Additive and Subtraction Effect of Shenqi Shenqi Wan on Urodynamics and Neuromodulation in Patients with Overactive Bladder

XU Hang; FENG Xiao-mei; ZENG Min

doi:10.13422/j.cnki.syfjx.20181831

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Additive and Subtraction Effect of Shenqi Shenqi Wan on Urodynamics and Neuromodulation in Patients with Overactive Bladder

更新时间：2024-01-04

- Additive and Subtraction Effect of Shenqi Shenqi Wan on Urodynamics and Neuromodulation in Patients with Overactive Bladder
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 24, Issue 18, Pages: 186-191(2018)
- 作者机构：
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- DOI：10.13422/j.cnki.syfjx.20181831
  CLC： R277.5
- Published：2018
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XU Hang, FENG Xiao-mei, ZENG Min. Additive and Subtraction Effect of Shenqi Shenqi Wan on Urodynamics and Neuromodulation in Patients with Overactive Bladder[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(18): 186-191.
DOI：

XU Hang, FENG Xiao-mei, ZENG Min. Additive and Subtraction Effect of Shenqi Shenqi Wan on Urodynamics and Neuromodulation in Patients with Overactive Bladder[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(18): 186-191. DOI： 10.13422/j.cnki.syfjx.20181831.

摘要

目的：观察参芪肾气丸加减治疗肾虚证膀胱过度活动症（OAB）的临床疗效及对尿动力学和尿液神经生长因子（NGF），脑源性神经营养因（BDNF）的影响。方法：将108例患者，采用随机按数字表法分为对照组和观察组各54例。对照组口服托特罗定片，2 mg/次，2次/d；观察组在对照组治疗的基础上加用参芪肾气丸加减，1剂/d。两组疗程均为连续治疗8周。患者记录排尿日记（24 h排尿次数、夜尿次数、尿急次数、漏尿次数）；进行治疗前后膀胱过度活动症症状评分（OABSS），尿急程度评分（IUSS），主要症状和肾虚证评分；采用膀胱过度活动症调查表（OAB-q）评价治疗前后生活质量；测量治疗前后最大尿流率（MFR），残余尿量（PVR），急迫尿意容量（VUD），初始尿意容量（VFD）等尿动力学指标；检测治疗前后NGF和BDNF，并计算与尿肌酐（UCr）的比值即NGF/UCr和BDNF/UCr。结果：观察组患者临床总有效率为92.59%，高于对照组75.93%（χ2=5.654，P<0.05）；治观察组24 h排尿次数、夜尿次数、尿急次数、漏尿次数均少于对照组（P<0.01）；观察组OABSS，IUSS，主要症状和肾虚证评分均低于对照组（P<0.01）；观察组VFD，VUD和MFR均多于对照组，PVR少于对照组（P<0.01）；观察组OAB-q量表症状评分均低于对照组，应对方式等4个维度评分均高于对照组（P<0.01）；治疗后观察组患者尿NGF，BDNF水平和NGF/UCr，BDNF/UCr均低于对照组（P<0.01）。结论：采用参芪肾气丸加减联合托特罗定片治疗肾虚型OAB，可明显改善临床症状、提高患者的生活质量，可调节尿动力学指标和尿液NGF，BDNF水平，改善逼尿肌功能。

Abstract

Objective: To observe the clinical efficacy of addition and subtraction treatment of Shenqi Shenqi Wan on overactive bladder (OAB) and investigate its effects on urodynamics

urine nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). Method: One hundred and eight patients were randomly divided into control group (54 cases) and observation group (54 cases) with the use of random number. In the control group

patients got Tolterodine 2 mg/time

2 times/days. On the basis of treatment in the control group

the patients in observation group additionally got Shenqi Shenqi Wan

1 dose/day. The treatment course was eight weeks in both groups. Daily urinating dairy (urination frequency in 24 h

nocturnal urination frequency

urinal urgency frequency

and urinal leakage frequency) was recorded. Before and after treatment

the symptoms of overactive bladder were assessed with overactive bladder symptom score (OABSS)

Indevus Urgency Severity Scale (IUSSU)

and the scores of main symptoms and kidney deficiency. Overactive bladder questionnaire (OAB-q) was used to evaluate the quality of life before and after treatment. Before and after treatment

the maximum flow rate (MFR)

post-void residual volume (PVR)

volume at urgent desire (VUD)

volume at first desire (VFD)

and other urodynamic indexes. NGF and BDNF were detected before and after treatment

and its ratio to urinary creatinine (UCr) (NGF/UCr) was calculated. Result: The total clinical efficacy was 92.59% in observation group

higher than 75.93% in control group (χ2=5.654

P<0.05). The urination frequency in 24 h

nocturnal urination frequency

urinal urgency frequency

and urinal leakage frequency in observation group were all less than those in control group (P<0.01). The scores of OABSS

IUSS

the main symptoms and kidney deficiency in observation group were all lower than those in control group (P<0.01). Scores of OAB-q scale were lower than those in control group

and the 4 dimension scores such as coping style were higher than those in control group (P<0.01). After treatment

the levels of NGF

BDNF

NGF/UCr and BDNF/UCr in the observation group were all lower than those in the control group (P<0.01). Conclusion: Addition and subtraction therapy of Shenqi Wan combined with Tolterodine can ameliorate clinical symptoms and detrusor function

improve quality of life

regulate urodynamic index as well as NGF and BDNF levels in the treatment of kidney deficiency type OAB.

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