阿米替林治疗间质性膀胱炎的临床研究

目的 探讨阿米替林治疗间质性膀胱炎的有效性和安全性. 方法 采用前瞻性研究.间质性膀胱炎患者54例,病程19～72个月,平均(40.7±11.6)个月.口服阿米替林治疗,起始剂量25 mg/次,每晚1次.1周后,若症状不缓解,可加量至50 mg/次;再观察1周,若症状仍不缓解,则可加量至75 mg/次;维持能够缓解症状的最小剂量,总疗程3个月.观察用药前及用药3个月后患者的临床症状(每日排尿次数、最大排尿容量、尿痛程度评分)和O'Leary-Sant间质性膀胱炎问卷表评分及生活质量评分情况.并记录不良反应发生情况. 结果 ①用药3个月后每日排尿次数明显减少,治疗前后分别为(28.5±8.4)和(15.6±3.3)次;最大排尿容量明显增加,治疗前后分别为(108.7±62.2)和(171.0±53.9)ml;尿痛程度评分明显下降,治疗前后分别为6.4±1.5和2.2±1.5,上述指标用药前后相比,差异均有统计学意义(P<0.01).②患者用药3个月后问卷评分和生活质量评分均明显减少,治疗前后分别为26.9±4.0和13.7±5.7及5.5±0.5和2.5±0.6;用药前后比较,差异有统计学意义(P<0.01).③45例在服药第1个月内有不同程度的困倦,43例1个月后自行缓解,2例由于困倦严重且不能缓解而停药.10例服药3个月后体质量增加(5.8±1.8)kg.11例有轻度便秘症状,可以耐受.9例有口干症状,可以耐受.3例出现重度排尿困难,停药后改为其他方法治疗. 结论 阿米替林口服治疗能有效缓解间质性膀胱炎患者的临床症状,改善生活质量,且耐受性及安全性好.

Application of amitriptyline in the treatment of interstitial cystitis

Objective To evaluate the safety and efficacy of the trieyelic antidepressant amitrip tyline in the treatment of patient with interstitial cystitis (IC). Methods Fifty-four patients diagnosed with IC were recruited in this prospective three-month clinical trial. The average course of patient's history was (40. 75±11.6)months, ranging from 19-72 months. All the 54 patients received oral administration of amitriptyline for 3 months. The initial dosage of amitriptyline was 25 mg per night. After 1 week, the dosage would be increased to 50 mg if the symptom didn't relief. After another 1 week, the dosage would be increased to 75 mg if the symptoms were still exist. The patients were kept on a minimum dosage which could relief patient's IC symptoms. Clinical symptoms, such as frequency per day, maximal voiding volume and odynuria degree score, O'Leary-Sant IC symptom and problem index and quality of life score were recorded and assessed at the beginning of the study and 3 months after the treatment. Results After 3 month treatment, the pre-treatment vs post-treatment parameters of frequency per day was 28.5±8. 4 vs 15.6±3.3, odynuria degree score was 6.4± 1.5 vs 2.2±1.5 and maximal voiding volume was 108.7±62.2 ml vs 171.0±53.9 ml respectively. There was significant improvement in all the above parameters comparing between the baseline and 3 months after the treatment. At the 3 months after treatment, the pre-treatment vs post-treatment O 'Leary-Sant IC symptom and problem index and quality of life score was 26.9±4.0 vs 13.7±5.7 and 5.5±0. 5 vs 2.5±0. 6, receptively. There were significant decreases compared with the baseline. There was no serious adverse event after taking amitriptyline. Drowsiness occurred in 45 of the 54 patients at the first month administration. Of the 45 patients, 43 patients relieved and 2 patients quitted from the study. Mild weight increase was noted in 10 patients. Mild constipation was recorded in 11 patients. Mouth dryness was recorded in 9 patients. Three patients quitted because of suffering dysuria. Conclusions Oral administration of amitriptyline can effectively relieve clinical symptoms of IC and improve IC patients" quality of life. The side effects are well tolerated.