山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (10): 72-79.doi: 10.6040/j.issn.1671-7554.0.2024.1336
• 临床医学 • 上一篇
贾振存1,2,3,吴晨睿3,赵德龙1,朱可嘉1,丁森泰1,3
JIA Zhencun1,2,3, WU Chenrui3, ZHAO Delong1, ZHU Kejia1, DING Sentai1,3
摘要: 目的 探讨八宝丹胶囊联合米拉贝隆治疗女性膀胱过度活动症(overactive bladder, OAB)的临床疗效及安全性。 方法 选取2021年 10月至 2023年 1月在山东第一医科大学附属省立医院就诊的60例女性OAB患者为研究对象,按随机数字表法进行分组,30例给予八宝丹胶囊和米拉贝隆联合治疗(试验组)、30例给予安慰剂和米拉贝隆联合治疗(对照组),治疗12周。分别于治疗前及治疗后给予女性OAB症状评分(overactive bladder syndrome score, OABSS)、生活质量评估(quality of life, QOL)、记录排尿日记,检测治疗前后一氧化氮(nitric oxide, NO)、内皮素-1(endothelin-1,ET-1)及炎症因子相关指标白细胞介素-6(interleukin- 6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)的水平,比较2个组的临床疗效及不良反应的发生率和严重程度。 结果 治疗后 4周、12周,试验组OABSS低于对照组(P=0.001,P<0.001);两组QOL评分均低于治疗前,且试验组低于对照组(P<0.001);治疗后12周两组TNF-α、IL-6、ET-1表达降低,NO水平升高,组内比较差异均有统计学意义(P<0.001);试验组和对照组治疗总有效率分别为90.0%、73.0%,差异无统计学意义(P=0.182);治疗过程中,两组均未出现Ⅲ级及以上的不良反应。 结论 八宝丹胶囊与米拉贝隆联合使用治疗女性OAB能明显减轻患者的临床症状,缩短治疗周期,减轻患者痛苦,其疗效优于单用米拉贝隆。
中图分类号:
| [1] 郝海东. 经皮低频电刺激联合索利那新治疗女性膀胱过度活动症的疗效分析[D]. 十堰: 湖北医药学院, 2024. [2] Zhang L, Cai N, Mo L, et al. Global prevalence of overactive bladder: a systematic review and meta-analysis[J]. Int Urogynecol J, 2025. doi:10.1007/s00192-024-06029-2 [3] Henry Lai H, Vetter J, Jain S, et al. Systemic nonurological symptoms in patients with overactive bladder[J]. J Urol, 2016, 196(2): 467-472. [4] 陈升星,杨斌斌,应家佩,等.电针联合盆底肌训练治疗女性膀胱过度活动症的临床研究[J].上海针灸杂志,2024,43(11):1239-1244. CHEN Shengxing, YANG Binbin, YING Jiapei, et al. Clinical study on electroacupuncture plus pelvic floor muscle training for female overactive bladder bladder[J]. Shanghai Journal of Acupuncture and Moxibustion, 2024, 43(11): 1239-1244. [5] 贾振存, 郭安东, 曹吉双, 等. 八宝丹胶囊联合米拉贝隆治疗伴Ⅲ型前列腺炎膀胱过度活动症的临床效果[J/OL]. 泌尿外科杂志(电子版), 2024, 16(2): 45-49. JIA Zhencun, GUO Andong, CAO Jishuang, et al. Clinical efficacy of Babaodan combined with Milabelon in the treatment of overactive bladder with type Ⅲ prostatitis[J/OL]. Journal of Urology for Clinicians(Electronic Version), 2024, 16(2): 45-49. [6] Homma Y, Yoshida M, Seki N, et al. Symptom assessment tool for overactive bladder syndrome: overactive bladder symptom score[J]. Urology, 2006, 68(2): 318-323. [7] Meng LF, Tian ZJ, Diao TX, et al. Variable-versus constant-frequency sacral neuromodulation in black-zone overactive bladder patients: a study protocol for a multicenter, prospective, randomized, blind, self-controlled trial[J]. Transl Androl Urol, 2021, 10(1): 504-511. [8] 毛岚, 詹辉, 栾婷, 等. 