\u3010\u6587\u732e\u3011
\n\u8457\u8005\u540d\uff1aDudley Robinson, Linda Cardozo.
\n\u6587\u732e\u30bf\u30a4\u30c8\u30eb\uff1aAntimuscarinic drugs to treat overactive bladder.\u00a0
\n\u96d1\u8a8c\u540d\u30fb\u66f8\u7c4d\u540d\uff1aBMJ 2012;344:e2130 doi: 10.1136\/bmj.e2130.
\n\u767a\u884c\u5e74\uff1aPublished 27 March 2012<\/p>\n
\u3010\u8981\u7d04\u3011
\n\uff1cOAB\u3068\u306f\uff1e
\n\u5c3f\u610f\u5207\u8feb\u3092\u8d77\u3053\u3059\u75c7\u5019\u7fa4\u306e\u7dcf\u79f0\u3002\u901a\u5e38\u983b\u5c3f\u3092\u4f34\u3046\u3002\u5c3f\u5931\u7981\u306e\u6709\u7121\u306f\u554f\u308f\u306a\u3044\u3002\u307e\u305f\u3001\u5c3f\u8def\u611f\u67d3\u75c7\u3084\u4ed6\u306e\u660e\u3089\u304b\u306a\u75c5\u56e0\u3092\u4f34\u308f\u306a\u3044\u3002\u539f\u56e0\u306f\u4e0d\u660e\uff08\u6392\u5c3f\u7b4b\u3084\u526f\u4ea4\u611f\u795e\u7d4c\u306b\u539f\u56e0\u304c\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u308b\uff09\u3002<\/p>\n
\uff1c\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac\u306e\u52b9\u679c\uff1e
\n\u30fb\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac\u306b\u6709\u52b9\u6027\u3042\u308a
\n\u3000\u2460systematic review: 32\u306eRCT(\u8a086800\u540d): \u6cbb\u7652\u307e\u305f\u306f\u6539\u5584\u52b9\u679c\u3000RR 1.41, 95%CI 1.29-1.54
\n\u3000\u2461Cochrane review: 61\u306eRCT(\u8a0811956\u540d): \u6cbb\u7652\u307e\u305f\u306f\u6539\u5584\u52b9\u679c\u3000RR 1.39, 95%CI 1.28-1.51, NNT 7
\n\u3000\u2462\u6700\u65b0\u306esystematic review: 83\u306eRCT(\u8a0830699\u540d, 6\u7a2e\u985e\u306e\u7570\u306a\u308b\u85ac\u5264):
\n\u30fb\u6392\u5c3f\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u53ef\u80fd…RR 1.3-3.5
\n\u30fb\u5931\u7981\u56de\u6570…0.4-1.1\u56de\u6e1b\u5c11, \u6392\u5c3f\u56de\u6570…0.5-1.3\u56de\u6e1b\u5c11, \u5c3f\u610f\u5207\u8feb…0.64-1.56\u56de\u6e1b\u5c11
\n\u30fb\u5404\u85ac\u5264\u9593\u306e\u52b9\u679c\u3092\u6bd4\u8f03\u3057\u305fevidence\u306b\u306f\u4e4f\u3057\u3044<\/p>\n
\uff1c\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac\u306e\u5b89\u5168\u6027\uff1e
\n\u526f\u4f5c\u7528\uff1a\u53e3\u6e07\u30fb\u4fbf\u79d8\u30fb\u304b\u3059\u307f\u76ee\u30fb\u7720\u6c17\u30fb\u8a8d\u77e5\u80fd\u969c\u5bb3\u30fbQT\u5ef6\u9577
\n\u3000\u2460systematic review : 149\u306e\u8ad6\u6587: \u5185\u670d\u958b\u59cb\u5f8c30\u65e5\u4ee5\u5185\u306b43-83%\u304c\u4e2d\u65ad
\n\u3000\u2461meta-analysis: prospective randomized trials:
\n\u30fbCNS\u3078\u306e\u5f71\u97ff\u3092\u8abf\u67fb\u3002\u4e8b\u6545\u3092\u5831\u544a\u3057\u305f\u7814\u7a76\u306f\u5c11\u306a\u3044
\n\u30fb\u6700\u3082\u591a\u3044\u306e\u306f\u3081\u307e\u3044(oxybutynin 3%, propiderine 3.2%, tolterodine 1.8%, placebo 1.6%)<\/p>\n
\uff1c\u526f\u4f5c\u7528\u306e\u4e88\u9632\u7b56\uff1e
\n\u30fb\u9ad8\u9f62\u8005\uff1a\u8d77\u7acb\u6027\u4f4e\u8840\u5727\u3084\u8a8d\u77e5\u969c\u5bb3\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u305f\u3081\u3001\u5c11\u91cf\u6295\u4e0e
\n\u30fb\u6392\u5c3f\u969c\u5bb3\uff1a\u7537\u6027\u306f\u305d\u306e\u5897\u60aa\u3092\u8003\u616e, \u5973\u6027\u306f\u307e\u308c\u3002\u305d\u306e\u305f\u3081\u3001\u30eb\u30fc\u30c1\u30f3\u306e\u6b8b\u5c3f\u30e2\u30cb\u30bf\u30fc\u306f\u4e0d\u8981<\/p>\n
\uff1c\u8cbb\u7528\u5bfe\u52b9\u679c\uff1e
\n\u30fbUK National Health Service\u306e\u8a55\u4fa1\uff1asolifenacin\u304c\u6700\u3082QALY\u304c\u9ad8\u304b\u3063\u305f<\/p>\n
\uff1c\u5185\u670d\u6cd5\u3084\u305d\u306e\u5f8c\u306e\u30e2\u30cb\u30bf\u30fc\uff1e
