夜尿症に対する薬物療法と膀胱訓練の比較

Abstract

機能性夜尿症168例を, 主としてimipramine 1 mg/kgを就寝前に服用させ, 効果のみられた場合には漸減するか, 2～3ヵ月投与しても効果のみられなかった場合には他剤に変更する薬物療法群(88例)と初回治療として3ヵ月間膀胱訓練を施行し, 治癒した場合には, さらに2～3ヵ月間膀胱訓練を継続し, 3ヵ月間の訓練で効果の少なかった場合には, 薬物療法群と同じ方法で薬物療法を併用した.膀胱訓練群(80例)に分けた.両群における3ヵ月間の効果を比較すると, 薬物療法群では54例に有効で, このうち治癒は10例であり, 膀胱訓練群では55例に有効で, このうち治癒は22例であった.有効例に関しては両群の間に有意差はなかったが, 治癒例では, 膀胱訓練群の方が薬物療法群に比べて有意に多かった.両群における6ヵ月間の長期効果を比較すると, 薬物療法群では56例に有効でそのうち治癒は16例であり, 膀胱訓練群では66例に有効でそのうち治癒は30例であった.有効例, 治癒例ともに膀胱訓練群の方が薬物療法群よりも有意に多かった.以上の結果から, 膀胱訓練を中心に, 効果の少ない例に薬物療法を併用する方法は, 薬物単独療法よりも優れた治療法であると考えた

Treatment of enuresis was studied in 168 patients. The patients were divided into two groups, the drug therapy group which consisted of 88 patients who were treated with drugs only, and the bladder training therapy group which consisted of 80 patients who were treated mainly with bladder training supplemented with drug therapy. In the drug therapy group imipramine was the first choice and was used at bed time. The dose of imipramine was initially 1 mg/kg and was gradually decreased if it worked well, and changed to other drugs if it did not work well. In the bladder training therapy group, bladder training was performed in all patients for 3 months, and 22 patients who cured further bladder training was continued, whereas the rest of the patients (58 patients) drug therapy was started in addition to bladder training. After 3 months, drug therapy was effective for 54 patients (61%) including 10 patients (11%) who were cured, and bladder training therapy plus drug therapy was effective for 55 patients (69%) including 22 patients (28%) who were cured. The number of cured patients in the bladder training therapy group was significantly larger than that of the drug therapy group (p less than 0.01). After 6 months, drug therapy was effective for 56 patients (64%) including 16 patients (18%) who were cured, and bladder training therapy plus drug therapy was effective for 66 patients (83%) including 30 patients (38%) who were cured. The number of effective and cured patients in the bladder training therapy group was significantly larger than that in the drug therapy group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)