尿动力学在女性膀胱过度活动症诊疗中的应用研究进展[J]. 昆明医科大学学报, 2023, 44(4): 154-158. MAO Lan, ZHAN Hui, LUAN Ting, et al. Urodynamics in the diagnosis and treatment of overactive bladder among females[J]. Journal of Kunming Medical University, 2023, 44(4): 154-158. [9] Jin F, Huang YQ, Zhang YL, et al. Comment on “the association between different levels of depression and overactive bladder: a cross-sectional study of the 2005-2018 national health and nutrition examination survey” by Muwei Li et al[J]. Neurourol Urodyn, 2025, 44(2): 522-523. [10] Guzman-Negron JM, Goldman HB. New devices and technologies for the management of overactive bladder[J]. Curr Urol Rep, 2017, 18(12): 94. doi:10.1007/s11934-017-0739-y [11] 卢燨, 陈勇, 董小勇. 索利那新联合米拉贝隆治疗女性膀胱过度活动症的疗效及安全性[J]. 重庆医学, 2020, 49(10): 1611-1614. LU Xi, CHEN Yong, DONG Xiaoyong. Efficacy and safety of Solifenacin combined with Mirabegron in women with overactive bladder[J]. Chongqing Medicine, 2020, 49(10): 1611-1614. [12] 史本康. 膀胱过度活动症的诊断及治疗进展[J]. 山东大学学报(医学版), 2018, 56(3): 1-5. SHI Benkang. Advances in the diagnosis and treatment of overactive bladder[J]. Journal of Shandong University(Health Sciences), 2018, 56(3): 1-5. [13] 崔占武,赵建中. 膀胱过度活动症治疗药物临床研究进展[J]. 中国临床药理学杂志, 2021, 37(4): 473-478. CUI Zhanwu,ZHAO Jianzhong. Clinical research progress on therapeutic drugs for overactive bladder[J]. The Chinese Journal of Clinical Pharmacology, 2021, 37(4): 473-478. [14] Hutchinson A, Nesbitt A, Joshi A, et al. Overactive bladder syndrome: management and treatment options[J]. Aust J Gen Pract, 2020, 49(9): 593-598. [15] Tubaro A, Batista JE, Nitti VW, et al. Efficacy and safety of daily mirabegron 50 Mg in male patients with overactive bladder: a critical analysis of five phase III studies[J]. Ther Adv Urol, 2017, 9(6): 137-154. [16] 李碧怡, 彭嘉健, 邝敏华, 等. 八正散加减联合超声药物透入治疗女性膀胱过度活动症的临床疗效[J]. 中医临床研究, 2021, 13(16): 109-112. LI Biyi, Peng Jiajian, Kuang Minhua, et al. Clinical efficacy of Bazheng San plus ultrasound drug penetration treatment on overactive bladder syndrome[J]. Clinical Journal of Chinese Medicine, 2021, 13(16): 109-112. [17] 吴若愚, 汤康敏, 宋奇翔. 膀胱过度活动症的热点问题及治疗进展[J]. 临床外科杂志, 2024, 32(2): 113-117. WU Ruoyu, TANG Kangmin, SONG Qixiang. Hot topics and treatment progress of overactive bladder[J]. Journal of Clinical Surgery, 2024, 32(2): 113-117. [18] 李董平. 中医治疗代谢综合征用药规律分析及Meta分析[D]. 广州: 暨南大学, 2017. [19] 徐帅,张玲,赵玉清,等.中药多靶点干预代谢综合征血管内皮损伤研究进展[J]. 中国药物警戒, 2023, 20(3): 353-359. [20] 高远,袁志浩,王永鑫,等.