Zonić-Imamović Maida, Imamović Semir, Čičkušić Amela, Delalić Azra, Hodžić Renata, Imamović Mirza
Clinic for Physical Medicine and Rehabilitation, University Clinical Center Tuzla, Bosnia and Herzegovina.
Clinic of Anesthesiology and Resuscitation, University Clinical Center Tuzla, Bosnia and Herzegovina.
Acta Med Acad. 2019 Dec;48(3):271-277. doi: 10.5644/ama2006-124.267.
The purpose of this study was to evaluate the efficiency of the anticholinergic therapy with oxybutynin and the effects of daily transcutaneous tibial nerve stimulation (TTNS) on the quality of life of patients with an overactive bladder (OAB) and multiple sclerosis (MS).
The study was designed as a randomized controlled trial. The patients who suffer from MS underwent urodynamic tests which showed that they had an OAB. The tests used to assess symptoms and quality of life were Overactive Bladder Questionnaires (OAB-q) SF. Patients were divided into 2 groups of 30 patients each. The first group received a 5 mg oxybutynin tablet twice a day for 3 months and the second group had TTNS every day for 3 months.
The anticholinergic therapy showed a statistically significant improvement in all symptoms and quality of life (P<0.001). Side effects such as dry mouth were observed in about 35% of patients. The results of the study TTNS daily therapy showed good performance in the reduction all clin ical symptoms of the bladder and improved quality of life, with statistical significance (P<0.05) and with no side effects. It was found that the improved quality of life parameters and the reduced symptoms were more statistically significant in the treatment with oxybutynin tablets than TTNS therapy (P<0.001).
Our recommendation for the treatment of OAB is oxybutynin in doses of 2x5 mg. If a patient can not tolerate anticholinergic drugs, daily TTNS is recommended to reduce OAB symptoms and improve quality of life, without side effects.
本研究旨在评估奥昔布宁抗胆碱能疗法的疗效以及每日经皮胫神经刺激(TTNS)对膀胱过度活动症(OAB)合并多发性硬化症(MS)患者生活质量的影响。
本研究设计为随机对照试验。患有MS的患者接受了尿动力学检查,结果显示他们患有OAB。用于评估症状和生活质量的测试是膀胱过度活动症问卷(OAB-q)简表。患者被分为两组,每组30名患者。第一组患者每天服用两次5毫克奥昔布宁片,持续3个月,第二组患者每天接受TTNS治疗,持续3个月。
抗胆碱能疗法在所有症状和生活质量方面均显示出具有统计学意义的改善(P<0.001)。约35%的患者出现口干等副作用。每日TTNS治疗的研究结果显示,在减轻膀胱所有临床症状和改善生活质量方面表现良好,具有统计学意义(P<0.05)且无副作用。研究发现,与TTNS疗法相比,奥昔布宁片治疗在改善生活质量参数和减轻症状方面具有更显著的统计学意义(P<0.001)。
我们对OAB治疗的建议是使用2×5毫克剂量的奥昔布宁。如果患者不能耐受抗胆碱能药物,建议每日进行TTNS治疗以减轻OAB症状并改善生活质量,且无副作用。