中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2014年
5期
376-380
,共5页
刘秉乾%李建华%王义昆%武玉东
劉秉乾%李建華%王義昆%武玉東
류병건%리건화%왕의곤%무옥동
膀胱,过度活动性%膀胱颈梗阻%肾上腺素能α拮抗剂%胆碱能拮抗剂%Meta分析
膀胱,過度活動性%膀胱頸梗阻%腎上腺素能α拮抗劑%膽堿能拮抗劑%Meta分析
방광,과도활동성%방광경경조%신상선소능α길항제%담감능길항제%Meta분석
Urinary bladder,overactive%Urinary bladder neck obstruction%Adrenergic alpha-antagonists%Cholinergic antagonists%Meta-analysis
目的 评价M受体阻滞剂联合α受体阻滞剂治疗膀胱过度活动症(OAB)合并膀胱出口梗阻(BOO)患者的疗效及安全性.方法 检索PubMed、EMBase、Ovid、万方数据知识服务平台和中国期刊全文数据库;检索时间范围均为建库至2013年10月.收集比较M受体阻滞剂联合α受体阻滞剂与α受体阻滞剂单药治疗BOO +OAB患者的随机对照试验.由2名研究者按Cochrane系统评价方法来筛选文献、评价质量、提取资料,并用RevMan 5.2软件进行Meta分析.结果 共纳入7个随机对照试验,其中1737例患者接受联合治疗,1 721例患者接受单药治疗.Meta分析结果显示,联合组总IPSS和储尿期IPSS的改善优于单药组(RR=-0.23,95％ CI:-0.44～-0.02,P=0.03;RR=-0.69,95％ CI:-0.88 ～-0.51,P＜0.01),两组间排尿期IPSS及Qmax的差别无统计学意义(P=0.86、0.89).联合组的口干(OR =2.53)、便秘(OR=3.74)、头晕(OR=0.73)以及尿潴留(OR=0.26)等不良反应的发生率高于单药组(P＜0.05),但是总体发生率低,表现轻微.结论 M受体阻滞剂联合α受体阻滞剂治疗BOO+OAB的整体疗效优于单用α受体阻滞剂,不良反应能为患者所耐受.
目的 評價M受體阻滯劑聯閤α受體阻滯劑治療膀胱過度活動癥(OAB)閤併膀胱齣口梗阻(BOO)患者的療效及安全性.方法 檢索PubMed、EMBase、Ovid、萬方數據知識服務平檯和中國期刊全文數據庫;檢索時間範圍均為建庫至2013年10月.收集比較M受體阻滯劑聯閤α受體阻滯劑與α受體阻滯劑單藥治療BOO +OAB患者的隨機對照試驗.由2名研究者按Cochrane繫統評價方法來篩選文獻、評價質量、提取資料,併用RevMan 5.2軟件進行Meta分析.結果 共納入7箇隨機對照試驗,其中1737例患者接受聯閤治療,1 721例患者接受單藥治療.Meta分析結果顯示,聯閤組總IPSS和儲尿期IPSS的改善優于單藥組(RR=-0.23,95％ CI:-0.44～-0.02,P=0.03;RR=-0.69,95％ CI:-0.88 ～-0.51,P＜0.01),兩組間排尿期IPSS及Qmax的差彆無統計學意義(P=0.86、0.89).聯閤組的口榦(OR =2.53)、便祕(OR=3.74)、頭暈(OR=0.73)以及尿潴留(OR=0.26)等不良反應的髮生率高于單藥組(P＜0.05),但是總體髮生率低,錶現輕微.結論 M受體阻滯劑聯閤α受體阻滯劑治療BOO+OAB的整體療效優于單用α受體阻滯劑,不良反應能為患者所耐受.
목적 평개M수체조체제연합α수체조체제치료방광과도활동증(OAB)합병방광출구경조(BOO)환자적료효급안전성.방법 검색PubMed、EMBase、Ovid、만방수거지식복무평태화중국기간전문수거고;검색시간범위균위건고지2013년10월.수집비교M수체조체제연합α수체조체제여α수체조체제단약치료BOO +OAB환자적수궤대조시험.유2명연구자안Cochrane계통평개방법래사선문헌、평개질량、제취자료,병용RevMan 5.2연건진행Meta분석.결과 공납입7개수궤대조시험,기중1737례환자접수연합치료,1 721례환자접수단약치료.Meta분석결과현시,연합조총IPSS화저뇨기IPSS적개선우우단약조(RR=-0.23,95％ CI:-0.44～-0.02,P=0.03;RR=-0.69,95％ CI:-0.88 ～-0.51,P＜0.01),량조간배뇨기IPSS급Qmax적차별무통계학의의(P=0.86、0.89).연합조적구간(OR =2.53)、편비(OR=3.74)、두훈(OR=0.73)이급뇨저류(OR=0.26)등불량반응적발생솔고우단약조(P＜0.05),단시총체발생솔저,표현경미.결론 M수체조체제연합α수체조체제치료BOO+OAB적정체료효우우단용α수체조체제,불량반응능위환자소내수.
Objective To compare the clinical effectiveness and safety of alpha-blocker alone and combined tamsulosin with an anticholinergic drug for bladder outlet obstruction (BOO) with overactive bladder (OAB).Methods Literature search was performed using PubMed,EMBASE,Ovid,Wanfang,and CNKI from inception to October 2013 for comparative studies assessing alpha-blocker alone and combined alpha-blocker with an anticholinergic drug for BOO + OAB.Data were extracted and evaluated by two reviewers independently according to the Cochrane Handbook for systematic reviews.Meta-analyses were conducted using RevMan 5.2.Results A total of 7 studies involving 3 458 patients were included for the analysis.The values of total IPSS and storage IPSS reduced significantly after treatment in combination group (RR =-0.23,95％CI:-0.44--0.02,P=0.03;RR=-0.69,95％CI:-0.88--0.51,P＜0.01)There were no significant differences between the two groups in voiding IPSS and Qmax (P =0.86 and 0.89).The incidences of dry mouth (OR =2.53),constipation (OR =3.74),dizziness (OR =0.73),and urinary retention (OR =0.26) were higher in combination group than in alpha-blocker alone group (P ＜ 0.05).But most adverse events were mild in degree.Conclusion Alpha-blocker combined with an anticholinergic drug in the treatment of BOO + OAB was better than that of alpha-blocker alone,and was safe and well tolerated.
