頻尿,尿失禁に対する塩酸テロジリン,塩酸クレンブテロール併用投与の臨床的観察

Abstract

頻尿, 尿失禁を主訴とする患者51例(神経因性膀胱18例, 腹圧性尿失禁12例, 神経性頻尿10例, 不安定膀胱8例, その他3例)に対し, 塩酸テロジリン1日24 mg, 塩酸クレンブテロール20～40 μgを投与し尿失禁の改善度は中等度改善以上は18例, 軽度改善以上は25例であった.他覚所見では, 初発尿意時膀胱容量, 最大膀胱容量は平均41 mlと有意に増加した.膀胱コンプライアンスも平均2.5 ml/cmH2Oと有意に増加した.しかし, 最高尿道内圧は0.5 cmH2Oと僅かに上昇したのみであった.尿流量測定, 残尿量測定結果でも有意な変化はなかった.全般改善度は著明改善6例, 中等度改善20例, 軽度改善11例, 不変13例, 悪化1例であった.特に腹圧性尿失禁においては, 12例中著明改善2例, 中等度改善7例と好結果が得られた.副作用は13例に見られ, 手指振戦が7例と多く, 塩酸クレンブテロール1日20 μg投与群に有意に少なかった.以上より, 両薬剤の併用投与は頻尿, 尿失禁に有効な治療法と考えられ, 特に腹圧性尿失禁に対してはより高い有用性が期待できる

The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence.