米拉贝隆联合赛洛多辛治疗逼尿肌过度活动伴收缩功能受损患者的效果

doi:10.3969/j.issn.1006-9771.2022.04.015

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (4): 473-478.doi: 10.3969/j.issn.1006-9771.2022.04.015

米拉贝隆联合赛洛多辛治疗逼尿肌过度活动伴收缩功能受损患者的效果

丛惠伶^1a,2,廖利民^1a,2,付光^1a,2,查丽华^1a,2,杨宇琦^1b,2,王艺铮^1c,2,李兴^1a,2,吴娟^1d,2,高轶^1d,2,靖华芳^1d,2

1.中国康复研究中心北京博爱医院,a.泌尿外科;b.神经康复科;c.贵宾康复科;d.神经泌尿科,北京市 100068
2.首都医科大学康复医学院,北京市 100068

收稿日期:2021-12-06 修回日期:2022-03-04 出版日期:2022-04-25 发布日期:2022-05-05
作者简介:丛惠伶(1984-),女,汉族,山东烟台市人,博士,主治医师,主要研究方向：神经泌尿学、尿动力学、泌尿康复学。
基金资助:
中国康复研究中心课题(2018ZX-Q2)

Effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile

CONG Huiling^1a,2,LIAO Limin^1a,2,FU Guang^1a,2,ZHA Lihua^1a,2,YANG Yuqi^1b,2,WANG Yizheng^1c,2,LI Xing^1a,2,WU Juan^1d,2,GAO Yi^1d,2,JING Huafang^1d,2

1. a.Department of Urology; b.Department of Neurological Rehabilitation; c.Department of VIP Rehabilitation; d.Department of Neurourological Ward, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
2. Capital Medical University School of Rebabilitation Medicine, Beijing 100068, China

Received:2021-12-06 Revised:2022-03-04 Published:2022-04-25 Online:2022-05-05
Supported by:
China Rehabilitation Research Center Research Project(2018ZX-Q2)

摘要/Abstract

摘要：

目的观察米拉贝隆联合赛洛多辛治疗逼尿肌过度活动伴收缩功能受损(DHIC)患者的临床效果。方法选取本院2019年9月至2021年11月收治的DHIC患者40例,随机分为对照组和试验组,每组20例。对照组口服赛洛多辛,试验组口服米拉贝隆和赛洛多辛,共4周。治疗前后,比较两组排尿日记、残余尿量、膀胱过度活动症状评分(OABSS)、生活质量评分及安全性。结果最终对照组18例,试验组19例完成随访。治疗后,对照组每日夜尿次数、残余尿量、生活质量评分明显改善(P<0.01),试验组每24小时排尿次数、每日夜尿次数、每次排尿量、残余尿量、每日尿急评分、OABSS评分和生活质量评分均明显改善(P<0.01)。试验组每24小时排尿次数下降值、每次排尿量下降值、每日尿急评分下降值、OABSS评分和生活质量评分均明显大于对照组(P<0.01)。不良反应包括心悸、心率增快、排尿困难、血压升高、胃部不适、体位性低血压、逆行性射精等,两组间比较无显著性差异(P > 0.05)。结论米拉贝隆联合赛洛多辛治疗DHIC患者疗效优于单用赛洛多辛,且药物相关不良反应无明显增加。

关键词: 米拉贝隆, 赛洛多辛, 逼尿肌过度活动伴收缩功能受损, 药物联用, 泌尿康复

Abstract:

Objective To observe the clinical effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile (DHIC).Methods From September, 2019 to December, 2021, 40 patients with DHIC in the Department of Urology of Beijing Bo'ai Hospital were selected and randomly divided into control group and experimental group, with 20 cases in each group. The control group took Silodosin only, and the experimental group took Mirabegron in addition, for four weeks. The urinary diary, residual urine volume, Overactive Bladder Symptom Score (OABSS) and quality of life (QOL) score were compared before and after treatment.Results A total of 18 patients in the control group and 19 in the experimental group finished the trial. After treatment, the number of night urination per day, the residual urine volume and QOL score improved in the control group (P<0.01); the number of urination per 24 hours, the number of night urination per day, the volume per urination, the residual urine volume, the daily urgency score, the OABSS score and QOL score improved in the experimental group (P<0.01). The number decrease of urination per 24 hours, the volume decrease of per urination, the daily urgency score decrease, the OABSS score decrease and QOL score decrease were more in the experimental group than in the control group (P<0.01). The adverse reactions included palpitations, increased heart rate, dyspareunia, increased blood pressure, gastric discomfort, postural hypotension, and retrograde ejaculation, and there was no significant difference between two groups (P > 0.05).Conclusion The efficacy of Mirabellone combined with Silodosin on DHIC is better than Silodosin only, and there was no significant increase in drug-related adverse effects.

