/svs 14.2 ± 2.3] ml/s ）, andOABSS （5.3 ± 1.3 vs9.7 ± 2.7） （P 〈 0.05）, but there were no obvious differences in residual urine, urine routine test results and adverse events between the two therapies （ P 〉 O. 05 ）. In those with moderate obstruction symptoms, the combination therapy significantly improved IPSS, VSS, Qmax and OABSS （P 〈 0.05 ） but not the residual urine （P 〉 O. 05 ） in comparison with the baseline. The tamsulosin therapy achieved obvious improvement in IPSS, VSS, Qmax, OABSS and residual urine. The combination therapy showed a better effect than tamsulosin only in OABSS （4.8 ± 1.5 vs 6.5 ± 2.5, P 〈 O. 05 ） , but no significant differences from the latter in IPSS, Qmax, VSS, routine urine test results, and adverse events （ P 〉 0.05 ）. Conclusion ： Combination therapy of tamsulosin and solifenacin is obviously safe and efficacious in the treat- ment of both mild and moderate BPH with concomitant OAB, and it is superior to tamsulosin alone. Natl J Androl, 2014, 20 （3） ： 239 -243