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目的探讨阿米替林口服及肝素膀胱灌注治疗间质性膀胱炎(IC)的临床效果。方法 IC患者23例,病程15～65个月,平均(30.7±11.50)个月。单纯阿米替林治疗组12例患者,11例患者阿米替林治疗同时行肝素膀胱灌注治疗,疗程均3个月。观察用药前及用药3个月后患者每日排尿次数、最大膀胱容量、O’Leary-Sant间质性膀胱炎问卷表症状评分和问题评分情况。结果两组患者经治疗3个月后O’Leary-SantIC症状评分分别从治疗前的(14.5±2.5)、(14.8±2.7)减少到治疗后的(8.0±3.1)、(7.5±2.8);O’Leary-SantIC问题评分分别从用药前的(11.0±3.5)、(11.5±3.1)减少到治疗后的(5.8±2.4)、(5.1±2.3);最大膀胱容量明显增加,分别从治疗前的(105.8±62.0)mL、(110.3±63.0)mL增加到(171.3±54.0)mL、(173.5±56.0)mL;每日排尿次数明显减少,分别从治疗前的(28.5±8.4)、(29.5±8.3)次减少到(15.6±3.3)次、(14.5±3.5)次;生活质量评分分别从用药前的(5.5±0.5)、(5.6±0.7)减少到(2.5±0.6)、(2.4±0.5),治疗前后对比差异均有显著性(P<0.05)。结论阿米替林口服及合并应用肝素膀胱灌注治疗均能有效缓解IC患者的临床症状,阿米替林口服合并肝素膀胱灌注治疗患者改善症状方面优于单纯阿米替林口服。
Objective To investigate the clinical effect of oral amitriptyline and heparin in the treatment of interstitial cystitis (IC). Methods IC patients were 23 cases, duration of 15 to 65 months, with an average of (30.7 ± 11.50) months. Simple amitriptyline treatment group of 12 patients, 11 patients treated with amitriptyline heparin treatment of bladder irrigation, treatment were 3 months. The number of daily urination, the maximum bladder capacity, the O’Leary-Sant interstitial cystitis questionnaire symptom score and the problem score were observed before treatment and 3 months after treatment. Results The O’Leary - SantIC symptom score decreased from (14.5 ± 2.5) and (14.8 ± 2.7) to (8.0 ± 3.1) and (7.5 ± 2.8) after treatment for 3 months in both groups. The score of O’Leary-SantIC was decreased from (11.0 ± 3.5) and (11.5 ± 3.1) before treatment to (5.8 ± 2.4) and (5.1 ± 2.3) after treatment respectively. The maximum bladder capacity increased significantly (110.8 ± 62.0) mL and (110.3 ± 63.0) mL to (171.3 ± 54.0) mL and (173.5 ± 56.0) mL, respectively. The frequency of urination was significantly decreased from 28.5 ± 8.4 to 29.5 (5.5 ± 0.5), (5.6 ± 0.7) to (2.5 ± 0.6), (2.4 ± ±), respectively 0.5), before and after treatment, the difference was significant (P <0.05). Conclusion Amitriptyline oral administration and heparin treatment combined with intravesical instillation of bladder can effectively relieve the clinical symptoms of IC patients. Amitriptyline oral heparinization and bladder irrigation are superior to amitriptyline alone in improving symptoms.