Division of Vascular Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil.
J Vasc Surg. 2012 Jun;55(6):1696-700. doi: 10.1016/j.jvs.2011.12.039. Epub 2012 Feb 16.
Video-assisted thoracic sympathectomy provides excellent resolution of palmar and axillary hyperhidrosis but is associated with compensatory hyperhidrosis. Low doses of oxybutynin, an anticholinergic medication that competitively antagonizes the muscarinic acetylcholine receptor, can be used to treat palmar hyperhidrosis with fewer side effects.
This study evaluated the effectiveness and patient satisfaction of oral oxybutynin at low doses (5 mg twice daily) compared with placebo for treating palmar hyperhidrosis.
This was prospective, randomized, and controlled study. From December 2010 to February 2011, 50 consecutive patients with palmar hyperhidrosis were treated with oxybutynin or placebo. Data were collected from 50 patients, but 5 (10.0%) were lost to follow-up. During the first week, patients received 2.5 mg of oxybutynin once daily in the evening. From days 8 to 21, they received 2.5 mg twice daily, and from day 22 to the end of week 6, they received 5 mg twice daily. All patients underwent two evaluations, before and after (6 weeks) the oxybutynin treatment, using a clinical questionnaire and a clinical protocol for quality of life.
Palmar and axillary hyperhidrosis improved in >70% of the patients, and 47.8% of those presented great improvement. Plantar hyperhidrosis improved in >90% of the patients. Most patients (65.2%) showed improvements in their quality of life. The side effects were minor, with dry mouth being the most frequent (47.8%).
Treatment of palmar and axillary hyperhidrosis with oxybutynin is a good initial alternative for treatment given that it presents good results and improves quality of life.
胸腔镜交感神经切断术可极好地治疗手掌和腋窝多汗症，但会导致代偿性多汗。低剂量的奥昔布宁（一种竞争性拮抗毒蕈碱乙酰胆碱受体的抗胆碱能药物）可用于治疗手掌多汗症，且副作用更少。
本研究评估了低剂量（每日两次，每次 5 毫克）口服奥昔布宁治疗手掌多汗症的有效性和患者满意度，并与安慰剂进行了比较。
这是一项前瞻性、随机、对照研究。2010 年 12 月至 2011 年 2 月，50 例手掌多汗症患者接受了奥昔布宁或安慰剂治疗。共纳入 50 例患者的数据，但有 5 例（10.0%）失访。第 1 周，患者每晚服用 2.5 毫克奥昔布宁。第 8 天至第 21 天，他们每天服用 2.5 毫克两次；第 22 天至第 6 周末，他们每天服用 5 毫克两次。所有患者在接受奥昔布宁治疗前后（6 周）均接受了临床问卷和生活质量临床方案的两次评估。
超过 70%的患者手掌和腋窝多汗症得到改善，47.8%的患者改善明显。超过 90%的患者足底多汗症得到改善。大多数患者（65.2%）的生活质量得到改善。副作用轻微，最常见的是口干（47.8%）。
奥昔布宁治疗手掌和腋窝多汗症是一种较好的初始治疗选择，因为它效果良好，可改善生活质量。