八宝丹胶囊预防导尿管相关性尿路感染的效果[J]. 郑州大学学报(医学版), 2024, 59(5): 701-703. GAO Yuan, YUAN Zhihao, WANG Yongxin, et al. Efficacy of Babaodan capsules in preventing catheter-associated urinary tract infection[J]. Journal of Zhengzhou University(Medical Sciences), 2024, 59(5): 701-703. [21] Li J, Ma XJ, Xu FY, et al. Babaodan overcomes cisplatin resistance in cholangiocarcinoma via inhibiting YAP1[J]. Pharm Biol, 2024, 62(1): 314-325. [22] Cheng ZX, Zhuo S, Guo S, et al. Quantification and discovery of quality control chemical markers for Ba-Bao-Dan by UPLC-MS/MS combined with chemometrics[J]. J Pharm Biomed Anal, 2021, 204: 114273. doi:10.1016/j.jpba.2021.114273 [23] Qian J, Xu HD, Lv DQ, et al. Babaodan controls excessive immune responses and may represent a cytokine-targeted agent suitable for COVID-19 treatment[J]. Biomed Pharmacother, 2021, 139: 111586. doi:10.1016/j.biopha.2021.111586 [24] Li YF, Sheng HD, Qian J, et al. The Chinese medicine babaodan suppresses LPS-induced sepsis by inhibiting NLRP3-mediated inflammasome activation[J]. J Ethnopharmacol, 2022, 292: 115205. doi:10.1016/j.jep.2022.115205 [25] Lu L, Wu C, Lu BJ, et al. BabaoDan cures hepatic encephalopathy by decreasing ammonia levels and alleviating inflammation in rats[J]. J Ethnopharmacol, 2020, 249: 112301. doi:10.1016/j.jep.2019.112301 [26] 赵棋琴, 陈进晓, 沃达, 等. 八宝丹胶囊抑制TNF-α诱导C2C12成肌细胞Atrogin-1表达的研究[J]. 福建中医药, 2022, 53(7): 21-25. [27] 黄彬, 白雪松, 彭军, 等. 八宝丹胶囊基础和临床应用研究进展[J]. 福建中医药, 2018, 49(1): 83-85. [28] Sheng DD, Zhao SM, Gao L, et al. BabaoDan attenuates high-fat diet-induced non-alcoholic fatty liver disease via activation of AMPK signaling[J]. Cell Biosci, 2019, 9: 77. doi:10.1186/s13578-019-0339-2 [29] Hennigs JK, Matuszcak C, Trepel M, et al. Vascular endothelial cells: heterogeneity and targeting approaches[J]. Cells, 2021, 10(10): 2712. doi:10.3390/cells10102712 [30] Jourde-Chiche N, Fakhouri F, Dou L, et al. Endothelium structure and function in kidney health and disease[J]. Nat Rev Nephrol, 2019, 15(2): 87-108. [31] Choi YK, Kim YM. Regulation of endothelial and vascular functions by carbon monoxide via crosstalk with nitric oxide[J]. Front Cardiovasc Med, 2021, 8: 649630. doi:10.3389/fcvm.2021.649630 [32] Radi R. Oxygen radicals, nitric oxide, and peroxynitrite: redox pathways in molecular medicine[J]. Proc Natl Acad Sci USA, 2018, 115(23): 5839-5848. [33] 张莉, 夏彬凤, 黄慧慧, 等. 血管内皮生长因子及其受体抑制剂相关性高血压病理生理机制及临床诊疗的研究进展[J]. 