Behavioral vs drug treatment for urge urinary incontinence in older women - A randomized controlled trial
Behavioral vs drug treatment for urge urinary incontinence in older women - A randomized controlled trial
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DOI：
10.1001/jama.280.23.1995
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发表时间：
1998-12-16
影响因子：
120.7
通讯作者：
Candib, D
中科院分区：
文献类型：
--
作者：
Burgio, KL;Locher, JL;Candib, D
背景.-尿失禁是由多种因素引起的常见病症，有多种治疗方案。目的.-比较生物反馈辅助行为治疗与药物治疗和安慰剂对照条件治疗老年社区居住女性急迫性尿失禁和混合性尿失禁的有效性。设计.-1989 年至 1995 年进行的随机安慰剂对照试验。设置.-大学门诊老年医学 诊所.患者.-197 名年龄在 55 至 92 岁之间的女性志愿者样本，患有急迫性尿失禁或以急迫性尿失禁为主要模式的混合性尿失禁。受试者必须有膀胱功能障碍的尿动力学证据，能够走动，并且没有痴呆。干预。-受试者被随机分配到 4 个疗程（8 周）的生物反馈辅助行为治疗、药物治疗（使用氯化奥昔布宁，可能的剂量范围，每天 2.5 毫克至 5.0 毫克，每天 3 次）或安慰剂对照条件。主要结果措施。-减少 通过膀胱日记确定的失禁发作频率，以及患者对治疗的改善感觉以及他们对治疗的舒适度和满意度。结果-对于所有 3 个治疗组，失禁的减少在治疗早期最为明显，此后进展更为缓慢。行为治疗使失禁发作平均减少 80.7%，明显比药物治疗更有效（平均减少 68.5%；P=0.04），并且两者都比安慰剂对照条件更有效（平均减少 39.4%；P
Context.-Urinary incontinence is a common condition caused by many factors with several treatment options.Objective.-To compare the effectiveness of biofeedback-assisted behavioral treatment with drug treatment and a placebo control condition for the treatment of urge and mixed urinary incontinence in older community-dwelling women.Design.-Randomized placebo-controlled trial conducted from 1989 to 1995.Setting.-University-based outpatient geriatric medicine clinic.Patients.-A volunteer sample of 197 women aged 55 to 92 years with urge urinary incontinence or mixed incontinence with urge as the predominant pattern. Subjects had to have urodynamic evidence of bladder dysfunction, be ambulatory, and not have dementia,Intervention.-Subjects were randomized to 4 sessions (8 weeks) of biofeedback-assisted behavioral treatment, drug treatment (with oxybutynin chloride, possible range of doses, 2.5 mg daily to 5.0 mg 3 times daily), or a placebo control condition.Main Outcome Measures.-Reduction in the frequency of incontinent episodes as determined by bladder diaries, and patients' perceptions of improvement and their comfort and satisfaction with treatment.Results.-For all 3 treatment groups, reduction of incontinence was most pronounced early in treatment and progressed more gradually thereafter. Behavioral treatment, which yielded a mean 80.7% reduction of incontinence episodes, was significantly more effective than drug treatment (mean 68.5% reduction; P=.04) and both were more effective than the placebo control condition (mean 39.4% reduction; P