盐酸坦索罗辛治疗前列腺增生症的系统回顾及更新荟萃分析

摘要

目的：利用 Meta 分析系统观察盐酸坦索罗辛治疗前列腺增生症的疗效。方法：检索 Co-chrane 图书馆，Embase 数据库，Pubmed 数据库，中国生物医学文献数据库，CNKI 数据库，VIP 数据库，万方数据库，纳入盐酸坦索罗辛治疗前列腺增生症的随机对照治疗（RCT），并进行方法学质量评价，采用 Rev-Man5．2软件进行统计分析，并发表偏倚评估和敏感性分析。结果：最终有10篇 RCT 文献纳入本项研究， Meta 分析结果显示盐酸坦索罗辛在 IPSS ／Boyarsky symptom score，Qmax ／MFR 以及 QoL score[SMD ＝－0．34，P ＜0．00001；WMD ＝1．10，P ＜0．00001；WMD ＝－0．39，P ＝0．0007]效果方面明显优于安慰剂组（P＜0．01），但该药的某些副作用较安慰剂相比亦有显著差别（RR ＝1．12，P ＜0．0001）。结论：盐酸坦索罗辛在治疗前列腺增生症中疗效确切，是治疗前列腺增生症的有效方法，但需注意其潜在的副作用。%To systematically update and review the efficacy and safety of different dosages of tamsulosin treatments on lower urinary tract symptoms (LUTS)in male benign prostatic hyperplasia (BPH)patients to provide more reliable evidence for the use of tamsulosin.Methods:Relevant paper in PubMed (1 966 - May 201 4),Em-base (1 974 - May 201 4),the Cochrane Library Database (201 4,Issue 5)and China National Knowledge Infra-structure (CNKI)(1 995 -201 4)were reviewed.The assessed outcome measures included international Prostate Symptom Score (IPSS)/Boyarsky symptom score,quality of life (QOL)score,maximum flow rate (MFR/Qmax ) and AEs (adverse events).Two authors independently assessed the study quality and extracted data.All data were analyzed through RevMan 5.2.The meta -analysis included ten randomized controlled trials and the study durations ranged from 4 weeks to 1 2 weeks.Results:The pooled results showed that the change in the tamsulosin group was significantly higher than the placebo group in the aspects of the IPSS /Boyarsky symptom score,Qmax /MFR,QoL score [standardized mean difference (SMD)= -0.34,P <0.00001 ;weighted mean difference (WMD)=1 .1 0, P <0.00001 ;WMD =-0.39,P =0.0007 respectively].According to the AEs pooled results,abnormal ejacula-tion,dizziness,rhinitis (nasal congestion),infection,back pain and asthenia/fatigue were the most commonly re-ported adverse events,and the risk ratio (RR)of 1 .1 2 was significantly different from the placebo group (p <0. 0001 ).Conclusion:The current meta -analysis suggests that tamsulosin is effective in treating LUTS of male BPH patients,but its side effects also need further attention.