Abstract:Objective To investigate the free urine flow rate of tolterodine combined with estrogen in the treatment of adult female patients with overactive bladder (OAB). Methods From September 2012 to September 2014, 144 cases of OAB patients with frequent micturition and urgency treated in the Department of Urology, Nephrology and Gynecology of Affiliated Hospital of Chengde Medical College were selected as the research object and divided into the observation group and the control group accorded to the random draw envelope principle, with 72 cases in each group. The control group was given estrogen therapy, while the observation group was given tolterodine combined with estrogen. Both groups were treated for 3 months. The therapeutic effects, adverse reactions, the free urine flow rate, frequency of urination and urgency at night between the two groups were compared. Results After treatment, the total effective rate in the observation group (98.6%) was higher than that of control group (84.7%), with statistically significant difference (P < 0.05). Before treatment, there were no statistically significant differences between the two groups in the free urine flow rate, frequency of urination and urgency at night (P > 0.05). After treatment, the free urine flow rate in both groups were all higher than those of before treatment, the symptoms of frequency of urination and urgency at night in both groups were lower than those of before treatment, and the indicators above in the observation group improved much more remarkably, with statistically significant differences (all P < 0.05). During the treatment, the incidence of adverse reactions such as dry mouth and constipation in the observation group were lower than those of control group, but with no significant differences (P > 0.05). Conclusion Tolterodine combined with estrogen in the treatment of adult female patients with OAB can increase the free urine flow rate, improve the clinical symptoms, promote the curative effect and has good security. It is worthy of clinical promotion and application.
马光 徐辉 马红亮 韩冰 刘英 王志勇. 托特罗定联合雌激素治疗成年女性膀胱过度活动症对患者自由尿流率的影响[J]. 中国医药导报, 2018, 15(9): 49-52.
MA Guang XU Hui MA Hongliang HAN Bing LIU Ying WANG Zhiyong. The effect of tolterodine combined with estrogen in free urine flow rate in the treatment of adult female patients with overactive bladder. 中国医药导报, 2018, 15(9): 49-52.
[1] Grenabo L,Herschorn S,Kaplan SA,et al. Characteristics of antimuscarinic responders versus suboptimal responders in a randomized clinical trial of patients with overactive bladder symptoms [J]. Curr Med Res Opin,2017,7(31):1-19.
[2] 刘书航,黄涛,尔启东,等.抗胆碱能药物索利那新和托特罗定治疗膀胱过度活动症的比较研究[J].临床医学,2016,36(1):17-18.
[3] Dahlinger D,Aslan S,Pietsch M,et al. Assessment of inhibitory effects on major human cytochrome P450 enzymes by spasmolytics used in the treatment of overactive bladder syndrome [J]. Ther Adv Urol,2017,9(7):163-177.
[4] 张建龙,陈建德,林超禄,等.索利那新治疗经尿道前列腺电切术后膀胱过度活动症的疗效观察[J].海峡药学,2016,28(12):148-150.
[5] 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 Ⅲstudies [J]. Ther Adv Urol,2017,9(6):137-154.
[6] Telek HH,Doluoglu OG,Burcu A,et al. The effects of tolterodine on anterior segment and choroidal thickness in patients with overactive bladder syndrome [J]. Ther Adv Urol,2017,9(5):91-97.
[7] Herschorn S,Nazir J,Ramos B,et al. Cost-effectiveness of mirabegron compared to tolterodine ER 4 mg for overactive bladder in Canada [J]. Can Urol Assoc J,2017,11(3/4):123-130.
[8] 吕共生.托特罗定联合雌激素治疗绝经后女性尿道综合征的临床观察[J].山西医药杂志,2016,45(5):583-584.
[9] Zhang HL,Huang ZG,Qiu Y,et al. Tamsulosin for treatment of lower urinary tract symptoms in women:a systematic review and meta-analysis [J]. Int J Impot Res,2017, 29(4):148-156.
[10] Tijani KH,Akanmu NO,Olatosi JO,et al. Role of tolterodine in the management of postoperative catheter-related bladder discomfort:Findings in a Nigerian teaching hospital [J]. Niger J Clin Pract,2017,20(4):484-488.
[11] 詹自力,祝海洲,王富军,等.坦洛新联合托特罗定对老年膀胱过度活动综合症患者P2X3受体表达的影响[J].现代生物医学进展,2017,17(17):3347-3350.
[12] Kaye JA,Margulis AV,Fortuny J,et al. Cancer Incidence after Initiation of Antimuscarinic Medications for Overactive Bladder in the United Kingdom:Evidence for Protopathic Bias [J]. Pharmacotherapy,2017,37(6):673-683.
[14] Zachariou A,Filiponi M. The effect of extended release tolterodine used for overactive bladder treatment on female sexual function [J]. Int Braz J Urol,2017,43(4):713-720.
[15] Chapple CR,Nazir J,Hakimi Z,et al. Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder:A Retrospective Observational Study in UK Clinical Practice [J]. Eur Urol,2017,72(3):389-399.
[16] 韦高猛,黄勇平,何丽桥.雌二醇、盐酸米多君、托特罗定经阴道给药治疗轻中度FSUI临床观察[J].山东医药,2017,57(28):73-76.
[17] Abbass IM,Caplan EO,Ng DB,et al. Impact of Overactive Bladder Step Therapy Policies on Medication Utilization and Expenditures Among Treated Medicare Members [J]. J Manag Care Spec Pharm,2017,23(1):27-37.
[18] Di Salvo J,Nagabukuro H,Wickham LA,et al. Pharmacological Characterization of a Novel Beta 3Adrenergic Agonist,Vibegron:Evaluation of Antimuscarinic Receptor Selectivity for Combination Therapy for Overactive Bladder [J]. J Pharmacol Exp Ther,2017,360(2):346-355.
[19] 邹羽真,姜微哲,赵蕾蕾,等.索利那新与托特罗定疗效和不良反应的相关文献汇总分析[J].临床药物治疗杂志,2017,15(1):33-37.
[20] Nomura Y,Iitsuka H,Toyoshima J,et al. Pharmacokinetic drug interaction study between overactive bladder drugs mirabegron and tolterodine in Japanese healthy postmenopausal females [J]. Drug Metab Pharmacokinet,2016,31(6):411-416.
[21] Wallis CJ,Lundeen C,Golda N,et al. Anticholinergics for overactive bladder:Temporal trends in prescription and treatment persistence [J]. Can Urol Assoc J,2016,10(7/8):277-280.
[22] Liu W,Teng L,Yu K,et al. Design of hydrogels of 5-hydroxymethyl tolterodine and their studies on pharmacokinetics,pharmacodynamics and transdermal mechanism [J]. Eur J Pharm Sci,2017,1(96):530-541.
[23] Kachru N,Sura S,Chatterjee S,et al. Antimuscarinic Medication Use in Elderly Patients with Overactive Bladder [J]. Drugs Aging,2016,33(10):755-763.
[24] Rajabalaya R,Leen G,Chellian J,et al. Tolterodine Tartrate Proniosomal Gel Transdermal Delivery for Overactive Bladder [J]. Pharmaceutics,2016,8(3):118-120.
[25] Perk S,Wielage RC,Campbell NL,et al. Estimated Budget Impact of Increased Use of Mirabegron,A Novel Treatment for Overactive Bladder [J]. J Manag Care Spec Pharm,2016,22(9):1072-1084.