1、Chatelain C et al.Benign Prostatic hyperplasia.2000Kirby R,et al.Urology 2003;61(1):119-126Kirby R,et al.Urology 2003;61(1):119-1261 1多沙唑嗪多沙唑嗪(n=249)非那雄胺非那雄胺(n=237)多沙唑嗪多沙唑嗪+非那雄胺非那雄胺(n=261)安慰剂安慰剂(n=252)*1098765432108.3 0.46.6 0.48.5 0.45.7 0.4Kirby R,et al.Urology 2003;61(1):119-126多沙唑嗪多沙唑嗪(n=236)非那雄
2、胺非那雄胺(n=228)多沙唑嗪多沙唑嗪+非那雄胺非那雄胺(n=252)安慰剂安慰剂(n=245)*0.00.51.01.52.02.53.03.54.03.6 0.31.8 0.33.8 0.31.4 0.34.5Kirby R,et al.Urology 2003;61(1):119-126Kirby R,et al.Urology 2003;61(1):119-126Kirby R,et al.Urology 2003;61(1):119-126McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-23
3、98(*)Define as the time from randomization to the first occurrence of any of the five BPH progression events defined aboveMcConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-23980 01 12 23 34 45 56 6每100患者年中的终点数PSA4.0McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:
4、2387-2398McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-2398343966危险性下降危险性下降多沙唑嗪非那雄胺联合治疗7.07.05.05.06.06.04.04.00 02 24 46 68 8安慰剂多沙唑嗪非那雄胺多沙唑嗪非那雄胺AUA评分较基线值的改变 多沙唑嗪显著优于非那雄胺多沙唑嗪显著优于非那雄胺 (P=0.002)(P=0.002)联合治疗显著优于单药治疗联合治疗显著优于单药治疗 (P0.05)(P0.05)McConnell,etc;NEJM;2003,349:2387-239
5、83.73.72.22.22.52.51.41.40 01 12 23 34 4安慰剂多沙唑嗪非那雄胺多沙唑嗪非那雄胺Qmax较基线值的改变(mL/s)多沙唑嗪优于非那雄胺多沙唑嗪优于非那雄胺 联合治疗显著优于单药治疗联合治疗显著优于单药治疗 (P0.01)(P0.01)McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-2398McConnell,etc;NE
6、JM;2003,349:2387-2398McConnell,etc;NEJM;2003,349:2387-2398BPH的药物联合治疗的药物联合治疗Ji Youl Lee et al,BJU,June,2004Ji Youl Lee et al,BJU,June,2004Ji Youl Lee et al,BJU,June,2004Cardura X 3月CarduraimprovedCardura+tolterodineimprovedBOOCardura X 3月CarduraimprovedCardura+tolterodineimprovedBOO+OABUDSLUTS1441447
7、676(5353)6868(4747)YesYesYesYesNoNoNoNoWatchful waitingProstate smallPSA lowPreventive therapy5a-inhibitor?Prostate largePSA highIPSS7BPHAdd OAB MedicationContinueBPH的药物联合治疗的药物联合治疗De Rose AF,et al.International J.of Importence Research.2002;14:50-530 01 12 23 34 45 56 67 78 89 950-59 50-59 岁岁60-6960
8、-69岁岁70-7970-79岁岁IPSS=0IPSS=0IPSS 1-7IPSS 1-7IPSS 8-19IPSS 8-19IPSS 19IPSS 19Age effectLUTS effectLUTS effectLUTS effectJOHN M.FITZPATRICK and FRANOIS DESGRANDCHAMPS*,2 0 0 5 B J U60天天De Rose AF,et al.International J.of Importence Research.2002;14:50-53非器质性非器质性DEDE万艾可治疗效果不佳万艾可治疗效果不佳入选试验入选试验 n=28万艾可万
9、艾可+安慰剂安慰剂万艾可万艾可+可多华可多华IIEF5 5101015152020基础值基础值30天30天60天60天万艾可+可多华万艾可+可多华万艾可+安慰剂万艾可+安慰剂1010151520202525基础值基础值30天30天60天60天万艾可+可多华万艾可+可多华万艾可+安慰剂万艾可+安慰剂IIEF基础值:基础值:6-10IIEF基础值:基础值:11-16De Rose AF,et al.International J.of Importence Research.2002;14:50-53注:有其他研究显示,与1受体阻滞剂合用时,万艾可的剂量如果超过25mg,部分患者有出现低血压的可能。故服用受体阻滞剂后4小时内应避免服用50mg或100mg的万艾可,25mg不受限制。