CAJ | 학술논문

目的探讨阿米替林治疗间质性膀胱炎的有效性和安全性. 方法采用前瞻性研究.间质性膀胱炎患者54例,病程19～72个月,平均(40.7±11.6)个月.口服阿米替林治疗,起始剂量25 mg/次,每晚1次.1周后,若症状不缓解,可加量至50 mg/次;再观察1周,若症状仍不缓解,则可加量至75 mg/次;维持能够缓解症状的最小剂量,总疗程3个月.观察用药前及用药3个月后患者的临床症状(每日排尿次数、最大排尿容量、尿痛程度评分)和O'Leary-Sant间质性膀胱炎问卷表评分及生活质量评分情况.并记录不良反应发生情况. 结果 ①用药3个月后每日排尿次数明显减少,治疗前后分别为(28.5±8.4)和(15.6±3.3)次;最大排尿容量明显增加,治疗前后分别为(108.7±62.2)和(171.0±53.9)ml;尿痛程度评分明显下降,治疗前后分别为6.4±1.5和2.2±1.5,上述指标用药前后相比,差异均有统计学意义(P<0.01).②患者用药3个月后问卷评分和生活质量评分均明显减少,治疗前后分别为26.9±4.0和13.7±5.7及5.5±0.5和2.5±0.6;用药前后比较,差异有统计学意义(P<0.01).③45例在服药第1个月内有不同程度的困倦,43例1个月后自行缓解,2例由于困倦严重且不能缓解而停药.10例服药3个月后体质量增加(5.8±1.8)kg.11例有轻度便秘症状,可以耐受.9例有口干症状,可以耐受.3例出现重度排尿困难,停药后改为其他方法治疗. 结论阿米替林口服治疗能有效缓解间质性膀胱炎患者的临床症状,改善生活质量,且耐受性及安全性好.
목적 탐토아미체림치료간질성방광염적유효성화안전성. 방법 채용전첨성연구.간질성방광염환자54례,병정19～72개월,평균(40.7±11.6)개월.구복아미체림치료,기시제량25 mg/차,매만1차.1주후,약증상불완해,가가량지50 mg/차;재관찰1주,약증상잉불완해,칙가가량지75 mg/차;유지능구완해증상적최소제량,총료정3개월.관찰용약전급용약3개월후환자적림상증상(매일배뇨차수、최대배뇨용량、뇨통정도평분)화O'Leary-Sant간질성방광염문권표평분급생활질량평분정황.병기록불량반응발생정황. 결과 ①용약3개월후매일배뇨차수명현감소,치료전후분별위(28.5±8.4)화(15.6±3.3)차;최대배뇨용량명현증가,치료전후분별위(108.7±62.2)화(171.0±53.9)ml;뇨통정도평분명현하강,치료전후분별위6.4±1.5화2.2±1.5,상술지표용약전후상비,차이균유통계학의의(P<0.01).②환자용약3개월후문권평분화생활질량평분균명현감소,치료전후분별위26.9±4.0화13.7±5.7급5.5±0.5화2.5±0.6;용약전후비교,차이유통계학의의(P<0.01).③45례재복약제1개월내유불동정도적곤권,43례1개월후자행완해,2례유우곤권엄중차불능완해이정약.10례복약3개월후체질량증가(5.8±1.8)kg.11례유경도편비증상,가이내수.9례유구간증상,가이내수.3례출현중도배뇨곤난,정약후개위기타방법치료. 결론 아미체림구복치료능유효완해간질성방광염환자적림상증상,개선생활질량,차내수성급안전성호.
Objective To evaluate the safety and efficacy of the trieyelic antidepressant amitrip tyline in the treatment of patient with interstitial cystitis (IC). Methods Fifty-four patients diagnosed with IC were recruited in this prospective three-month clinical trial. The average course of patient's history was (40. 75±11.6)months, ranging from 19-72 months. All the 54 patients received oral administration of amitriptyline for 3 months. The initial dosage of amitriptyline was 25 mg per night. After 1 week, the dosage would be increased to 50 mg if the symptom didn't relief. After another 1 week, the dosage would be increased to 75 mg if the symptoms were still exist. The patients were kept on a minimum dosage which could relief patient's IC symptoms. Clinical symptoms, such as frequency per day, maximal voiding volume and odynuria degree score, O'Leary-Sant IC symptom and problem index and quality of life score were recorded and assessed at the beginning of the study and 3 months after the treatment. Results After 3 month treatment, the pre-treatment vs post-treatment parameters of frequency per day was 28.5±8. 4 vs 15.6±3.3, odynuria degree score was 6.4± 1.5 vs 2.2±1.5 and maximal voiding volume was 108.7±62.2 ml vs 171.0±53.9 ml respectively. There was significant improvement in all the above parameters comparing between the baseline and 3 months after the treatment. At the 3 months after treatment, the pre-treatment vs post-treatment O 'Leary-Sant IC symptom and problem index and quality of life score was 26.9±4.0 vs 13.7±5.7 and 5.5±0. 5 vs 2.5±0. 6, receptively. There were significant decreases compared with the baseline. There was no serious adverse event after taking amitriptyline. Drowsiness occurred in 45 of the 54 patients at the first month administration. Of the 45 patients, 43 patients relieved and 2 patients quitted from the study. Mild weight increase was noted in 10 patients. Mild constipation was recorded in 11 patients. Mouth dryness was recorded in 9 patients. Three patients quitted because of suffering dysuria. Conclusions Oral administration of amitriptyline can effectively relieve clinical symptoms of IC and improve IC patients" quality of life. The side effects are well tolerated.