Sant G R, LaRock D R
Department of Urology, New England Medical Center Hospitals, Boston, Massachusetts.
Urol Clin North Am. 1994 Feb;21(1):73-83.
The treatment of interstitial cystitis is difficult and at time frustrating--both for the patient and for the physician. Treatment is hampered by the lack of a clear understanding of its pathophysiology, which makes it difficult to objectively assess disease severity and/or progression. Intravesical therapy appears to be the most successful approach to the relief of symptoms. Clearly, there are drawbacks to intravesical therapy, particularly Clorpactin lavage. Responses to intravesical lavage are variable in duration, unpredictable, and unamenable to objective measurement. Multiple treatments are frequently needed, as with DMSO, and multiple anesthetics may be required for Clorpactin therapy. There have been no double-blind, placebo-controlled studies comparing the mainstays--Clorpactin and DMSO--of intravesical treatment. It is hoped that current research into the pathogenesis and causation of interstitial cystitis will lead to an improved understanding of this disease or syndrome. The introduction of newer, more specific intravesical therapies will surely follow such advances.
间质性膀胱炎的治疗困难且有时令人沮丧，对患者和医生来说都是如此。由于对其病理生理学缺乏清晰的认识，治疗受到阻碍，这使得客观评估疾病的严重程度和/或进展变得困难。膀胱内治疗似乎是缓解症状最成功的方法。显然，膀胱内治疗存在缺点，尤其是氯普拉替因灌洗。膀胱内灌洗的反应持续时间不一、不可预测且无法进行客观测量。与二甲基亚砜一样，通常需要多次治疗，而氯普拉替因治疗可能需要多种麻醉剂。目前尚无比较膀胱内治疗的主要药物——氯普拉替因和二甲基亚砜——的双盲、安慰剂对照研究。希望目前对间质性膀胱炎发病机制和病因的研究能增进对这种疾病或综合征的了解。随着这些进展，肯定会引入更新、更具特异性的膀胱内治疗方法。
