阿米替林与二甲基亚砜治疗间质性膀胱炎的临床研究

目的探讨口服阿米替林及膀胱灌注二甲基亚砜（DMSO）治疗间质性膀胱炎的临床有效性及安全性。方法2004年7月~2008年5月，采用美国国立肾病、消化病和糖尿病研究所（NIDDK）制定的标准诊断间质性膀胱炎19例，口服阿米替林25mg／d。治疗1周效果不佳的患者加服阿米替林至50mg／d，最大不超过75mg／d。对无效或不能耐受阿米替林副作用的患者加用50％DMSO50mL膀胱灌注连续10次（其中2例用50％DMSO50mL＋1万单位低分子肝素钠灌注），总疗程3个月。观察指标：O’Leary间质性膀胱炎症状指数、间质性膀胱炎问题指数、视觉疼痛模拟量表及排尿日记。结果19例患者均完成治疗，17例患者取得良好的效果，2例患者效果较差。结论口服阿米替林及膀胱灌注DMSO是治疗间质性膀胱炎简单有效的方法，可以缓解患者的临床症状，提高生活质量，其副作用可以被大多数患者耐受。

The therapy effect of amitriptyline and dimethyl sulfoxide for interstitial cystitisa-a clinical research

Objective To investigate the therapy effect and security of amitriptyline （oral administration） and dimethyl sulfoxide （irrigation of bladder） for interstitial cystitis. Methods During July 2004 to May 2008, 19 interstitial cystitis patients （based on diagnose standardization of National Institute of Diabetes and Digestive and Kidney, NIDDK） were administrated amitriptyline for 1 week in the dosage of 25-75 mg per day for oral use. Additionally 50% dimethyl sulfoxide 50 mL irrigation in bladder for 10 times during 3 month was used for those patients who could not stand side effects of amitriptyline or have poor therapy response for amitriptyline. O＇Leary interstitial cystitis symptom index, problem index and urination diary were observed and recorded. Results All the 19 patients were completed the whole therapy process. The therapy effect was satisfactory in 17 patients. 2 patients had poor response for this therapy. Conclusion Amitriptyline peroral administration and dimethyl sulfoxide irrigation in bladder can significantly alleviate interstitial cystitis patient＇s clinical symptom and improve their quality of life. Most interstitial cystitis patients could stand the side effects of this therapy.