吉林大学学报(医学版), 2024, 50(3): 854-863. ZHANG Li, XIA Binfeng, HUANG Huihui, et al. Research progress in pathophysiological mechanism and clinical diagnosis and treatment of hypertension associated with vascular endothelial growth factor and its receptor inhibitors[J]. Journal of Jilin University(Medicine Edition), 2024, 50(3): 854-863. [34] Jankowich M, Choudhary G. Endothelin-1 levels and cardiovascular events[J]. Trends Cardiovasc Med, 2020, 30(1): 1-8. [35] 贾远航,江义霞,何振华,等.SENP-1/HIF-1α通路对慢性间歇性低氧诱导大鼠血管内皮损伤的影响[J].吉林大学学报(医学版), 2024, 50(4): 1026-1034. JIA Yuanhang, JIANG Yixia, HE Zhenhua, et al. Effect of SENP-1/HIF-1α pathway on vascular endothelial injury in rats with chronic intermittent hypoxia[J]. Journal of Jilin University(Medicine Edition), 2024, 50(4): 1026-1034. [36] 韩明, 王亚辉, 杜昌国, 等. 膀胱癌患者术后尿路感染免疫状态与炎症介质的变化[J]. 海南医学, 2020, 31(11): 1380-1383. HAN Ming, WANG Yahui, DU Changguo, et al. Changes of immune status and inflammatory mediators in the postoperative urinary tract infection of patients with bladder cancer[J]. Hainan Medical Journal, 2020, 31(11): 1380-1383. [37] Liu HT, Jiang YH, Kuo HC. Increased serum adipokines implicate chronic inflammation in the pathogenesis of overactive bladder syndrome refractory to antimuscarinic therapy[J]. PLoS One, 2013, 8(10): e76706. doi:10.1371/journal.pone.0076706 |
| [1] | 冯绪强,高萍,孙超,陶琳,闫根全,冷冰. 替加环素治疗感染性疾病临床疗效及影响因素[J]. 山东大学学报 (医学版), 2024, 62(12): 11-20. |
| [2] | 张国英,王静,王传霞,张玄,迟翔宇,李青. 经鼻高流量湿化氧疗对急性心源性肺水肿患者的临床疗效[J]. 山东大学学报 (医学版), 2020, 58(1): 77-80. |
| [3] | 潘艳艳,孙永超,刘雪梅,张洪霞,周蔚然,赵翠芬. 尿液α1-抗胰蛋白酶、尿转铁蛋白水平与小儿原发性肾病综合征激素治疗效果的关联分析[J]. 山东大学学报 (医学版), 2019, 57(12): 74-79. |
| [4] | 耿二冬,宁涓. 阿替洛尔对急性冠脉综合征合并心律失常患者的临床疗效及预后影响[J]. 山东大学学报 (医学版), 2018, 56(5): 70-73. |
| [5] | 种铁,陈琦. 米拉贝隆治疗膀胱过度活动症的临床应用[J]. 山东大学学报 (医学版), 2018, 56(3): 6-11. |
| [6] | 张明明,安永辉,韩彩莉,张瑛琪,马明,李娜,邹长鹏. CIK细胞联合光动力治疗中晚期食管癌的疗效观察[J]. 山东大学学报(医学版), 2016, 54(1): 38-41. |
| [7] | 樊庆凯, 龚维明, 宁斌, 宋宏亮, 蔚建鲁, 贾堂宏. PKP治疗骨质疏松性多节段椎体压缩性骨折的临床疗效[J]. 山东大学学报(医学版), 2014, 52(11): 73-76. |
| [8] | 王秉翔1,聂林1, 蒲华清2,张志勉2. Dynesys动态稳定系统与腰椎后路椎体间融合术术后疗效的Meta分析[J]. 山东大学学报(医学版), 2013, 51(9): 72-78. |
| [9] | 李波翰,吴东进,宋杨,张程,赵杰,李德全,张颖哲,马胜忠,高春正. 周围神经吻合后神经生长因子-纤维蛋白胶包埋的临床观察[J]. 山东大学学报(医学版), 2013, 51(7): 58-61. |
| [10] | 王美建,侯新国,宋君,周克华,杨俊朋,肖芳,刘继东,邓楠,周晓莹,陈丽. 2型糖尿病患者胰岛素治疗结构化管理模式研究[J]. 山东大学学报(医学版), 2012, 50(10): 1-5. |
| [11] | 吴玉生1,刘雪莹1,姜文杰2,张道杰3. 麝香注射液对急性脑梗死患者血单核细胞趋化蛋白-1水平及中性粒细胞CD11b/CD18表达的影响[J]. 山东大学学报(医学版), 2010, 48(6): 111-114. |
|
||