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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 鍾旭東 | 合併Doxazosin and Tenoxicam治療男性下泌尿道症狀 | 2009/11/26 下午 02:11:37 | 0 |
| 原 文 | 題 目 | Combination Therapy With Doxazosin and Tenoxicam for the Management of Lower Urinary Tract Symptoms |
| 作 者 | Ozdemir I, Bozkurt O, Demir O, Aslan G, Esen AA. | |
| 出 處 | UROLOGY | |
| 出版日期 | 2009 Aug; 74:431-5. | |
| 評 論 | 男性下泌尿道症狀在過去就有研究指出， 除了解剖位置上膀胱出口的前列腺造成阻塞之病因之外， 其他可能的病因包括自律神經的功能失調、 膀胱頸的神經協調功能、 骨盆腔器官包括直腸女性生殖系統的相互影響以及所謂的全身性發炎反應或是前列腺組織內之發炎反應。本篇論文的研究方式為隨機分配男性排尿障礙病患投與Doxazosin 或合併Doxazosin加上Tenoxicam (一種COX-2 抑制劑 可抑制發炎反應)。 結果發現的確在這樣的男性病患的療效上 ，合併治療的效果在Overactive Bladder Symptom Score (OABSS) 、International Index of Erectile Function (IIEF) 、The International Prostatic Symptom Score (IPSS)、IPSS-Quality of Life (IPSS-QoL)這些重要的指標上， 較單一給予Doxazosin好。 這個結果或許提供了一些臨床的證據來說明發炎反應(無法區別是全身性或是局部性發炎反應)的確在男性排尿障礙的病生理上有其角色。 | |
| abstract |
OBJECTIVE: To compare the efficacy and safety of a combination therapy, doxazosin plus tenoxicam, and doxazosin alone for lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), as various combination therapies increase the efficacy of medical therapy. Alpha blocker agents have been widely used for the treatment of LUTS secondary to BPH. METHOD: Fifty-seven patients complaining of LUTS secondary to BPH were enrolled in this clinical trial. Patients were randomly assigned to receive doxazosin 4 mg or doxazosin 4 mg plus tenoxicam 20 mg treatment. Patients were evaluated for BPH according to the European Association of Urology and American Urological Association clinical guidelines. In addition, patients were assessed with Overactive Bladder Symptom Score (OABSS) and International Index of Erectile Function (IIEF). Patients were reevaluated after a 6-week treatment course. The International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Qmax), and average urinary flow rates (AFR) were determined at baseline and again at 6 weeks as efficacy parameters. RESULTS: The total IPSS, IPSS-QoL, and OABSS decreased significantly in both tenoxicam plus doxazosin group and doxazosin alone group compared with baseline (p<0.01). Also, Qmax and AFR significantly improved in both groups (p<0.01). The improvements in IPSS, IPSS-QoL, and OABSS were significantly better in patients treated with combination therapy (p <0.05). CONCLUSIONS: COX-2 inhibitors in combination with an alpha blocker may increase the effectiveness of the therapy for LUTS secondary to BPH without significant effects on side effect profile |
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