Okada H, Kawaida N, Ogawa T, Arakawa S, Matsumoto O, Kamidono S
Department of Urology, Kobe University School of Medicine, Japan.
Scand J Urol Nephrol. 1996 Oct;30(5):379-85. doi: 10.3109/00365599609181314.
The recent introduction of selective alpha-adrenoceptor blockers adds a further therapeutic option for the treatment of benign prostatic hyperplasia (BPH). Tamsulosin, a selective alpha 1-blocker, has proved effective in relieving irritative and obstructive symptoms caused by BPH. To investigate whether the combination of tamsulosin with the anti-androgenic drug chlormadinone is of further therapeutic benefit, 80 patients randomly received tamsulosin 0.2 mg daily, chlormadinone 50 mg daily or a combination of tamsulosin 0.2 mg and chlormadinone 50 mg daily for 16 weeks. Greater improvement in subjective symptoms of BPH was obtained with either tamsulosin alone or in combination with chlormadinone than with chlormadinone alone. However, the greatest improvement in objective uroflowmetric data was obtained with chlormadinone in combination with tamsulosin. Thus, the combination of tamsulosin with chlormadinone appears to be more beneficial than either of these agents used as monotherapy. Further investigation is required to fully evaluate the therapeutic effects of this combination. After the trial period one-third of the chlormadinone and tamsulosin/chlormadinone-treated patients needed no further treatment due to the satisfactory relief of symptoms. At 12 months follow-up, however, one-fourth of the patients had undergone transurethral resection of the prostate (TUR-P) regardless of medication. This suggests a limitation of the medical treatment of BPH.
近期选择性α-肾上腺素受体阻滞剂的引入为良性前列腺增生（BPH）的治疗增加了一种新的治疗选择。坦索罗辛，一种选择性α1受体阻滞剂，已被证明能有效缓解由BPH引起的刺激性和梗阻性症状。为了研究坦索罗辛与抗雄激素药物氯地孕酮联合使用是否具有更大的治疗益处，80例患者被随机分为三组，分别每日服用0.2mg坦索罗辛、50mg氯地孕酮或每日服用0.2mg坦索罗辛与50mg氯地孕酮的组合，持续16周。单独使用坦索罗辛或与氯地孕酮联合使用在BPH主观症状改善方面均优于单独使用氯地孕酮。然而，在客观尿流率数据方面，氯地孕酮与坦索罗辛联合使用改善最大。因此，坦索罗辛与氯地孕酮联合使用似乎比单独使用这两种药物中的任何一种更有益。需要进一步研究以全面评估这种联合用药的治疗效果。在试验期后，三分之一接受氯地孕酮和坦索罗辛/氯地孕酮治疗的患者由于症状得到满意缓解而无需进一步治疗。然而，在12个月的随访中，无论用药情况如何，四分之一的患者接受了经尿道前列腺切除术（TUR-P）。这表明BPH药物治疗存在局限性。
