摘要
目的采用Meta分析方法评价赛洛多辛治疗BPH的安全性和有效性。方法制定原始文献的纳入标准、排除标准及检索策略,检索MEDIINE(1966-2012年)、EMBASE(1988-2012年)、Cochrane图书馆、中国生物医学期刊文献数据库(1979-2012年),CNK1数字图书馆(1979-2012年)有关赛洛多辛治疗BPH的随机对照研究(RCT),利用RevMan软件进行固定效应模型和随机效应模型的Meta分析。计算合并效应尺度以标准均数差(standardmeandifference,SMD)及其95%可信区间(95%CI)表示。结果共纳入4篇文献,包括2543例患者,包含3个赛洛多辛与安慰剂比较的RCT和3个赛洛多辛与坦索罗辛比较的RCT。患者使用赛洛多辛后,总IPSS(SMD=2.92,95%CI=2.19~3.65)、排尿期IPSS(SMD=1.92,95%CI=1.44~2.39)、储尿期IPSS(SMD=0.92,95%CI=0.60~1.24)和Qmax(SMD=1.56,95%CI=1.38~1.75)与安慰剂组比较差异均有统计学意义(P〈0.05);主要不良反应是异常射精。与0.2mg坦索罗辛相比,8mg赛洛多辛可以更有效地改善IPSS和Qmax(P〈0.05);以异常射精为主的不良反应也较明显(SMD=1.37,95%CI=1.18~1.58,P〈0.05)。与0.4mg坦索罗辛相比,8mg赛洛多辛治疗BPH的有效性和总体不良反应的发生率差异无统计学意义(SMD=1.21,95%CI=0.98~1.49,P〉0.05)。结论赛洛多辛治疗BPH引起的下尿路症状较安慰剂和0.2mg坦索罗辛更有效,与0.4mg坦索罗辛作用相当。赛洛多辛的主要不良反应为异常射精。
Objective To evaluate the efficacy and safety of silodosin in the treatment of benign prostatic hyperplasia (BPH). Methods Randomized controlled trials (RCT) on the efficacy and safety of silodosin for the treatment of BPH were retrieved from Medline ( 1966 - 2012) , Embase ( 1988 - 2012) , Coehrane liberary, CMCC ( 1979 - 2012) , CNK1 ( 1979 - 2012) and the quality of the included RCTs were evaluated using Cochrane systematic evaluation to analyze the data statistically using Rev Man 5. 1.0 soft- ware. Results Six RCTs involving 2543 participants were included for the meta-analysis. Results of anal- ysis showed that silodosin was effective in the treatment of BPH in term of total international prostate symp- tom score (IPSS) ( standard mean difference (SMD) = 2.92, 95% CI = 2.19 - 3.65, P 〈 0.05 ) , voiding symptom score (SMD = 1.92, 95% CI = 1.44 - 2.39, P 〈0.05) , storage symptom score (SMD = 0.92, 95% CI = 0.60 - 1.24, P 〈 0.05 ), and maximum flow rate ( Qmax ) score ( SMD = 1.56, 95% CI = 1.38 - 1.75, P 〈 0.05 ) , compared with the placebo. Silodosin 8 mg was more effective than tamsulosin 0.2 mg in term of IPSS-related parameters and Qmax ( P 〈0. 05 ). Silodosin 8mg and tamsulosin 0.4 mg were similarly effective in all the efficacy analyses. Abnormal ejaculation was less common with tamsulosin 0. 2 mg and 0. 4mg (P〈0.05); overall adverse events were similar with tamsulosin 0.2 and 0.4 mg (P 〈0.05). Conclusions Silodosin was significantly more effective than placebo and tamsulosin0. 2 mg in improving symptoms and as effective as tamsulosin 0. 4 mg. For adverse events, abnormal ejaculation was more com- mon with silodosin.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第4期310-313,共4页
Chinese Journal of Urology
基金
北京市卫生系统高层次卫生技术人才培养计划(2009-3-15)