Joo K-J, Sung W-S, Park S-H, Yang W-J, Kim T-H
Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Int Med Res. 2012;40(3):899-908. doi: 10.1177/147323001204000308.
This study compared α-blocker monotherapy with combination therapy involving an α-blocker and a 5-α reductase inhibitor for benign prostatic hyperplasia (BPH), according to baseline prostate volume.
Korean men diagnosed with BPH were randomized to 12 months' treatment with 0.2 mg tamsulosin or 0.2 mg tamsulosin plus 0.5 mg dutasteride. Prostate specific antigen (PSA), prostate volume, transition zone volume (TZV), International Prostate Symptom Score (IPSS), maximal urinary flow rate (Q(max)), postvoid residual urine volume and sexual function were assessed at baseline and after 12 months' treatment. Variables were analysed based on baseline prostate volumes of ≤ 35 ml or > 35 ml.
In total, 216 men with BPH were included. Combination therapy resulted in significant improvements in prostate volume, TZV, PSA, IPSS and Q(max), which were most pronounced in men with a prostate volume > 35 ml.
Tamsulosin monotherapy was sufficient treatment for BPH in Korean men with a prostate volume ≤ 35 ml. Combination tamsulosin and dutasteride therapy provided greater benefits than tamsulosin monotherapy in men with BPH whose prostate volume was > 35 ml.
本研究根据基线前列腺体积，比较α受体阻滞剂单药治疗与α受体阻滞剂联合5-α还原酶抑制剂治疗良性前列腺增生（BPH）的效果。
将诊断为BPH的韩国男性随机分为两组，分别接受为期12个月的0.2mg坦索罗辛治疗或0.2mg坦索罗辛加0.5mg度他雄胺治疗。在基线和治疗12个月后评估前列腺特异性抗原（PSA）、前列腺体积、移行区体积（TZV）、国际前列腺症状评分（IPSS）、最大尿流率（Q(max)）、排尿后残余尿量和性功能。根据基线前列腺体积≤35ml或>35ml对变量进行分析。
总共纳入了216例BPH男性患者。联合治疗使前列腺体积、TZV、PSA、IPSS和Q(max)有显著改善，在前列腺体积>35ml的男性中最为明显。
对于前列腺体积≤35ml的韩国BPH男性患者，坦索罗辛单药治疗就足够了。对于前列腺体积>35ml的BPH男性患者，坦索罗辛与度他雄胺联合治疗比坦索罗辛单药治疗更有益。
