α受体阻滞剂治疗慢性前列腺炎/慢性骨盆疼痛综合征的meta分析

Role of α-Receptor Blockers in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Meta-analysis

目的系统评价α受体阻滞剂治疗慢性前列腺炎/慢性骨盆疼痛综合征的疗效及安全性。方法计算机检索Cochrane图书馆、PUBMED、EMBASE、中国学术文献总库、中国生物医学文献数据库和中文科技期刊数据库。追查所获资料的参考文献,手检相关文献,截止时间均为2013年7月。文献检索无语种限制。处理组为α受体阻滞剂,对照组为安慰剂或其他治疗措施。对纳入的随机对照试验进行质量评价,运用RevMan4.2软件进行meta分析。以NIH-CPSI、IPSS或PSSI评分为疗效观察的主要指标,通过合并值比较治疗组与对照组的疗效及安全性。结果共纳入13个临床随机对照试验包括1145例患者,其中7篇文献质量评分较高。meta分析结果显示,在改善NIH-CPSI、IPSS、PSSI总分及各部评分等方面,α受体阻滞剂效果优于对照组,二者的差异有统计学意义。亚组分析显示患者能从较长疗程治疗中获得更大的收益。结论α受体阻滞剂能轻度改善慢性前列腺炎/慢性骨盆疼痛综合征患者的NIH-CPSI评分。但由于纳入的研究之间普遍存在着不同程度的异质性,且存在发表偏倚的可能性,故应谨慎看待上述结论,需要更多高质量的前瞻性随机对照试验来进一步证实。

Objective To evaluate the efficacy and safety of α-receptor blockers for chronic prostatitis/chronic pelvic pain syndrome .Methods A fully recursive literature search to July 2013 was conducted in the Co-chrane library,PubMed,EMBASE,China National Knowledge Infrastructure ,the Chinese Biological Medicine Da-tabase,The Chinese Science and Technology Jomual Full -text database to identify potentially relevant random-ized controlled trials ,co-mparing α-receptor blockers to placebo or other treatments control in patients with CP/CPPS and with no restricttions of languages .References of all included trials were also checked .Additional studies were identified through a manual search of the bibliographies of the retrieved articles ,recent reviews and monographs .Data mainly including NIH -CPSI、IPSS、PSSI scores were extracted from the treatment arm and the control arm respectively .RevMan4.2 was used for statistical analysis .Results A total of 13 CP/CPPS treatment random control trials involving 1145 patients were included ,of which 7 met the high-quality criteria .Combined analysis showed a statistically significant reduction of total and subtotal NIH -CPSI、IPSS、PSSI in patients .Indi-vidual treatment effects were statistically significant more often when treatment was administered for 3 months or longer.Conclusions The meta -analysis reveals that slightly effective treatment is available for CP /CPPS,and the treatment duration should be long (more than 3 months).More? high-quality,randomized,controlled trials are essential to prove the conclusions of this research .