索利那新与托特罗定治疗膀胱过度活动症效果及安全性的荟萃分析  

Comparisons of therapeutic efficacy and safety of solifenacin versus tolterodine in patients with overactive bladder： a meta-analysis of outcomes

作　　者：刘秉乾[1] 李沛寰[2] 李建华[1] 王义昆[1] 武玉东[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,450052 [2]郑州大学学报编辑部

出　　处：《中华医学杂志》2014年第30期2350-2354,共5页National Medical Journal of China

摘　　要：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.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.

关 键 词：膀胱 过度活动性 META分析 索利那新 托特罗定 

分 类 号：R694[医药卫生—泌尿科学]