Effect of Chinese herbal medicine on overactive bladder

Abstract

Gosha-jinki-gan (GJG), a traditional Chinese medicine, is known to be potentially effective for urinary disturbance. For the clinical evaluation of Gosha-jinki-gan, we administered GJG for 6 weeks to elderly male patients with overactive bladder (OAB) and assessed its efficacy and tolerability. In this study, 30 male patients with over 6 months of OAB symptoms had received 2.5 g GJG mixture x 3/day. After 6 weeks of treatment, the efficacy, safety, and tolerability were assessed. We evaluated International Prostate Symptom Score (I-PSS), Overactive Bladder Symptom Score (OABSS), quality of life (QOL), maximal urinary flow rate (Qmax), average urinary flow rate (Qave), incidence of urinary incontinence, and post-void residual before and after treatment. We observed significant improvements in I-PSS (15.2 +/- 1.0 vs. 12.0 +/- 0.9, p < 0.0001), OABSS (7.5 +/- 0.6 vs. 4.9 +/- 0.5, p < 0.0001), and QOL score (4.4 +/- 1.0 vs. 3.3 +/- 1.1, p < 0.0001, Wilcoxon rank sum test). GJG was significantly effective in improving urgency, micturition frequency, nocturia, and urinary incontinence (p < 0.05). However, Qmax, Qave, and post void residual did not significantly change. Mild adverse effects were observed in 3 cases. The symptoms were diarrhea, nausea, and urinary frequency. These data suggest that Gosha-jinki-gan may be a new potential therapeutic agent for OAB without deterioration of voiding function in men with benign prostatic obstruction (BPO).

頻尿, 尿意切迫などを主症状とする過活動膀胱に対して以前より西洋薬とともに漢方薬も排尿障害に広く使われており, なかでも牛車腎気丸は過活動膀胱に対する基礎的研究が報告され始め, その臨床的応用が期待できる漢方薬である。われわれは頻尿, 尿意切迫などを主症状とする過活動膀胱の男性患者30人に牛車腎気丸を6週間投与し, 国際前立腺症状スコア, QOLスコア, 尿失禁回数, 最大尿流率, 残尿量を測定した。その結果, 牛車腎気丸は頻尿, 夜間頻尿, 切迫性尿失禁などの蓄尿症状に有効であった。一方, 排出症状スコア, 最大尿流率, 残尿量について有意差はなかった。牛車腎気丸は頻尿, 夜間頻尿, 切迫性尿失禁などの過活動膀胱の症状を改善する可能性があり, 高齢者や抗コリン薬非適応症例の治療薬として期待できる。