- 期刊
Treatment of hypersensitive Bladder and Interstitial Cystitis by Intravesical Instillation of Capsaicin
膀胱內灌注紅辣椒素治療超敏感性膀胱及間質性膀胱炎
摘要
紅辣椒素已經證實對哺乳類動物的膀胱內之無髓鞘感覺神經纖維具有特別的作用，可以使神經未梢大量釋放出substance P，並且使得由這些神經所傳遞的感覺受到影響。紅辣椒素在臨床上已被使用於治療脊髓損傷所產生之逼尿肌反應射抗進，以及超敏感性膀胱的疼痛及頻尿症狀。為了更進一步厘清紅辣椒素在膀胱感覺性障礙疾病的治療效果，作者選擇10位超敏感性膀胱（HSB）患者以及10位具有質性膀胱炎(IC)的患者進行此一前行性研究。 所有的病人均經過臨床明確的診斷，但對於傳統抗孔醯膽胺治療無效，而且均有頻尿、急尿、夜尿、尿量少及恥骨上疼痛等膀胱刺激症狀。我們先以含有10μΜ紅辣椒素之生理鹽水進行膀胱壓力及尿流速，隨後以30毫升內含10μΜ紅辣椒素之生理鹽水每週灌注膀胱一次；一共進行六週。共有8位HSB病人在灌注後3-5天內症狀明顯改善消除，但隨後症狀即恢復直至下一次灌注為止，繼續灌注亦不會使有效期間增長。在IC 病人群中只有2位覺得症狀略有改善，而且有效期間僅在灌注2-3天而北，其餘8人完全無效。 使用紅辣椒素灌注膀胱後並無任何副作用或尿路感染發生。但是以10Μμ濃度灌注膀胱卻因其有效期間太短以及膀胱的刺激症狀，使得用於治療HSB及IC病人的臨床用途受到影響。如何改良灌注的濃度，頻度、方法使得臨床效果更好應是繼續研究的目標。(慈濟醫學 1994; 6: 239-244)
並列摘要
Capsaicin has been proven to exert a selective action on certain unmyelinated sensory fiber in the urinary bladder. This drug been used in treatment of detrusor hyperreflexia in spinal cord injury and bladder pain in hypersensitive patients with good results. In oder to further clarify the effect of capsaicin on bladder hypersensitivity, 10 patients with hypersensitive bladder (HSB) and 10 with interstitial cystitis (IC) entered this prospective study. The patients were refractory to conventional anticholinergic therapy and were bothered with symptoms of frequency, nocturia, small urine amount and/or suprapubic pain. Cystometry wasn performed with the medium containing 10 μM capsaicin in every patients. Then normal saline containing 10μM capsaicin was in-tilled into the bladder once per week for a total of 6 sessions. Eight HSB patients had symptoms relieved in the first 3 to 5 days but relapsed thereafter, further treatment could not prolong the response duration nor desensitization achieved. In IC patients, only 2 felt symptoms relief in the first 2 to 3 days, the other 8 showed no response. There was no side effect nor infection related to capsaicin instillation. The short duration of effect limits the clinical application of capsaicin on HSB and IC. (Tzu-Chi Med J 1994; 6: 239-244)
延伸閱讀
- Jung-Lun Wu、Chih-Cheng Yi、Shih- Kai Tu（2022）。骨盆腔放射線治療及經尿道膀胱腫瘤切除術後以肉眼可見的血尿及糞尿為表現的腸道膀胱廔管：病例報告及文獻回顧。台灣家庭醫學雜誌，32(4)，301-308。https://doi.org/10.53106/168232812022123204006
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