CAJ | 학술논문

目的：对坦索罗辛联合体外冲击波碎石（ESWL）的治疗方法对上尿路结石（输尿管结石及肾结石）疗效评价分析。方法通过计算机检索 PubMed、MEDLINE、万方数据库、CKNI 数据库、维普数据库、Embase、Google数据库，收集相关外文随机对照试验，纳入符合研究并评价其方法学质量。使用统计学软件RevMan 4.2.2进行Meta分析。结果共纳入13个随机对照试验，7个在国外，6个在国内，共1322例患者。Meta分析结果表明：坦索罗辛联合ESWL较单用ESWL有更高的结石清除率[RR＝1.29，95%CI（1.16，1.44）]，其中6个试验分析提示试验组与对照组的结石清除时间无统计学差异[SMD＝0.46，95%CI（-0.01，0.94）]，3个试验分析提示试验组的疼痛评分比对照组较低[SMD＝-1.02，95%CI（-1.27，-0.76）]，9个试验分析提示试验组与对照组患者出现的不良反应无统计学差异[RR＝3.51，95%CI（0.97，12.63）]。结论坦索罗辛联合ESWL比单用ESWL在治疗上尿路结石有更好的治疗效果，而且坦索罗辛联合ESWL可以减轻患者的疼痛，在一定程度上可以减少止痛药物的使用，试验中患者不良反应发生较少，患者耐受良好，表明坦索罗辛联合ESWL的安全性较好。
목적：대탄색라신연합체외충격파쇄석（ESWL）적치료방법대상뇨로결석（수뇨관결석급신결석）료효평개분석。방법통과계산궤검색 PubMed、MEDLINE、만방수거고、CKNI 수거고、유보수거고、Embase、Google수거고，수집상관외문수궤대조시험，납입부합연구병평개기방법학질량。사용통계학연건RevMan 4.2.2진행Meta분석。결과공납입13개수궤대조시험，7개재국외，6개재국내，공1322례환자。Meta분석결과표명：탄색라신연합ESWL교단용ESWL유경고적결석청제솔[RR＝1.29，95%CI（1.16，1.44）]，기중6개시험분석제시시험조여대조조적결석청제시간무통계학차이[SMD＝0.46，95%CI（-0.01，0.94）]，3개시험분석제시시험조적동통평분비대조조교저[SMD＝-1.02，95%CI（-1.27，-0.76）]，9개시험분석제시시험조여대조조환자출현적불량반응무통계학차이[RR＝3.51，95%CI（0.97，12.63）]。결론탄색라신연합ESWL비단용ESWL재치료상뇨로결석유경호적치료효과，이차탄색라신연합ESWL가이감경환자적동통，재일정정도상가이감소지통약물적사용，시험중환자불량반응발생교소，환자내수량호，표명탄색라신연합ESWL적안전성교호。
Objective To evaluate and analyze the curative effects of using tamsulosin combined with ESWL (extracorporeal shock-wave lithotripsy) for the treatment of upper urinary tract calculi. Methods We collect relevant foreign randomized control groups by retrieving PubMed, MEDLINE, Wanfang database, CNKI database, VIP database, Embase and google database on the computer, included in the study and evaluated the quality of its methodology. At last, we used the statistical software of RevMan 4.2.2 to Meta analyze. Results We collected 13 randomized controlled trials (a total of 1322 patients), 7 in foreign countries, 6 in China.The Meta analysis showed that using tamsulosin combined with ESWL was higher than only using ESWL in calculi clearance rate[RR=1.29, 95% CI (1.16, 1.44)], in which 6 experiments' analyses indicated that the calculi clearance time of the experimental groups and control groups had no statistic-al differences[SMD=-0.46, 95%CI (-0.01, -0.94)], in which 3 experiments' analyses showed that the pain of experimental groups was lower than the pain of control groups[SMD=-1.02, 95%CI (-1.27, -0.76)], in which 9 experiments' analyses suggested that the patients' adverse reactions of the experimental groups and control groups had no statistical differences[RR=3.51, 95% CI (0.91, 12.63)]. Conclusion Using tamsulosin combined with ESWL has a better therapeutic effect than only using ESWL for the treatment of upper urinary tract calculi, and it can ease the pain of the patients and reduce the use of painkillers to some extent.In the experiment, there were fewer adverse effects in patients, and the patients were well tolerated, so it showed that the security of tamsulosin combined with ESWL is better.