{"title":"一项研究,评估和比较杜洛西汀联合达非那新与达非那新作为单一疗法对膀胱过度活动症(OAB)患者的症状感知、生活质量和标准的效果","authors":"Nidhi Goel, Ved Prakash, K. R. Giri, Amol Dehade","doi":"10.18231/j.pjms.2024.015","DOIUrl":null,"url":null,"abstract":": Overactive bladder is chronic debilitating condition, with physical, psychological, and economical consequences. Urinary vesicle tissue contains muscarinic receptors, M3 is principal mediator of detrusor contraction. Muscarinic receptor antagonists, comprises traditional pharmacological treatment. But due to non-selective inhibition, these agents, probably been related with safety and tolerability concerns. Drugs particular inhibiting sM3 receptor (Darifenacin) have potential to present effective relief while reducing side effects concerned with blockade of M1, M2 and M5 receptors. Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.","PeriodicalId":30643,"journal":{"name":"PANACEA JOURNAL OF MEDICAL SCIENCES","volume":"22 11","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A study evaluating and comparing the effectiveness of combination therapy – Duloxetine with darifenacin versus darifenacin as monotherapy on perception of symptoms, quality and standard of life in patients suffering with overactive bladder (OAB)\",\"authors\":\"Nidhi Goel, Ved Prakash, K. 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Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.\",\"PeriodicalId\":30643,\"journal\":{\"name\":\"PANACEA JOURNAL OF MEDICAL SCIENCES\",\"volume\":\"22 11\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"PANACEA JOURNAL OF MEDICAL SCIENCES\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18231/j.pjms.2024.015\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"PANACEA JOURNAL OF MEDICAL SCIENCES","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18231/j.pjms.2024.015","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
:膀胱过度活动症是一种使人衰弱的慢性疾病,会对身体、心理和经济造成影响。尿囊组织中含有毒蕈碱受体,M3 是导致逼尿肌收缩的主要介质。毒蕈碱受体拮抗剂是传统的药物治疗方法。但由于这些药物具有非选择性抑制作用,因此可能存在安全性和耐受性方面的问题。抑制 sM3 受体的药物(达非那新)有可能在有效缓解症状的同时,减少因阻断 M1、M2 和 M5 受体而产生的副作用。度洛西汀是羟色胺和去甲肾上腺素再摄取抑制剂,可增加突触间隙中 5-HT 和 NE 的浓度,增加对阴部运动神经元的刺激,从而增强尿道括约肌的静息张力和收缩。 在本项前瞻性、随机、平行组、开放标签对比研究中,60 名 OAB 患者接受了度洛西汀和达非那新的联合治疗,与使用达非那新的单一疗法进行了比较。研究结果通过三种不同的 OAB 问卷进行了分析和统计比较。 研究结果表明:虽然 OAB-V8、OABss 平均得分的差异不显著,但治疗组 II 与治疗组 I 相比,OAB-qSF 平均得分的降低(百分比变化)更大(w6:13.82±3.17% Vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%),且具有统计学意义(P<0.05):度洛西汀与达非那新具有协同作用,其增加膀胱容量的能力可能是改善 OAB 症状的原因,无论是单独使用还是与抗胆碱能药物联合使用,都有望控制和治疗症状。
A study evaluating and comparing the effectiveness of combination therapy – Duloxetine with darifenacin versus darifenacin as monotherapy on perception of symptoms, quality and standard of life in patients suffering with overactive bladder (OAB)
: Overactive bladder is chronic debilitating condition, with physical, psychological, and economical consequences. Urinary vesicle tissue contains muscarinic receptors, M3 is principal mediator of detrusor contraction. Muscarinic receptor antagonists, comprises traditional pharmacological treatment. But due to non-selective inhibition, these agents, probably been related with safety and tolerability concerns. Drugs particular inhibiting sM3 receptor (Darifenacin) have potential to present effective relief while reducing side effects concerned with blockade of M1, M2 and M5 receptors. Duloxetine is Serotonin and nor-epinephrine reuptake inhibitor, leading increased concentration of 5-HT and NE in synaptic cleft, increases stimulation of pudendal motor neurons, thus increasing resting tone and contraction of urethral sphincter.: In present prospective, randomized, parallel group, comparative open label study with 60 OAB patients the combination therapy of Duloxetine with Darifenacin was equated with monotherapy using Darifenacin. The outcome thus analyzed using three different OAB-questionnaires and was statistically compared. : We demonstrated that addition of Duloxetine has shown better result outcome in symptoms as well as quality of life, though the difference of OAB-V8, OABss mean score was non-significant, but for OAB-qSF the reduction (percentage change) in mean score was more in treatment group II as compare to group I (w6:13.82±3.17% vs 12.13±3.24% & W12 29.99±5.40% Vs 25.56±5.17%) , and was statistically significant.(p<0.05).: Duloxetine has synergistic effect to Darifenacin, its ability to increase bladder capacity may be the reason for the improvement OAB symptoms, promising in controlling and treating symptoms either alone or in combination with anti-cholinergic drugs.