Miller Janis M, Garcia Caroline E, Hortsch Sarah Becker, Guo Ying, Schimpf Megan O
Janis M. Miller, PhD, RN, APRN, School of Nursing, University of Michigan, Ann Arbor, Michigan. Caroline E. Garcia, BA, School of Nursing, University of Michigan, Ann Arbor, Michigan. Sarah Becker Hortsch, MSW, RN, School of Nursing, University of Michigan, Ann Arbor, Michigan. Ying Guo, MS, School of Nursing, University of Michigan, Ann Arbor, Michigan. Megan O. Schimpf, MD, Department of Obstetrics and Gynecology, Division of Urogynecology, University of Michigan, Ann Arbor, Michigan.
J Wound Ostomy Continence Nurs. 2016 Jan-Feb;43(1):69-79. doi: 10.1097/WON.0000000000000197.
Common advice for lower urinary tract symptoms (LUTS) such as frequency, urgency, and related bother includes elimination of potentially irritating beverages (coffee, tea, alcohol, and carbonated and/or artificially sweetened beverages). The purpose of this study was to determine compliance with standardized instruction to eliminate these potentially irritating beverages, whether LUTS improved after instruction, and whether symptoms worsened with partial reintroduction.
The 3-phase fixed sequence design was (1) baseline, (2) eliminate potentially irritating beverages listed above, and (3) reintroduce at 50% of baseline volume, with a washout period between each 3-day phase. We asked participants to maintain total intake volume by swapping in equal amounts of nonpotentially irritating beverages (primarily water).
The study sample comprised 30 community-dwelling women recruited through newspaper advertisement.
Quantification measures included 3-day voiding diaries and detailed beverage intake, and LUTS questionnaires completed during each phase.
During Phase 2, we found significant reduction in potentially irritating beverages but complete elimination was rare. Despite protocol demands, total beverage intake was not stable; mean (± standard deviation) daily total intake volume dropped by 6.2 ± 14.9 oz (P = .03) during Phase 2. In Phase 3, the volume of total beverage intake returned to baseline, but the intake of potentially irritating beverages also returned to near baseline rather than 50% as requested by protocol. Despite this incomplete adherence to study protocols, women reported reduction in symptoms of urge, inability to delay voiding, and bother during both phases (P ≤ .01). The number of voids per day decreased on average by 1.3 and 0.9 voids during Phases 2 and 3, respectively (P = .002 and P = .035).
Education to reduce potentially irritating beverages resulted in improvement in LUTS. However, eliminating potentially irritating beverages was difficult to achieve and maintain. Study findings do not allow us to determine whether LUTS improvement was attributable to intake of fewer potentially irritating beverages, reduced intake of all beverages, the effect of self-monitoring, or some combination of these factors.
对于诸如尿频、尿急及相关困扰等下尿路症状（LUTS）的常见建议包括避免饮用可能具有刺激性的饮料（咖啡、茶、酒精以及碳酸饮料和/或人工甜味饮料）。本研究的目的是确定是否遵守了消除这些可能具有刺激性饮料的标准化指导，指导后LUTS是否有所改善，以及部分重新引入这些饮料后症状是否会恶化。
采用三阶段固定顺序设计，即（1）基线期，（2）消除上述可能具有刺激性的饮料，（3）以基线量的50%重新引入，每3天为一个阶段，各阶段之间设有洗脱期。我们要求参与者通过等量换入无潜在刺激性的饮料（主要是水）来维持总摄入量。
研究样本包括通过报纸广告招募的30名社区居住女性。
量化指标包括3天排尿日记、详细的饮料摄入量以及各阶段完成的LUTS问卷。
在第二阶段，我们发现可能具有刺激性的饮料摄入量显著减少，但很少能完全消除。尽管有方案要求，但总饮料摄入量并不稳定；在第二阶段，每日平均总摄入量下降了6.2±14.9盎司（P = 0.03）。在第三阶段，总饮料摄入量恢复到基线水平，但可能具有刺激性的饮料摄入量也恢复到接近基线水平，而不是按照方案要求的50%。尽管对研究方案的遵守并不完全，但女性在两个阶段均报告尿急、无法延迟排尿及困扰等症状有所减轻（P≤0.01）。在第二阶段和第三阶段，每日排尿次数平均分别减少了1.3次和0.9次（P = 0.002和P = 0.035）。
减少可能具有刺激性饮料的教育使LUTS得到改善。然而，消除可能具有刺激性的饮料难以实现和维持。研究结果无法让我们确定LUTS的改善是归因于摄入较少的可能具有刺激性的饮料、所有饮料摄入量的减少、自我监测的效果，还是这些因素的某种组合。
