课件：OAB的流行病学,诊断及治疗.ppt

* Survey results show that OAB adversely affects the lives of those with symptoms of OAB. Studies have shown that patients with OAB have a significantly poorer quality of life than age-matched populations.1 Using the patient administered Short Form 36 (SF-36) quality-of-life questionnaire, it has been found that patients who suffer from OAB have a lower quality of life in the social and functional domains than patients with diabetes.1 The characteristic symptoms of OAB (urgency, frequency, nocturia, and urge incontinence) affect productivity at home and at work, interfere with social relationships and sexual intimacy, and affect physical functioning.2 References Abrams P, Kelleher CJ, Kerr LA, Rogers RG. Overactive bladder significantly affects quality of life. Am J Manag Care 2000; 6 (11 Suppl): S580–90. Lackner T and Reed K. Understanding the impact of overactive bladder from a patient perspective. Pharmacy Today 2009; 15: 54–65. * Antimuscarinic agents are used in conjunction with conservative management as initial therapy for OAB in both women and men; an α-blocker may be added in men with suspected bladder outlet obstruction.1,2 A Cochrane review of 61 randomised trials in nearly 12,000 patients found that antimuscarinic agents significantly improved OAB symptoms compared to placebo, with a mean reduction of approximately four incontinence episodes per week, higher rates of self-reported cure or improvement (56% versus 41%; relative risk [RR] 1.39; 95% confidence interval [CI], 1.28–1.51), and significantly better QOL.3 Dry mouth occurred in 31% of patients, but the rate of withdrawal due to adverse events did not differ significantly from placebo.3 A recent systematic review of 73 trials also found antimuscarinic agents to be effective and well tolerated.4 A second Cochrane review found antimuscarinic treatment to be more effective than bladder training (RR 0.75; 95% CI 0.59–0.90 for symptomatic improvement), but the data favoured a combined approac