膀胱過動症的中醫治療臨床評估先驅研究

楊中賢,陳汶吉,李采娟
中國醫藥大學附設醫院
膀胱過動症（overactive bladder）或不穩定性膀胱（unstable bladder），是由於膀胱不受大腦的控制，發生不隨意或過度活動而導致尿頻（frequency）、尿急（urgency）或急迫性尿失禁（urge incontinence）的現象。根據統計，中老年女性20﹪罹患尿失禁，其中約四分之一導因於不穩定性膀胱，而男性尿失禁人口雖較女性少，僅6﹪，卻有九成是不穩定性膀胱引起。國外推估，全球至少五千萬人受其困擾，在歐洲四十歲以上人口就有17﹪罹病。 膀胱過動症是現在泌尿學最後的禁地，對於膀胱過動症的內科療法，主要是利用抗毒蕈鹼（antimuscarinic）藥物抑制膀胱肌肉的不隨意性收縮，但常伴有口乾舌燥、視力模糊、便秘等副作用，且因過度抑制膀胱肌肉的收縮常造成膀胱尿液滯留(urinary retention)。根據1999年台灣對新藥「妥滴樂定」（Tolterodine）所作的人體試驗報告中發現：只有受試者自我評估的臨床症狀有顯著的改善；其餘，如24小時的小便次數、每次小便的平均量與安慰劑組比較皆沒有顯著的差異。 為避免以上之不良反應及提高臨床療效，我們提出運用中醫古方五苓散和芍藥甘草湯來治療膀胱過動症的患者。本研究採隨機、雙盲、實驗安慰劑對照組設計，預計納入128人，隨機分成實驗與對照組各64人，用藥6週後，分析統計兩組間尿路動力學與臨床症狀之差異。
關鍵字：膀胱過動症；五苓散；芍藥甘草湯

The pilot study of clinical assessment of overactive bladder treated by Chinese medicine

Chung-Hsien, Yang; Wen-Chi Chen; Tsai-Chung Li
China Medical University Hospital
Overactive bladder and urinary incontinence are the last taboo of modern urology. Although overactive bladder and incontinence affect more than 17 million Americans, it is estimated that perhaps only 15% of patients with incontinence and overactive bladder have sought medical help. Unfortunately, until recently medications prescribed for overactive bladder and incontinence have had crippling side effects. For promoting clinical treating efficacy, we try using traditional Chinese herbs to deal with this problem. This randomized, double blind and placebo controlled research will recruit about 128 persons divided into experimental and controlled groups. Prescriptions will be given to everyone lasting for 6 weeks and than we will assess the variances about urodynamic expressions and some clinical symptoms between these two groups.
關鍵字：Overactive bladder；Wu Ling San；Shao Yao Gan Cao Tang