學術論壇
學術論壇可提供瀏覽者及一般會員閱讀瀏覽學術文章。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
您必須為協會會員或專科醫師才可擁有發表文章及討論之權限。
| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李建達 | 膀胱疼痛症候群/間質性膀胱炎的症狀嚴重程度與對A型肉毒桿菌素的治療反應並不因潰瘍性和非潰瘍性的差異而有所不同 | 2014/5/29 下午 06:40:16 | 0 |
| 原 文 | 題 目 | Ulcerative and nonulcerative forms of bladder pain syndrome/interstitial cystitis do not differ in symptom intensity or response to onabotulinum toxin a. |
| 作 者 | Pinto R, Lopes T, Costa D, Barros S, Silva J, Silva C, Cruz C, Dinis P, Cruz F. | |
| 出 處 | Urology. 2014 May;83(5):1030-4. doi: 10.1016/j.urology.2014.01.018. | |
| 出版日期 | May, 2014. | |
| 評 論 |
目的：為了了解膀胱三角内注射A型肉毒桿菌素(Onabotulinum toxin A)在潰瘍性和非潰瘍性的膀胱疼痛症候群/間質性膀胱炎治療是否會產生不同的症狀以及有效期；並進一步比較注射後尿中NGF、BDNF和GDNF等神經營養素的量。 方法：本實驗注射含10單位A型肉毒桿菌素在1毫升的生理食鹽水至10個膀胱三角注射處共100單位，共有10位潰瘍性與14位非潰瘍性的膀胱疼痛症候群/間質性膀胱炎患者參與本實驗，在注射前，注射一個月後和之後每三個月追蹤等時間點以疼痛視覺類比量表(0-10)，三日排尿日誌，Oleary-Sant指數(OSS)和國際前列腺症狀評估指數(IPSS)中的生活品質問卷(QoL)等評估，同一時間也以ELISA測定尿中NGF、BDNF和GDNF的量。療程以注射後到下次注射前為一週期。 結果：在平均年齡是40 ± 12歲的潰瘍性和47 ± 13歲的非潰瘍性膀胱疼痛症候群/間質性膀胱炎病人中，兩組的疼痛強度、頻率、夜尿、OSS、QoL等底線與尿中NGF、BDNF和GDNF等的平均量值是相同的。除了潰瘍性的病人症狀持續較久外(28.8 ± 11 vs 19.2 ± 8個月，P = 0.018)，A型肉毒桿菌素注射對兩組疼痛強度、頻率、夜尿、OSS、QoL、尿中NGF、BDNF和GDNF等的量都是一樣有顯著的影響並持續約9 ± 2.8(潰瘍型)和10.5 ± 2(非潰瘍型)個月。 結論：在本次對列研究中潰瘍性和非潰瘍性的膀胱疼痛症候群/間質性膀胱炎病人對於膀胱三角内注射A型肉毒桿菌素治療在症狀上和臨床反應的原始與療效上皆有著相似的結果，表示膀胱潰瘍與否和該病徵的疼痛感可能不是直接的相關聯。 |
|
| abstract |
OBJECTIVE: To determine whether intratrigonal Onabotulinum toxin A (OnabotA) injection produces a different symptomatic outcome and duration of effect on ulcerative (Ulc) and nonulcerative (NUlc) bladder pain syndrome/interstitial cystitis (BPS/IC) patients and to compare the urinary levels of neurotrophines (NGF, BDNF, and GDNF) in response to OnabotA. METHODS: Ten Ulc and 14 NUlc bladder pain syndrome/interstitial cystitis patients were included in this study. OnabotA (100 U) was injected in 10 trigonal sites, each receiving 10 U in 1 mL of saline. Outcome measures included pain visual analog scale (0-10), a 3-day voiding chart, OLeary-Sant Score (OSS), and quality of life (QoL) from International Prostate Symptoms Score assessed before treatment, 1 month after injection, and every 3 months afterwards. Urinary NGF, BDNF, and GDNF were accessed using ELISA, at same time points. Treatment duration was determined at the time patients requested another injection. RESULTS: Patients had a mean age of 40 ± 12 years in the Ulc and 47 ± 13 years in the NUlc group (ns). Mean values at baseline of pain intensity, frequency, nocturia, OSS, QoL, and urinary NGF, BDNF, GDNF were identical in the 2 groups. Patients with the Ulc phenotype had a longer duration of symptoms (28.8 ± 11 vs 19.2 ± 8 months, P = .018). Both groups responded equally to OnabotA, with significant improvements in pain intensity, frequency, nocturia, OSS, QoL, and urinary NGF, BDNF, GDNF. The effect lasted for 9 ± 2.8 (Ulc) and 10.5 ± 2 (NUlc) months. CONCLUSION: In this cohort, Ulc and NUlc patients had similar symptoms at baseline and comparable clinical response to intratrigonal OnabotA. These findings suggest that pain may not be directly related with ulcers themselves. |
|
| 回覆發表 | 回覆討論主題內容 | 最後發表 |
| 目前尚無任何相關的回覆資料 | ||