Key words: Mirabellone, Silodosin, detrusor overactivity with impaired contractile function, drug combination, urinary rehabilitation

丛惠伶, 廖利民, 付光, 查丽华, 杨宇琦, 王艺铮, 李兴, 吴娟, 高轶, 靖华芳. 米拉贝隆联合赛洛多辛治疗逼尿肌过度活动伴收缩功能受损患者的效果[J]. 《中国康复理论与实践》, 2022, 28(4): 473-478.

CONG Huiling, LIAO Limin, FU Guang, ZHA Lihua, YANG Yuqi, WANG Yizheng, LI Xing, WU Juan, GAO Yi, JING Huafang. Effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 473-478.

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组别	n	性别(男/女)/n	年龄/岁	身高/cm	体质量/kg	病程/年	并发神经系统损伤(有/无)/n	既往尿潴留 (有/无)/n
对照组	18	11/7	54.00±17.76	169.5(164.0, 172.0)	67.39±10.37	3.0(2.0, 6.0)	15/3	6/12
试验组	19	12/7	59.32±17.57	170.0(160.5, 171.0)	66.95±9.64	3.0(1.1, 5.5)	16/3	6/13
t/Z值		0.016	0.951	-0.579	-0.134	-0.153	0.005	0.013
P值		0.898	0.366	0.562	0.894	0.878	0.942	0.909

组别	n		每24小时排尿次数/n	每日夜尿次数/n	每次排尿量 /ml	每日尿量 /ml	残余尿量 /ml	每日尿急评分	OABSS 评分	生活质量评分
对照组	18	治疗前	17.07±6.21	3.0(2.0, 4.0)	129.03(103.28, 190.41)	2340.0(2023.3, 2340.0)	145.8±65.7	3.0(2.7,3.0)	7.0(6.0,8.3)	6.0(5.8,6.0)
		治疗后	16.44±5.77	2.7(2.0, 3.8)	130.24(89.42, 188.73)	2300.0(2024.9, 2316.7)	92.3±42.1	3.0(2.3,3.0)	7.0(6.0,8.3)	5.0(5.0,6.0)
		差值	0.63±1.42	0.3(0.0, 1.0)	-6.03(-23.26, 3.99)	40(-61.7, 86.3)	53.6±32.4	0.0(0.0,0.1)	0.0(0.0,1.0)	1.0(0.0,1.0)
试验组	19	治疗前	15.93±5.81	3.30(2.7, 4.7)	155.64(74.00, 178.85)	2100(1340.0, 2233.3)	168.1±83.4	3.0(3.0,3.0)	7.0(5.0,8.0)	6.0(5.0,6.0)
		治疗后	12.65±4.99	2.3(2.0, 3.3)	183.18(107.38, 225.18)	2100(1466.7, 2240.0)	100.6±60.2	2.3(2.3,2.7)	6.0(4.0,7.0)	3.0(3.0,4.0)
		差值	3.28±2.41	1.0(0.3, 1.7)	-36.70(-49.84, -19.31)	-60(-60, -40)	67.5±70.3	0.34(0.33,1.0)	1.0(1.0,2.0)	2.0(2.0,3.0)
t/Z值^a			-0.579	-1.147	-0.046	-1.854	0.898	-1.909	-0.031	-0.959
P值^a			0.567	0.258	0.964	0.066	0.375	0.105	0.988	0.461
t/Z值^b			1.875	-2.946	-1.416	-0.678	7.024	-0.843	-0.791	-2.673
P值^b			0.078	0.003	0.157	0.498	< 0.001	0.399	0.429	0.008
t/Z值^c			5.937	-3.412	-3.823	-1.217	4.188	-3.429	-3.588	-3.934
P值^c			< 0.001	0.001	< 0.001	0.224	0.001	0.001	< 0.001	< 0.001
t/Z值^d			4.047	-1.902	-3.587	-1.231	0.768	-3.242	-3.592	-5.033
P值^d			< 0.001	0.061	< 0.001	0.233	0.448	0.001	< 0.001	< 0.001

不良反应	对照组(n=18)	试验组(n=19)	χ²值	P值
心悸	0	1	0.974	0.514
心率增快	0	2	2.118	0.243
排尿困难	1	1	0.002	0.743
血压升高	0	2	2.118	0.243
胃部不适	1	0	1.085	0.486
体位性低血压	1	0	1.085	0.486
逆行性射精	1	0	1.085	0.486
合计	4	6	0.410	0.395

米拉贝隆联合赛洛多辛治疗逼尿肌过度活动伴收缩功能受损患者的效果

Effect of Mirabegron combined with Silodosin on detrusor hyperactivity with impaired contractile

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