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夜尿的中西醫學臨床探討

Clinical Exploration of Nocturia in Traditional Chinese and Western Medicine

摘要


夜尿(Nocturia,ICD10:R351)是臨床常見的主訴,在高齡者盛行率超過五成,若一晚超過兩次則會造成患者的困擾。傳統中醫主要認為夜尿是腎與膀胱虛寒所致;而西方醫學則認為是膀胱儲尿量的下降,夜間多尿或兩者兼有。夜尿的評估主要透過問診,排尿日記可作為重要的參考。現代醫學的治療包括正壓呼吸器,行為療法,alpha-1-adrenergic antagonists,5-alpha reductase inhibitor,antimuscarinics,beta-3 agonists及desmopressin等,各種藥物都有其對應的副作用。曹勇教授以縮泉丸為主方將夜尿分成四型論治,董氏奇穴與灸法在治療夜尿也有顯著的效果,完整詳細的衛教則是不可或缺的。

關鍵字

夜尿 腎陽虛 膀胱虛寒 縮泉丸

並列摘要


Nocturia (ICD10: R351) is a common clinical complaint, with a prevalence rate of more than 50% in the elderly. If it exceeds twice a night, it will cause trouble for the patient. Traditional Chinese medicine mainly believes that nocturia is caused by deficiency and cold of the kidneys and bladder; while Western medicine believes that it is a decrease in bladder urine storage capacity, nocturnal polyuria, or both. The evaluation of nocturia is mainly by consultation, and a voiding diary can be used as an important reference. The treatment of modern medicine includes Continuous positive airway pressure, behavioral therapy, alpha-1-adrenergic antagonists, 5-alpha reductase inhibitor, antimuscarinics, beta-3 agonists and desmopressin, etc. All kinds of drugs have their corresponding side effects. Professor Cao Yong divided nocturia into four types with Suoquan Wan as the main prescription. Tung's Acupuncture and moxibustion also have significant effects in treating nocturia, and detailed health education is indispensable.

參考文獻


Theodore M Johnson II, MD, MPH:Nocturia: Clinical presentation, evaluation, and management in adults。 UPTODATE@ 2022
朱文峰:中醫診斷學。中國中醫藥出版社 2002
王炯珵:台北夜未眠—如何使用排尿日記診 斷夜 尿。 台灣 尿失 禁防 治協 會(http://www.tcs.org.tw/forum/article_info.asp?/69.html)
楊家祥、陳俊傑:阻塞型睡眠呼吸中止症候 群的 診斷 與治 療。 基層 醫學 第二十一卷第十一期。 2006
Alan W. Partin MD PhD (Editor), Craig A. Peters MD (Editor), Louis R. Kavoussi MD MBA (Editor), Roger R. Dmochowski MD FACS (Editor), Alan J. Wein MD PhD (Hon) FACS (Editor) :Campbell Walsh Wein Urology 12th Edition。Elsevier 2021

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