壮医药线点灸治疗经尿道前列腺电切术后膀胱过度活动症的疗效研究

摘要

Objective To evaluate the efficacy and safety of Zhuang Medicine - based thread moxibustion therapy in the treatment of patients with overactive bladder(OAB)following transurethral resection of the prostate(TURP). Methods one of the three treatment groups:Zhuang Medicine - based thread moxibustion therapy in combination with pelvic floor muscle exercises(Group A),tolterodine tartrate tablets in combination with pelvic floor muscle exercises(Group B),and pelvic floor muscle exercises only( Group C). Outcome and safety data were collected and analyzed. Results There was no significant difference in all the variables assessed in three groups before treatment(P ﹥0. 05);while the frequency of urination,urine output ,max flow rate,International Prostate Symptom Score( IPSS)、Quality of Life( QOL) score were statistically significant differences after treatment( P ﹤ 0. 05). There was no significant difference in all the variables assessed between Group A and Group B(P ﹥0. 05). There were no significant differences in the rate of urinary retention(ischuria)and residual urine volume before and after treatment in all three groups(P ﹥0. 05). The proportion of patients with significant adverse reactions in Group A and Group C was significantly lower than in Group B(P ﹤0. 05),but was similar in Group A and Group C(P ﹥0. 05). Conclusion The Zhuang Medicine - based thread moxibustion therapy has an efficacy comparable to that of tolterodine in the treatment of overactive bladder with a good safety profile.%目的：评价壮医药线点灸治疗经尿道前列腺电切术（TUPR）后膀胱过度活动症（OAB）的有效性和安全性。方法选取2011年1月-2013年6月在我院治疗的老年男性 TUPR 后 OAB 患者60例，采用计算机随机数字法随机分为3组，分别采用壮医药线点灸联合膀胱训练（A 组）、口服酒石酸托特罗定片联合膀胱训练（B 组）和单纯膀胱训练（C 组）三种方法治疗。收集3组患者治疗前后相关指标〔包括排尿次数、排尿量、尿量、尿失禁次数、最大尿流率，国际前列腺症状评分表（IPSS）、生活质量评分表（QOL）评分及安全性评估指标〕并进行比较。结果3组治疗前各观测指标比较差异均无统计学意义（ P ﹥0.05）；而治疗后排尿次数、排尿量、最大尿流率、IPSS 评分、QOL 评分间差异均有统计学意义（P ﹤0.05），其中 A 组与 C 组、B 组与 C 组比较差异均有统计学意义（ P ﹤0.05），而 A 组与 B 组比较差异无统计学意义（P ﹥0.05）。3组治疗前后 B 超测定的残余尿量及残余尿异常发生率间差异均无统计学意义（P ﹥0.05）。3组总不良反应发生率间差异有统计学意义（P ﹤0.05），其中 A、C 组均低于 B 组差异有统计学意义（P ﹤0.05），而 A 组与 C 组比较差异无统计学意义（P ﹥0.05）。结论壮医药线点灸在治疗 TUPR 后 OAB方面的疗效等同于口服酒石酸托特罗定片的疗效，但不良反应发生率更低。