坦索罗辛联合双氯芬酸钠治疗输尿管结石的疗效与安全性的meta分析  

Efficacy and safety of tamsulosin combined with diclofenac sodium in the treatment of ureteral calculi:a meta-analysis

作　　者：范志楠 施鸿金 张劲松[1] 李宁[1] 王海峰 左毅刚[1] 王剑松[1] FAN Zhinan;SHI Hongjin;ZHANG Jinsong;LI Ning;WANG Haifeng;ZUO Yigang;WANG Jiansong(Department of Urology,Second Affiliated Hospital of Kunming Medical University,Kunming,650101,China)

机构地区：[1]昆明医科大学第二附属医院泌尿外科,昆明650101

出　　处：《临床泌尿外科杂志》2022年第2期138-145,共8页Journal of Clinical Urology

基　　金：昆明医科大学第二附属医院院内临床研究项目(No:2020ynlc015)。

摘　　要：目的:系统评价坦索罗辛联合双氯芬酸钠治疗输尿管结石的疗效及安全性。方法:计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、万方、维普及知网数据库,搜集坦索罗辛联合双氯芬酸钠治疗输尿管结石的随机对照试验,检索时限均从建库至2020年9月,采用RevMan 5.3软件进行meta分析。结果:共纳入18个RCT。meta分析结果显示:(1)联合用药比保守疗法结石排出率更高(RR=2.65,95%CI:1.99~3.52),肾绞痛发生率更低(RR=0.21,95%CI:0.12~0.38)。(2)联合用药与单用坦索罗辛相比,患者排石率更高(RR=1.34,95%CI:1.20~1.49),排石时间更短(SMD_(随机)=-1.01,95%CI:-1.34~-0.68),肾绞痛发生率更低(RR=0.4,95%CI:0.28~0.58)。(3)联合用药与单用双氯芬酸钠比较,排石率更高(RR=1.61,95%CI:1.44~1.79),排石时间更短(SMD_(随机)=-0.94,95%CI:-1.25~-0.63),肾绞痛发生率更低(RR=0.41,95%CI:0.24~0.70)。结论:坦索罗辛联合双氯芬酸钠治疗输尿管结石安全有效,有较高排石率,降低了肾绞痛的发生率,但仍需更多大样本,高质量研究予以验证。Objective:To systematically evaluate the efficacy and safety of tamsulosin combined with diclofenac sodium in the treatment of ureteral calculi.Methods:The randomized controlled trials of tamsulosin combined with diclofenac sodium in the treatment of ureteral calculi were retrieved from PubMed,EMbase,Web of Science,The Cochrane Library,Wanfang,VIP and CNKI databases.The retrieval time was from the establishment of the database to September 2020.The meta-analysis was performed using RevMan 5.3 software.Results:A total of 18 RCTs were included.The results of meta-analysis showed that:(1)Combined therapy had a higher rate of stone removal than conservative therapy[RR=2.65,95%CI:1.99-3.52],and a lower incidence of renal colic[RR=0.21,95%CI:0.12-0.38].(2)Compared with tamsulosin alone,combined treatment had higher stone discharge rate[RR=1.34,95%CI:1.20-1.49],shorter stone discharge time[SMD_(randomization)=-1.01,95%CI:-1.34 to-0.68],and lower incidence of renal colic[RR=0.4,95%CI:0.28-0.58].(3)Compared with diclofenac sodium alone,the combined treatment had higher stone discharge rate[RR=1.61,95%CI:1.44-1.79],shorter stone discharge time[SMD;=-0.94,95%CI:-1.25 to-0.63],and lower incidence of renal colic[RR=0.41,95%CI:0.24-0.70].Conclusion:The combination of tamsulosin and diclofenac sodium is safe and effective in the treatment of ureteral calculi,with a high rate of stone removal and a reduced incidence of renal colic.However,more large samples and high-quality studies are needed for verification.

关 键 词：输尿管结石 META分析 药物排石 坦索罗辛 双氯芬酸钠 

分 类 号：R693[医药卫生—泌尿科学]