\n\u30fb\u5185\u670d\u958b\u59cb\u524d\u306b\u5145\u5206\u306b\u305d\u306e\u526f\u4f5c\u7528\u3084\u5185\u670d\u4ee5\u5916\u306e\u65b9\u6cd5(Tips for patients\u4e0b\u306b\u8a18\u8f09)\u306b\u3064\u3044\u3066\u8a71\u3057\u5408\u3046\u3053\u3068
\n\u30fb\u4e00\u822c\u306b\u5c11\u91cf\u304b\u3089\u958b\u59cb\u3057\u3001\u52b9\u679c\u3084\u526f\u4f5c\u7528\u3092\u898b\u306a\u304c\u3089\u8abf\u6574\u3059\u308b\u3053\u3068
\n\u30fb\u809d\u6a5f\u80fd\u30fb\u814e\u6a5f\u80fd\u969c\u5bb3\u306e\u60a3\u8005\u3055\u3093\u306b\u809d\u814e\u6a5f\u80fd\u306e\u30e2\u30cb\u30bf\u30fc\u306f\u4e0d\u8981<\/p>\n
\uff1c\u4fdd\u5b58\u7684\u7642\u6cd5\u3084\u4ed6\u306e\u85ac\u5264\u3068\u306e\u6bd4\u8f03\uff1e
\n1.\u4fdd\u5b58\u7684\u7642\u6cd5\u3068\u306e\u6bd4\u8f03\uff1a
\nCochrane review: 13\u306e\u7814\u7a76(\u8a081770\u540d):\u00a0
\n\u30fb\u75c7\u72b6\u6539\u5584\u52b9\u679c…\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac vs \u8180\u80f1\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u3000RR 0.73, 95%CI 0.59-0.90
\n\u30fb\u75c7\u72b6\u6539\u5584\u52b9\u679c…\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac+\u8180\u80f1\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0 vs \u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac\u3000RR 0.55(0.32-0.93)
\n2.\u4ed6\u306e\u85ac\u5264\uff1a
\nvasopressin analogue\uff1aTable1
\n\u3000\u30fb\u591c\u9593\u983b\u5c3f\u3084\u591c\u5c3f\u75c7\u306b\u306f\u7b2c\u4e00\u9078\u629e\uff08\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac\u3068\u306e\u76f4\u63a5\u6bd4\u8f03\u306a\u3057\uff09<\/p>\n
Tips for patients
\nOveractive bladder is a common and distressing condition?Bladder retraining, lifestyle advice, and pelvic floor exercises should help to improve the symptoms of overactive bladder
\nThink about fluid intake and try to avoid caffeinated drinks, artificially sweetened carbonated drinks, and alcohol. Try not to drink too much (generally no more than 1.5 litres a day), and limit your fluid intake before bed
\nYour local continence advisory service will be able to provide you with tips for coping strategies and advice about containment products such as continence pads
\nAntimuscarinic drugs may be useful in addition to conservative measures when trying to control your bladder symptoms; these may be required long term as overactive bladder is a chronic condition
\nAntimuscarinic drugs may be associated with a dry mouth. Try sucking a sweet or chewing gum to increase salivation Constipation may also be associated with taking antimuscarinic drugs: it may be necessary to alter your diet or consider laxatives<\/p>\n
\u3010\u958b\u50ac\u65e5\u3011
\n2012\u5e744\u670818\u65e5<\/p>\n","protected":false},"excerpt":{"rendered":"
\u3010\u6587\u732e\u3011 \u8457\u8005\u540d\uff1aDudley Robinson, Linda Cardozo. \u6587\u732e\u30bf\u30a4\u30c8\u30eb\uff1aAntimuscarinic drugs to treat overactive bladder.\u00a0 \u96d1\u8a8c\u540d\u30fb\u66f8\u7c4d\u540d\uff1aBMJ … \u7d9a\u304d\u3092\u8aad\u3080 OAB\u306b\u5bfe\u3059\u308b\u6297\u30e0\u30b9\u30ab\u30ea\u30f3\u85ac<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-438","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/438","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=438"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/438\/revisions"}],"predecessor-version":[{"id":439,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/438\/revisions\/439"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=438"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=438"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=438"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}