目的:系统评价坦索罗辛单用或联合抗胆碱能药物治疗输尿管支架相关症状(SRSs)的疗效,为临床治疗提供循证参考。方法:计算机检索Pub Med、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万...目的:系统评价坦索罗辛单用或联合抗胆碱能药物治疗输尿管支架相关症状(SRSs)的疗效,为临床治疗提供循证参考。方法:计算机检索Pub Med、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万方数据库,检索时限均为各数据库自建库起至2019年10月,收集坦索罗辛单药(单用组)或联合抗胆碱能药物(联用组)对比安慰剂或空白对照(对照组)治疗SRSs的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取后,采用Cochrane协作网系统评价手册5.1.0进行质量评价,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入9项RCT,合计932例患者。Meta分析结果显示,在支架置入术后,单用组患者尿路症状评分[MD=-4.23,95%CI(-5.96,-2.51),P<0.00001]、躯体疼痛评分[MD=-4.20,95%C(I-5.30,-3.10),P<0.00001]、总体健康评分[MD=-1.36,95%C(I-1.75,-0.98),P<0.00001]均显著低于对照组,差异均有统计学意义;两组患者工作能力评分[MD=0.19,95%CI(-0.99,1.37),P=0.76]、性生活质量评分[MD=-0.31,95%CI(-0.68,0.05),P=0.09]比较,差异均无统计学意义。支架取出后4周,单用组患者躯体疼痛评分[MD=-0.64,95%CI(-0.84,-0.43),P<0.00001]、总体健康评分[MD=-0.28,95%CI(-0.41,-0.15),P<0.0001]、尿路症状评分[MD=-1.46,95%C(I-2.60,-0.32),P=0.01]均显著低于对照组,差异均有统计学意义;而两组患者工作能力评分[MD=0.31,95%CI(-0.22,0.84),P=0.25]、性生活质量评分[MD=-0.15,95%C(I-0.41,0.10),P=0.23]比较,差异无统计学意义。单用组患者尿路症状评分[MD=5.93,95%CI(2.83,9.02),P=0.0002]、躯体疼痛评分[MD=3.49,95%CI(1.39,5.60),P=0.001]、总体健康评分[MD=2.96,95%CI(1.44,4.49),P=0.0001]均显著高于联用组;两组患者工作能力评分[MD=1.53,95%CI(-0.12,3.18),P=0.07]、性生活质量评分[MD=0.46,95%CI(-1.03,1.96),P=0.54]比较,差异均无统计学意义。结论:坦索罗辛对SRSs有较好的治疗作用,联合抗胆碱�展开更多
Objective: To evaluate and compare the safety and efficacy of Solifenacin, Tamsulosin, and Tadalafil in treating ureteral stent related symptoms (SRS) in patients with indwelling Double-J ureteral stents. Materials an...Objective: To evaluate and compare the safety and efficacy of Solifenacin, Tamsulosin, and Tadalafil in treating ureteral stent related symptoms (SRS) in patients with indwelling Double-J ureteral stents. Materials and Methods: A prospective randomized controlled study was conducted on 146 consecutive patients in the department of urology, Government Stanley Medical College & Hospital, Chennai, Tamilnadu, India between Sept 2017-March 2019, with SRS after taking informed consent and confirming DJ Stent position by X-ray KUB post-operatively. Patients were randomized into 4 groups: Group A (Placebo), Group B (Solifenacin 5 mg), and Group B (Tamsulosin 0.4 mg) and group D (Tadalafil 5 mg) at end of 1st week till the removal of DJ stent at end of 3 weeks. All patients were assessed for bothersome lower urinary tract symptoms (LUTS) using the validated Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and 3 weeks after the starting of medications. Appropriate statistical analysis as carried out and the level of significance was set at P Results: LUTS, general health, and work performance improved with Solifenacin, Tamsulosin and Tadalafil and all the three were comparable in relieving urinary symptoms. Tadalafil was better at relieving body pain, additional problems and sexual problems better than Tamsulosin. Tadalafil showed comparable improvement in LUTS, better sexual health and decreased body pain compared to solifenacin, whereas the latter had better general health, additional problems & work performance scores. Conclusion: Solifenacin is more effective than Tamsulosin in alleviating LUTS associated with SRS and both show a distinctive advantage over placebo. PDE inhibitor Tadalafil can also be tried for SRS and is as effective as antimuscarinics and α-blockers in relieving urinary symptoms and is more efficacious in relieving sexual symptoms and body pain.展开更多
