坦索罗辛联合奥昔布宁治疗前列腺增生逼尿肌不稳定33例

目的评价坦索罗辛联合奥昔布宁治疗前列腺增生（BPH）并逼尿肌不稳定的有效性及安全性。方法采用随机数字表法将66例患者随机分为两组各33例，联合用药组13服坦索罗辛0．2mg／次（Qd）＋奥昔布宁5ms／次（Bid），对照组口服坦索罗辛0．2mg／次（Qd），持续4周。比较两组治疗前后平均I—PSS、SSS、QOL评分以及尿流率、残余尿。结果两组均无因药物副作用中途退出者。治疗前，联合用药组和对照组平均I—PSS评分、SSS评分、QOL评分、尿流率以及残余尿量分别为（22．3±1．7）分、（13．5±1．2）分、（4．3±0．8）分、（11．3±4．3）ml／s、（25．2±3．3）ml和（24．3±2．3）分、（13．8±5．3）分、（4．5±1．7）分、（10．5±2．5）ml／s、（28．6±3．8）ml，差别无统计学意义（P〉0．05）；治疗后两组平均I—PSS、SSS、QOL评分分别为（12．3±2．1）分、（5．4±0．8）分、（1．8±0．4）分和（15．2±2．5）分、（9．6±2．5）分、（3．9±1．4）分，差别有统计学意义（P〈0．01）；平均尿流率和残余尿分别为（16．8±2．3）ml／s、（10．8±4．1）ml和（13．6±3．1）ml／s、（16．8±3．1）ml，差别无统计学意义（P〉0．01）。结论哈乐联合奥昔布宁可改善BPH逼尿肌不稳定患者的下尿路症状和生活质量。对轻至中度膀胱出口梗阻（BOO）患者，应用小剂量奥昔布宁是安全的。

Tamsulosin combine with oxybutynin in the treatment of bladder outlet obstruction with detrusor instability

Objective To evaluate the effectiveness and safety of tamsulosin combine with oxybutynin in the treatment of bladder outlet obstruction with detrusor instability. Methods 66 men of BPH with LUTS were identified urodynamieally mild or moderate BOO with DI. The mean age was 67.3 years. The patients were random- ized into 2 groups. The study group was given amsulosin 0.2mg/d plus oxybutynin 5rag twice/d, and the control group was given tamsulosin 0.2mg/d. Reevaluation with I - PSS, SSS, QOL, urine flow rate and residual volume were done after 4 weeks. Results No patient withdrew because of side effect. The mean I - PSS, SSS, QOL scores, average urine flow and residual urine pre - treatment in study and control groups were 22. 3 ± 1.7,13.5 ± 1.2,4.3 ＋0.8.11.3 ±4.3 ml/s,25.2 ±3.3 mt and 24. 3 ±2.3,13.8 ±5.3,4.5 ±1.7,10.5 ±2.5 ml/s,28. 6 ± 3.8 ml, respectively （ P 〉 0. 05 ）. I - PSS, SSS, QOL score post - therapy in 2 groups were 12. 3 ± 2. 1, 5.4 ± 0. 8, 1. 8 ± 0.4 and 15.2 ± 2. 5,9. 6 ± 2.5,3.9 ± 1.4 with significant difference（ P 〈0. 01 ）. The mean urine flow and residual volume of 2 groups were 16. 8 ± 2. 3 ml/s, 10. 8 ±4. 1 ml and 13. 6± 3. 1 ml/s, 16. 8 ± 3. 1 ml （P 〉 0. 01 ）. It suggested combination therapy can improve the patients LUTS scores with no significantly effecting to patients＇ urination. Conclusion Combination therapy of tamsulosin plus oxybutynin can improve LUTS and QOL for patients of BOO with DI. For patients with mild and moderate BOO a suitable dosage of oxybutynin is safe.