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高齢女性における催促性尿失禁に対する行動対薬物治療:ランダム化制御試験
K L Burgio1, J L Locher, P S Goode
1Department of Medicine, School of Medicine, University of Alabama at Birmingham, USA. Kburgio@Aging.dom.uab.edu
JAMA
|December 24, 1998
まとめ
バイオフィードバック補助行動療法により,高齢の女性では,薬物治療またはプラセボよりも効果的に尿失禁のエピソードを大幅に減少させました. この安全で保守的な介入は,第一線療法として推奨されます.
科学分野:
- ゲリアトリック・メディシン (老年医学)
- 泌尿器科 泌尿器科とは
- 行動科学は,行動科学である.
背景:
- 尿失禁 (UI) は,多くの高齢者に影響する一般的な状態で,さまざまな要因と利用可能な治療法があります.
- 効果的な管理戦略は,UIを経験するコミュニティに住む高齢者の生活の質を改善するために不可欠です.
研究 の 目的:
- 薬物療法とプラセボに対するバイオフィードバック補助行動療法の有効性を比較するために,衝動性および混合性尿失禁.
- 尿失禁の異なる治療方法における患者による改善と満足度を評価する.
主な方法:
- ランダム化,プラセボ対照試験で,尿動力学的に確認された衝動または混合UIを持つ55~92歳の197人の女性が参加しました.
- 参加者は,バイオフィードバック補助行動療法,オキシブチニン塩化物薬,またはプラセボのいずれかを8週間受けました.
- 結果には, incontinenceエピソード (膀日記) の減少と,患者によって報告された改善と満足度の測定値が含まれています.
主要な成果:
- 行動療法による治療は,失禁のエピソードを80.7%減少させ,薬物治療 (68.5%) とプラセボ (39.4%) を大幅に上回りました.
- 患者の改善の認識は,薬物 (50.9%) とプラセボ (26.9%) と比較して,行動療法 (74.1%"はるかに良い") で最高でした.
- 行動療法を受けた患者は,薬物またはプラセボ群 (75.5%) よりも,変化を望んだ患者が少なく (14.0%) なりました.
結論:
- バイオフィードバック支援行動療法 (Biofeedback-assisted behavioral treatment) は,衝動性および混合性尿失禁に対する安全で効果的な,そしてよく耐える第一線介入です.
- 尿失禁を患っている高齢女性には,行動介入のアクセシビリティの向上が推奨されます.
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