文摘目的:系统评价坦索罗辛单用或联合抗胆碱能药物治疗输尿管支架相关症状(SRSs)的疗效,为临床治疗提供循证参考。方法:计算机检索Pub Med、Embase、Cochrane图书馆、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万方数据库,检索时限均为各数据库自建库起至2019年10月,收集坦索罗辛单药(单用组)或联合抗胆碱能药物(联用组)对比安慰剂或空白对照(对照组)治疗SRSs的随机对照试验(RCT),对符合纳入标准的临床研究进行资料提取后,采用Cochrane协作网系统评价手册5.1.0进行质量评价,采用Rev Man 5.3统计软件进行Meta分析。结果:共纳入9项RCT,合计932例患者。Meta分析结果显示,在支架置入术后,单用组患者尿路症状评分[MD=-4.23,95%CI(-5.96,-2.51),P<0.00001]、躯体疼痛评分[MD=-4.20,95%C(I-5.30,-3.10),P<0.00001]、总体健康评分[MD=-1.36,95%C(I-1.75,-0.98),P<0.00001]均显著低于对照组,差异均有统计学意义;两组患者工作能力评分[MD=0.19,95%CI(-0.99,1.37),P=0.76]、性生活质量评分[MD=-0.31,95%CI(-0.68,0.05),P=0.09]比较,差异均无统计学意义。支架取出后4周,单用组患者躯体疼痛评分[MD=-0.64,95%CI(-0.84,-0.43),P<0.00001]、总体健康评分[MD=-0.28,95%CI(-0.41,-0.15),P<0.0001]、尿路症状评分[MD=-1.46,95%C(I-2.60,-0.32),P=0.01]均显著低于对照组,差异均有统计学意义;而两组患者工作能力评分[MD=0.31,95%CI(-0.22,0.84),P=0.25]、性生活质量评分[MD=-0.15,95%C(I-0.41,0.10),P=0.23]比较,差异无统计学意义。单用组患者尿路症状评分[MD=5.93,95%CI(2.83,9.02),P=0.0002]、躯体疼痛评分[MD=3.49,95%CI(1.39,5.60),P=0.001]、总体健康评分[MD=2.96,95%CI(1.44,4.49),P=0.0001]均显著高于联用组;两组患者工作能力评分[MD=1.53,95%CI(-0.12,3.18),P=0.07]、性生活质量评分[MD=0.46,95%CI(-1.03,1.96),P=0.54]比较,差异均无统计学意义。结论:坦索罗辛对SRSs有较好的治疗作用,联合抗胆碱�
文摘Objective: To evaluate and compare the safety and efficacy of Solifenacin, Tamsulosin, and Tadalafil in treating ureteral stent related symptoms (SRS) in patients with indwelling Double-J ureteral stents. Materials and Methods: A prospective randomized controlled study was conducted on 146 consecutive patients in the department of urology, Government Stanley Medical College & Hospital, Chennai, Tamilnadu, India between Sept 2017-March 2019, with SRS after taking informed consent and confirming DJ Stent position by X-ray KUB post-operatively. Patients were randomized into 4 groups: Group A (Placebo), Group B (Solifenacin 5 mg), and Group B (Tamsulosin 0.4 mg) and group D (Tadalafil 5 mg) at end of 1st week till the removal of DJ stent at end of 3 weeks. All patients were assessed for bothersome lower urinary tract symptoms (LUTS) using the validated Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and 3 weeks after the starting of medications. Appropriate statistical analysis as carried out and the level of significance was set at P Results: LUTS, general health, and work performance improved with Solifenacin, Tamsulosin and Tadalafil and all the three were comparable in relieving urinary symptoms. Tadalafil was better at relieving body pain, additional problems and sexual problems better than Tamsulosin. Tadalafil showed comparable improvement in LUTS, better sexual health and decreased body pain compared to solifenacin, whereas the latter had better general health, additional problems & work performance scores. Conclusion: Solifenacin is more effective than Tamsulosin in alleviating LUTS associated with SRS and both show a distinctive advantage over placebo. PDE inhibitor Tadalafil can also be tried for SRS and is as effective as antimuscarinics and α-blockers in relieving urinary symptoms and is more efficacious in relieving sexual symptoms and body pain.
