Comparison of two α1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia:: a randomized crossover study
Comparison of two α1-adrenoceptor antagonists, naftopidil and tamsulosin hydrochloride, in the treatment of lower urinary tract symptoms with benign prostatic hyperplasia:: a randomized crossover study
复制标题
DOI：
10.1111/j.1464-410x.2006.06030.x
复制
发表时间：
2006-04-01
影响因子：
4.5
通讯作者：
Deguchi, T
中科院分区：
文献类型：
--
作者：
Nishino, Y;Masue, T;Deguchi, T
目的比较两种α 1肾上腺素能受体拮抗剂（α 1A肾上腺素能受体选择性盐酸坦索罗辛和α 1D肾上腺素能受体选择性萘哌地尔）治疗良性前列腺增生（BPH）伴下尿路症状（LUTS）的疗效。（平均年龄72.4岁，SD 4.3，范围66-79）患有继发于BPH的LUTS（国际前列腺症状评分，IPSS > 8）的患者被纳入随机交叉研究。17例患者最初处方萘哌地尔50 mg，持续4周，然后是坦索罗辛0.2 mg，持续4周（A组）;另外17例患者最初处方坦索罗辛0.2 mg，然后是萘哌地尔50 mg（B组）。患者在1周洗脱期后改为替代治疗。疗效标准是改善LUTS（IPSS），生活质量（QoL），尿流率，和压力-流量研究（PFS）值的基础上与每个agent.Results治疗在基线有没有组间的IPSS，生活质量，尿流率值或PFS值的显着差异，除了在最大的愿望，排尿量。每种药物治疗后，IPSS和QoL显著改善，PFS证实膀胱出口梗阻减少。萘哌地尔在缓解呕吐方面明显优于坦索罗辛。从基线（治疗前）到终点（每种药物治疗后），萘哌地尔组的首次排尿量和最大排尿量的增加显著高于坦索罗辛组。两名患者的不自主收缩消失，萘哌地尔缓解了痉挛，但坦索罗辛没有。在IPSS，生活质量，增加尿流率值和其他PFS值的变化的其他症状的减少是相似的两个agent.Conclusions两种药物在治疗前列腺增生的LUTS提供了相似的疗效。但萘哌地尔治疗尿道炎的疗效优于坦索罗辛。不自主收缩的消失和萘哌地尔第一欲望量的更大增加可能与排尿困难的缓解有关。α（1D）-肾上腺素受体拮抗剂可有效缓解排尿和储尿症状。α（1D）-肾上腺素受体拮抗剂可能比α（1A）-肾上腺素受体拮抗剂更有效地治疗伴有BPH的LUTS。
Objectives To compare the efficacy of two alpha(1)-adrenoceptor antagonists, alpha(1A)-adrenoceptor-selective tamsulosin hydrochloride and alpha(1D)-adrenoceptor-selective naftopidil, in the treatment of lower urinary tract symptoms (LUTS) with benign prostatic hyperplasia (BPH).Patients and Methods Thirty-four patients (mean age 72.4 years, SD 4.3, range 66-79) with LUTS (International Prostate Symptom Score, IPSS > 8) secondary to BPH were enrolled in a randomized crossover study. Seventeen patients were initially prescribed naftopidil 50 mg for 4 weeks, followed by tamsulosin 0.2 mg for 4 weeks (group A); another 17 were initially prescribed tamsulosin 0.2 mg, followed by naftopidil 50 mg (group B). Patients changed to the alternative treatment after a 1-week washout period. Efficacy criteria were improvement in LUTS (IPSS), quality of life (QoL), uroflowmetry, and pressure-flow study (PFS) values based on the treatment with each agent.Results At baseline there were no significant differences between the groups in IPSS, QoL, uroflowmetry values or PFS values, except for the volume at maximum desire to void. After treatment with each agent, the IPSS and QoL were significantly improved and the reduction in bladder outlet obstruction confirmed by PFS. Naftopidil was significantly more effective than tamsulosin in relieving nocturia. The increases from baseline (before treatment) to the endpoint (after treatment with each agent) in the volume at first desire and maximum desire to void were significantly higher with naftopidil than with tamsulosin. Involuntary contractions disappeared in two patients with relief of nocturia with naftopidil, but not with tamsulosin. The decrease in other symptoms of the IPSS, QoL, increase in uroflowmetry values and changes in other PFS values were similar for both agents.Conclusions The two agents provided similar efficacy in the treatment of LUTS with BPH. However, naftopidil was better than tamsulosin for nocturia. The disappearance of involuntary contraction and the greater increase in first-desire volume with naftopidil may be associated with the relief of nocturia. The alpha(1D)-adrenoceptor antagonist is effective in alleviating both voiding and storage symptoms. The alpha(1D)-adrenoceptor antagonist may be more effective than the alpha(1A)-adrenoceptor antagonist in LUTS with BPH.