CAJ | 학술논문

目的比较索利那新与托特罗定治疗膀胱过度活动症(OAB)的疗效及安全性.方法检索Pubmed、EMBASE、Ovid、Google学术搜索、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.收集比较索利那新与托特罗定治疗OAB患者的随机对照试验.由2名研究者按Cochrane评价方法筛选文献、提取资料,并用RevMan 5.2软件进行荟萃分析.结果纳入7个随机对照试验,919例索利那新治疗,541例托特罗定速释型治疗,345例托特罗定缓释型治疗.荟萃分析结果显示,索利那新治疗后24h尿急次数及急迫性尿失禁次数的改善优于托特罗定速释型(RR=-0.34,95％ CI:-0.50 ～-0.18,P=0.00;RR=-0.29,95％ CI:-0.55～-0.04,P=0.03),口干发生率低于托特罗定速释型(RR=0.58,95％ CI:0.41～0.83,P=0.00),便秘发生率高于托特罗定速释型(RR=2.72,95％ CI:1.38～5.39,P=0.00),两组间每次尿量及24 h排尿次数的差异无统计学意义(P =0.05、0.08).索利那新与托特罗定缓释型相比,24 h尿急次数、24 h排尿次数、24 h急迫性尿失禁、平均每次尿量及主要不良反应的发生率差异均无统计学意义(均P＞0.05).结论索利那新治疗OAB的疗效优于托特罗定速释型,但便秘发生率较高.索利那新与托特罗定缓释型治疗OAB的疗效及不良反应均相当.
목적 비교색리나신여탁특라정치료방광과도활동증(OAB)적료효급안전성.방법 검색Pubmed、EMBASE、Ovid、Google학술수색、만방수거지식복무평태화중국기간전문수거고,검색시간범위균위건고지2013년10월.수집비교색리나신여탁특라정치료OAB환자적수궤대조시험.유2명연구자안Cochrane평개방법사선문헌、제취자료,병용RevMan 5.2연건진행회췌분석.결과 납입7개수궤대조시험,919례색리나신치료,541례탁특라정속석형치료,345례탁특라정완석형치료.회췌분석결과현시,색리나신치료후24h뇨급차수급급박성뇨실금차수적개선우우탁특라정속석형(RR=-0.34,95％ CI:-0.50 ～-0.18,P=0.00;RR=-0.29,95％ CI:-0.55～-0.04,P=0.03),구간발생솔저우탁특라정속석형(RR=0.58,95％ CI:0.41～0.83,P=0.00),편비발생솔고우탁특라정속석형(RR=2.72,95％ CI:1.38～5.39,P=0.00),량조간매차뇨량급24 h배뇨차수적차이무통계학의의(P =0.05、0.08).색리나신여탁특라정완석형상비,24 h뇨급차수、24 h배뇨차수、24 h급박성뇨실금、평균매차뇨량급주요불량반응적발생솔차이균무통계학의의(균P＞0.05).결론 색리나신치료OAB적료효우우탁특라정속석형,단편비발생솔교고.색리나신여탁특라정완석형치료OAB적료효급불량반응균상당.
Objective To compare the clinical efficacy and safety of solifenacin versus tolterodine in patients with overactive bladder (OAB).Methods Literature searches were performed with PubMed,EMBASE,Ovid and Google Scholar databases,Wanfang and CNKI from inception to October 2013 for comparative studies assessing solifenacin and tolterodine for OAB.The data were extracted and evaluated by two reviewers independently according to the Cochrane Handbook for Systematic Reviews.Meta-analyses were conducted with RevMan 5.2.Results A total of 7 studies involving 1 805 patients were retrieved.Compared with tolterodine immediate release (IR),the number of urgency episodes and urge incontinence episodes in 24 h and the rate of dry mouth were significantly lower in patients on solifenacin (RR =-0.34,95％CI:-0.50--0.18,P=0.00; RR=-0.29,95％CI:-0.55--0.04,P=0.03; RR=0.58,95 ％ CI:0.41-0.83,P =0.00) and the rate of constipation was higher in those on solifenacin (RR =2.72,95％ CI:1.38-5.39,P =0.00).No significant differences existed between tolterodine IR and solifenacin in mean micturition volume per voiding and micturitions episodes in 24 h (P =0.05,0.08).Between solifenacin and tolterodine extended release (ER),the number of urgency episodes,micturition and urge incontinence episodes in 24 h and mean micturition volume per voiding were not statistically different (all P ＞ 0.05).The incidence of major adverse events,such as dry mouth,constipation and blurred vision,was not significantly different (all P ＞ O.05).And most adverse events were mild.Conclusions Solifenacin is superior to tolterodine IR in treating OAB symptoms.However the rate of constipation is higher for solifenacin.Both solifenacin and tolterodine ER have similar therapeutic efficacies and adverse events.