坦索罗辛联合丁溴东莨菪碱辅助体外冲击波碎石治疗泌尿系结石效果及安全性的meta分析  

Meta-analysis of the efficacy and safety of Tamsulosin combined with Butylscopolammonium Bromide assisted extracorporeal shock wave lithotripsy in the treatment of urinary calculi

作　　者：钟斌 邹军荣 彭鹏 王晓宁[3] 张国玺[3] 谢天朋[3] ZHONG Bin;ZOU Junrong;PENG Peng;WANG Xiaoning;ZHANG Guoxi;XIE Tianpeng(The First Clinical Medical College,Gannan Medical University,Jiangxi Province,Ganzhou341000,China;Urological Research Institute,Gannan Medical University,Jiangxi Province,Ganzhou341000,China;Department of Urology,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]赣南医学院第一临床医学院,江西赣州341000 [2]赣南医学院泌尿外科研究所,江西赣州341000 [3]赣南医学院第一附属医院泌尿外科,江西赣州341000

出　　处：《中国医药导报》2023年第9期84-88,共5页China Medical Herald

基　　金：国家自然科学基金资助项目(81760462);江西省教育厅科学技术研究项目青年项目(190820);江西省赣州市指导性科技计划项目(GZ2019ZSF051)。

摘　　要：目的系统评价坦索罗辛联合丁溴东莨菪碱在泌尿系结石体外冲击波碎石(ESWL)后辅助排石的效果及安全性。方法计算机检索中国知网、万方、VIP、CBM、PubMed、Cochrane Library、Web of Science核心合集数据库,检索时限从建库至2022年4月,查找坦索罗辛联合丁溴东莨菪碱辅助ESWL治疗泌尿系结石的随机对照试验,试验组ESWL后给予坦索罗辛+丁溴东莨菪碱,对照组ESWL后给予丁溴东莨菪碱。采用RevMan 5.4软件进行meta分析,分析两组有效率、排石时间、肾绞痛消失时间、疼痛评分及不良反应情况,其中根据排石时间单位选择分为小时组、天数组;根据评分量表选择分为视觉模拟评分法(VAS)组、数字疼痛评分法(NPRS)组。结果共纳入8篇文献,1762例患者。试验组有效率高于对照组(RR=1.21,95%CI:1.16,1.26,P<0.00001)。小时组排石时间短于对照组(SMD=-5.50,95%CI:-6.59,-4.41,P<0.00001)。天数组排石时间短于对照组(SMD=-4.21,95%CI:-6.40,-2.03,P=0.0002)。试验组肾绞痛消失时间短于对照组(SMD=-2.04,95%CI:-2.18,-1.91,P<0.00001)。VAS组疼痛程度低于对照组(SMD=-0.65,95%CI:-0.90,-0.39,P<0.00001)。NPRS组疼痛程度低于对照组(SMD=-1.59,95%CI:-1.80,-1.38,P<0.00001)。两组不良反应比较,差异无统计学意义(P>0.05)。结论坦索罗辛联合丁溴东莨菪碱辅助ESWL治疗泌尿系结石可以提高治疗的有效率,促进结石排出、缩短疼痛时间及减轻患者疼痛症状,是一种安全有效的方法。To systematically evaluate the efficacy and safety of Tamsulosin combined with Butylscopolammonium Bromide assisted extracorporeal shock wave lithotripsy (ESWL) in the treatment of urinary calculi. Methods CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, and Web of Science core collection databases were searched by computer, the search period was from establishment to April 2022. The randomized controlled trials of Tamsulosin combined with Butylscopolammonium Bubromine assisted ESWL for urinary calculi was found, the experimental group was given Tamsulosin + Butylscopolammonium Bromide after ESWL, and control group was given Butylscopolammonium Bromide after ESWL. Meta-analysis was performed using RevMan 5.4 software, the effective rate, stone discharge time, disappearance time of renal colic, pain score, and adverse reactions between two groups were analyzed. According to the stone discharge time, it can be divided into hour group and day group;according to the rating scale select, it can be divided into visual analog scale (VAS) group and numerical pain rating scale (NPRS) group. Results A total of eight articles with 1 762 patients were included. The effective rate of experimental group was higher than that of control group (RR=1.21, 95%CI:1.16 to 1.26, P<0.000 01). The stone discharge time of hour group was shorter than that of control group (SMD=-5.50, 95%CI:-6.59 to -4.41, P<0.000 01). The stone discharge time of day group was shorter than that of control group (SMD=-4.21, 95%CI:-6.40 to -2.03, P=0.000 2). The disappearance time of renal colic in experimental group was shorter than that in control group (SMD=-2.04, 95%CI:-2.18 to -1.91, P<0.000 01). The degree of pain in VAS group was lower than that in control group (SMD=-0.65, 95%CI:-0.90 to -0.39, P<0.000 01). The degree of pain in NPRS group was lower than that in control group (SMD=-1.59, 95%CI:-1.80 to -1.38, P<0.000 01). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion Tamsulosin combined with But

关 键 词：泌尿系结石 体外冲击波碎石 坦索罗辛 丁溴东莨菪碱 

分 类 号：R69[医药卫生—泌尿科学]