Hou Xiang-Yi, Zhang Li, Zhang Zhi-Jie, Xu Wei, Ye Liang-Wen, Zhao Hao-Yu, Suo Xiang-Hui, Hong An-Jie
Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Department of Urology, Macau University of Science and Technology, Macau 999078, China.
World J Methodol. 2025 Dec 20;15(4):104696. doi: 10.5662/wjm.v15.i4.104696.
Nocturia is a common clinical condition that severely affects patients' quality of life and is strongly associated with complications such as depression, cognitive dysfunction, mood disorders, and fall-related injuries. The etiology of nocturia is complex and mainly includes increased total urine output, nocturnal polyuria, decreased functional bladder capacity, sleep disorders, and confounding factors. In recent years, with the in-depth study of the pathophysiological mechanisms of nocturia, the diagnostic methods have been updated, and the application of tools such as the frequency volume chart, bladder capacity index, and bladder diary have provided an important basis for the precise identification of the etiology. Behavior modification has been widely used in clinical practice as a first-line treatment. In addition, advances in pharmacotherapy have provided new directions for the management of nocturia, and the efficacy and safety of α-blockers, cholinergic receptor antagonists, adrenergic β-agonists, desmopressin, melatonin, and other medications have been gradually validated. However, there are still some limitations in the existing studies, especially in the long-term safety and efficacy of drug therapy as well as the mechanism of action still need to be further explored. This article reviews the latest research advances in nocturia, aiming to provide clinicians with diagnostic and therapeutic strategies based on evidence-based medicine, and to promote the standardization and individualization of nocturia management.
夜尿症是一种常见的临床病症,严重影响患者的生活质量,并与抑郁症、认知功能障碍、情绪障碍和跌倒相关损伤等并发症密切相关。夜尿症的病因复杂,主要包括总尿量增加、夜间多尿、功能性膀胱容量减少、睡眠障碍和混杂因素。近年来,随着对夜尿症病理生理机制研究的深入,诊断方法不断更新,频率-尿量图、膀胱容量指数和膀胱日记等工具的应用为精确识别病因提供了重要依据。行为矫正作为一线治疗方法已在临床实践中广泛应用。此外,药物治疗的进展为夜尿症的管理提供了新方向,α受体阻滞剂、胆碱能受体拮抗剂、肾上腺素能β激动剂、去氨加压素、褪黑素等药物的疗效和安全性已逐渐得到验证。然而,现有研究仍存在一些局限性,特别是药物治疗的长期安全性和疗效以及作用机制仍有待进一步探索。本文综述了夜尿症的最新研究进展,旨在为临床医生提供基于循证医学的诊断和治疗策略,促进夜尿症管理的规范化和个体化。