王文涛 王伽利

【摘要】 目的：探討电针、清浊祛毒丸、托特罗定联合治疗前列腺电切（TURP）术后膀胱过度活动症（OAB）的效果。方法：选取2019年1月-2020年3月本院泌尿外科收治的96例TURP术后OAB患者为研究对象。随机数字表法将其分为A组（n=32）、B组（n=32）和C组（n=32）。三组常规进行TURP手术治疗，术后保留尿管5 d。TURP手术当天起，三组均口服托特罗定片至尿管拔除后7 d，此外B组口服清浊祛毒丸至尿管拔除后7 d，A组在B组基础上进行电针针刺治疗，连续治疗至尿管拔除后7 d。评价三组的疗效，统计比较三组术后1、2、3 d膀胱痉挛次数及其持续时间，比较三组治疗后24 h尿失禁次数、24 h排尿次数、初始尿意容量（FDV）和最大膀胱压容量（MCBC），统计比较三组不良反应发生情况。结果：三组治疗总有效率比较，差异有统计学意义（P<0.05）。A组、B组治疗总有效率均高于C组，差异均有统计学意义（P<0.05）。与C组比较，A组、B组术后1、2、3 d膀胱痉挛次数均降低，膀胱痉挛持续时间均缩短，差异均有统计学意义（P<0.05）。与B组比较，A组术后1、2、3 d膀胱痉挛次数均降低，膀胱痉挛持续时间均缩短，差异均有统计学意义（P<0.05）。与C组比较，A组、B组治疗后24 h尿失禁次数、24 h排尿次数均减少，FDV和MCBC均增加，差异均有统计学意义（P<0.05）。与B组比较，A组治疗后24 h尿失禁次数、24 h排尿次数均减少，FDV和MCBC均增加，差异均有统计学意义（P<0.05）。三组治疗期间均未发生明显不良反应。结论：电针、清浊祛毒丸、托特罗定联合治疗TURP术后OAB疗效良好，可有效缓解临床症状，且安全可靠。

【关键词】 电针 清浊祛毒丸 托特罗定 前列腺 电切术 膀胱过度活动症

[Abstract] Objective： To investigate the application effect of electroacupuncture， Qingzhuo Qudu Pill combined with Tolterodine in the treatment of overactive bladder （OAB） after transurethral resection of prostate （TURP）. Method： A total of 96 patients with OAB after TURP admitted to the Department of Urology of our hospital from January 2019 to March 2020 were selected as the research objects. They were divided into group A （n=32）， group B （n=32）  and group C （n=32） by random number table method. TURP was performed routinely in three groups， and the catheter was retained for 5 d after operation. From the day of TURP surgery， three groups were given Tolterodine Tablets orally until 7 d after catheter removal， in addition， group B was given Qingzhuo Qudu Pill orally until 7 d after catheter removal， and group A was treated with electroacupuncture on the basis of group B for continuous treatment until 7 d after catheter removal. The efficacy of three groups were evaluated， the frequency and duration of bladder spasm at 1， 2 and 3 d after operation were compared among three groups， the frequency of 24 h urinary incontinence， 24 h micturition， first desire to void （FDV） and maximum cystometric bladder capacity （MCBC） were compared among three groups， the adverse reactions of three groups were compared. Result： There was statistical significance in the total effective rate among three groups （P<0.05）. The total effective rate of group A and group B were higher than that of group C， with statistical significance （P<0.05）. Compared with group C， the times of bladder spasm and the duration of bladder spasm in group A and group B were decreased at 1， 2 and 3 d after operation， with statistical significance （P<0.05）. Compared with group B， the frequency of bladder spasm and the duration of bladder spasm in group A were all reduced at 1， 2 and 3 d after operation， with statistical significance （P<0.05）. Compared with group C， the frequency of 24 h urinary incontinence and 24 h micturition in group A and group B were decreased， while FDV and MCBC were increased， with statistical significance （P<0.05）. Compared with group B， the frequency of 24 h urinary incontinence and 24 h micturition in group A were decreased， FDV and MCBC were increased， with statistical significance （P<0.05）. There were no obvious adverse reactions in three groups. Conclusion： The combination of electroacupuncture， Qingzhuo Qudu Pill and Tolterodine in the treatment of OAB after TURP has a good effect， which can effectively alleviate clinical symptoms， and is safe and reliable.

[Key words] Electroacupuncture Qingzhuo Qudu Pill Tolterodine Prostate Electrotomy Overactive bladder

First-authors address： Fushun Second Hospital， Fushun 113001， China

doi：10.3969/j.issn.1674-4985.2021.03.022

前列腺增生是老年男性常见病症，经尿道前列腺电切术（transurethral resection of prostate， TURP）是其常用有效治疗方法[1]。膀胱过度活动症（overactive bladder， OAB）是前列腺增生行TURP术后常见并发症，其患者可出现尿频、尿急、夜尿等症状，部分患者可存在急迫性尿失禁，可严重影响患者的生存质量[2]。清浊祛毒丸、托特罗定均是TURP术后OAB治疗药物，此外电针针刺治疗在TURP术后OAB干预中亦可取得良好效果[3-4]。有研究表明多种治疗方法联合应用在TURP术后OAB中可取得更好的疗效[5]。因此，本研究进行组间试验比较，探讨电针、清浊祛毒丸、托特罗定联合治疗TURP术后OAB效果及其安全性，可为TURP术后OAB术后治疗方案的选择和疗效的提高提供参考，现报道如下。……