间质性膀胱炎基础与临床

间质性膀胱炎是一种以严重尿急、尿频、夜尿次数增加，耻骨上疼痛，膀胱充盈疼痛加重，排尿后疼痛减轻，尿常规检查和细菌培养阴性为特征的一组综合症，对患者的精神心理和生活质量的影响不亚于癌症，国内外还没有一部系统介绍其基础与临床诊疗研究的专著。全书共设30章，重点介绍间质性膀胱炎的认识、命名与演变史，流行病学与症状患病率，膀胱壁组织结构与生理功能；病因机制，神经生物学与疼痛；诊断与鉴别诊断方法，尿液相关分子标记物，尿流动力学与鉴别诊断，超声表现与评价，成像技术与表现特点，诊疗指南，患者初始管理与辅助治疗，微能量物理治疗原理与实践，中医学辨证论治、方药选择，灌注药物与疗效评价，肉毒杆菌毒素治疗与评价，膀胱水囊扩张术应用，外科治疗方法与适应症，患者健康教育与护理等。为了知识的系统性，本书还增加了动物实验模型的建立与评价，临床数据库的设计与网络信息资源查询与应用等相关内容。

\"牛远杰，医学博士，美国罗彻斯特大学博士后，教授，博士生导师，国务院政府特特殊津贴专家，中组部“万人计划”领军人才，国家卫生计生突出贡献中青年专家，海河医学学者，杰出津门学者，首届天津名医。现任天津医科大学第二医院院长，天津市泌尿外科研究所所长，天津市泌尿外科基础医学重点实验室主任。 兼任中国医促会泌尿男性生殖医学分会主任委员，中华医学会泌尿外科学分会常务委员、基础研究学组组长，中国中西医结合学会泌尿外科专业委员会副主任委员，天津市医学会泌尿外科学分会主任委员，天津市中西医结合学会泌尿外科专业委员会名誉主任委员，《中华泌尿外科学杂志》等12本杂志编委。 韩瑞发，医学博士，美国哈佛大学博士后，二级教授，博士生导师，国务院政府特殊津贴专家，天津市政府授衔泌尿肿瘤生物治疗专家，原天津市泌尿外科研究所所长，天津市重点实验室主任，国家重点学科学术带头人。现任天津泌尿外科研究所泌尿肿瘤研究方向PI，天津医科大学第二医院泌尿肾病中心名誉主任。兼任中国中西医结合外科杂志常务编委，天津市中西医结合学会常务理事，中国中西医结合学会泌尿外科专业委员会名誉主任委员。 先后担任国家自然科学基金二审专家、国家科技进步奖、教育部技进步奖、中华医学科技奖评审专家，CUA委员，AUA、SBUR、EAU会员。曾荣获天津市“九五、十五”科技立功奖章，天津市劳动模范、天津市优秀教师、天津市优秀留学归国人员和中国中西医结合泌尿外科专业委员会终身成就奖。\"

\"第一章　间质性膀胱炎认识与演变史 ···················································································1 第一节　间质性膀胱炎的认识起源 ················································································1 第二节　间质性膀胱炎的命名与演变 ·············································································3 第三节　间质性膀胱炎国际协作组织的起源与发展 ···························································7 第二章　间质性膀胱炎流行病学与症状患病率 ·····································································11 第一节　流行病学与相关研究 ····················································································11 第二节　间质性膀胱炎症状患病率 ··············································································13 第三节　工作效率与医疗保险利用率 ···········································································17 第三章　膀胱壁组织结构与相关生理学功能 ········································································19 第一节　膀胱黏膜上皮的结构与功能特点 ·····································································19 第二节　膀胱黏膜上皮的生理与生物学功能 ··································································21 第三节　膀胱平滑肌的结构与细胞生理功能 ··································································33 第四节　调控膀胱排尿功能的神经系统 ········································································38 第五节　调控膀胱排尿功能的化学信号、受体与传导通路 ················································44 第六节　间质性膀胱炎病理生理与膀胱功能的改变 ·························································56 第四章　肥大细胞与间质性膀胱炎 ····················································································78 第一节　概述 ·········································································································78 第二节　肥大细胞的起源与迁移 ·················································································79 第三节　肥大细胞的表型与分布 ·················································································81 第四节　肥大细胞的发育与成熟 ·················································································82 第五节　肥大细胞的激活与脱颗粒 ··············································································83 第六节　肥大细胞与间质性膀胱炎的相关证据 ·······························································87 第五章　膀胱黏膜上皮损伤与间质性膀胱炎 ········································································91 第一节　概述 ·········································································································91 第二节　黏膜组织结构与细胞生物学功能 ·····································································92 第三节　间质性膀胱炎黏膜损伤与病理组织学证据 ·························································95 第四节　结语 ·········································································································99 第六章　雌激素与间质性膀胱炎 ······················································································102 第一节　概述 ········································································································102 第二节　雌激素-受体与膀胱上皮细胞 ·······································································105 第三节　雌激素与肥大细胞雌激素受体 ·······································································106 第四节　雌激素水平变化与间质性膀胱炎症状的相关性 ··················································107 第五节　雌激素阻断剂治疗间质性膀胱炎作用与评价 ·····················································108 第六节　结语 ········································································································109 第七章　获得性免疫与间质性膀胱炎 ················································································112 第一节　获得性免疫的概念 ······················································································112 第二节　获得性免疫的构成与功能 ·············································································113 第三节　获得性免疫反应与间质性膀胱炎 ····································································119 第四节　间质性膀胱炎膀胱挛缩的病因机制 ·································································121 第八章　神经生物学与间质性膀胱炎疼痛机制 ····································································126 第一节　概述 ········································································································126 第二节　神经源性炎症与膀胱疼痛 ·············································································129 第三节　间质性膀胱炎膀胱疼痛与周围神经敏化 ···························································131 第四节　间质性膀胱炎膀胱疼痛与中枢神经敏化 ···························································132 第九章　间质性膀胱炎诊断与鉴别诊断方法 ·······································································135 第一节　概述 ········································································································135 第二节　临床表现与症状特点 ···················································································136 第三节　IC症状评分系统与评价 ················································································137 第四节　实验室检查与尿液分析 ················································································143 第十章　间质性膀胱炎与尿液相关分子标志物 ····································································147 第一节　概述 ········································································································147 第二节　间质性膀胱炎与白细胞介素 ··········································································149 第三节　趋化因子表达与间质性膀胱炎 ·······································································152 第四节　血管内皮生长因子表达与间质性膀胱炎 ···························································153 第五节　肿瘤坏死因子与间质性膀胱炎 ·······································································156 第六节　神经生长因子与间质性膀胱炎疼痛机制 ···························································158 第七节　类胰蛋白酶与间质性膀胱炎 ··········································································163 第八节　糖胺聚糖与间质性膀胱炎 ·············································································166 第九节　问题与展望 ·······························································································168 第十一章　间质性膀胱炎尿流动力学表现与鉴别疾病 ···························································170 第一节　概述 ········································································································170 第二节　尿流动力学原理与方法 ················································································171 第三节　间质性膀胱炎尿流动力学表现 ·······································································179 第四节　尿流动力学用于间质性膀胱炎的鉴别诊断 ························································181 第五节　结语 ········································································································182 第十二章　超声在间质性膀胱炎诊断中的应用 ····································································184 第一节　概述 ········································································································184 第二节　正常膀胱壁的超声表现 ················································································185 第三节　间质性膀胱炎的超声表现 ·············································································187 第四节　超声对间质性膀胱炎相关疾病的鉴别诊断 ························································188 第五节　问题与展望 ·······························································································191 第十三章　成像技术与间质性膀胱炎 ················································································193 第一节　概述 ········································································································193 第二节　成像技术基本原理与应用 ·············································································194 第三节　磁共振成像技术原理与进展 ··········································································195 第四节　正常膀胱壁磁共振成像与结构特点 ·································································197 第五节　间质性膀胱炎磁共振成像与结构改变 ······························································198 第六节　磁共振功能成像对间质性膀胱炎疼痛的中枢定位研究 ·········································200 第十四章　间质性膀胱炎诊断指南与评价 ··········································································203 第一节　欧洲泌尿外科学会间质性膀胱炎诊断指南与评价 ···············································203 第二节　美国泌尿外科学会间质性膀胱炎诊断指南与评价 ···············································205 第三节　加拿大泌尿外科学会间质性膀胱炎诊断指南与评价 ············································207 第十五章　男性间质性膀胱炎的认识与诊疗原则 ·································································214 第一节　概述 ········································································································214 第二节　流行病学与发病率 ······················································································214 第三节　病因与病理 ·······························································································215 第四节　诊断与鉴别诊断 ·························································································216 第五节　间质性膀胱炎治疗原则与方法 ·······································································219 第六节　问题与展望 ·······························································································219 第十六章　间质性膀胱炎患者初始管理与辅助治疗 ······························································221 第一节　概述 ········································································································221 第二节　患者教育 ··································································································221 第三节　社会心理支持 ····························································································222 第四节　共存疾病的治疗 ·························································································223 第五节　饮食控制与评价 ·························································································223 第六节　行为疗与评价 ·························································································224 第七节　认知行为疗法 ····························································································225 第八节　意象导引 ··································································································226 第九节　哈他瑜伽 ··································································································227 第十节　膈式呼吸 ··································································································227 第十一节　矛盾松弛 ·······························································································228 第十二节　针刺疗法 ·······························································································228 第十三节　结语 ·····································································································229 第十七章　微能量物理治疗间质性膀胱炎的应用研究 ···························································231 第一节　概述 ········································································································231 第二节　微能量治疗间质性膀胱炎的基本原理和机制 ·····················································234 第三节　微能量技术治疗间质性膀胱炎的方法及效果评价 ···············································240 第四节　问题与展望 ·······························································································242 第十八章　指南推荐的间质性膀胱炎治疗药物与药效作用 ·····················································244 第一节　概述 ········································································································244 第二节　指南推荐的行为与非药物治疗原则 ·································································245 第三节　指南推荐的口服治疗药物 ·············································································247 第四节　非指南推荐的治疗药物 ················································································251 第五节　问题与展望 ·······························································································252 第十九章　中医对间质性膀胱炎的认识与辨证论治 ······························································254 第一节　中医学对间质性膀胱炎的认识 ·······································································254 第二节　中医分型与治则治法 ···················································································255 第三节　中药方剂组成与药效作用 ·············································································256 第四节　中西药结合治疗方案与评价 ··········································································258 第二十章　中医络病学对间质性膀胱炎病因病机的认识与方药选择 ·········································261 第一节　概述 ········································································································261 第二节　中医络病学与间质性膀胱炎的关系 ·································································262 第三节　中医络病学与膀胱的解剖相关 ·······································································262 第四节　中医络病学与间质性膀胱炎的生理相关 ···························································262 第五节　中医络病学与间质性膀胱炎的病理相关 ···························································263 第六节　从中医络病辨证分析间质性膀胱炎的病因 ························································264 第七节　基于中医络病学探讨间质性膀胱炎治法与方药 ·················································265 第八节　基于中医络病学探索间质性膀胱炎的诊疗思路 ··················································267 第二十一章　中医学对女性性功能障碍的认识 ····································································270 第一节　概述 ········································································································270 第二节　女性性功能的中医调节机制 ··········································································271 第三节　中医对女性间质性膀胱炎性功能障碍的认识 ·····················································273 第四节　女性间质性膀胱炎性功能障碍的症候分型 ························································276 第五节　中医辨证论治与方药选择 ·············································································276 第二十二章　间质性膀胱炎灌注药物与疗效评价 ·································································285 第一节　膀胱内常用灌注药物与原理 ··········································································285 第二节　药物灌注治疗与相关护理 ·············································································287 第三节　药物灌注疗程与疗效的评估方法 ····································································288 第四节　问题与展望 ·······························································································289 第二十三章　膀胱壁肉毒杆菌毒素治疗疗效与评价 ······························································291 第一节　概述 ········································································································291 第二节　肉毒杆菌毒素A逼尿肌注射治疗作用机制 ························································291 第三节　肉毒杆菌毒素A逼尿肌注射治疗方法与选择 ·····················································294 第四节　肉毒杆菌毒素A逼尿肌注射临床疗效与评价 ·····················································295 第五节　问题与展望 ·······························································································295 第二十四章　间质性膀胱炎膀胱水囊扩张术的应用与评价 ·····················································298 第一节　概述 ········································································································298 第二节　膀胱水囊扩张术应用与评价 ··········································································298 第三节　术后并发症与随访治疗 ················································································300 第四节　临床疗效与评价要点 ···················································································303 第二十五章　间质性膀胱炎外科治疗方法与评价 ·································································306 第一节　骶神经调控术治疗间质性膀胱炎 ····································································306 第二节　Hunner溃疡与红斑TUR切除术 ······································································315 第三节　间质性膀胱炎原位膀胱扩大术 ·······································································317 第四节　膀胱切除与输尿管造口术 ·············································································321 第五节　腹腔镜膀胱切除与回肠原位新膀胱术 ······························································328 第二十六章　间质性膀胱炎患者预防调护与健康教育 ···························································339 第一节　概述 ········································································································339 第二节　患者的健康教育 ·························································································339 第三节　精神心理支持与护理 ····