Speakman M J
Taunton and Somerset Hospital, Musgrove Park, Taunton, Somerset TA1 5DA, UK.
Eur Urol. 2001;39 Suppl 3:6-12. doi: 10.1159/000052561.
Because of the need for a more rational management of LUTS suggestive of BPO, EBM is receiving more attention. Treatment decisions should be based on scientific evidence more than on personal preferences of physicians and patients. EBM is more than following rigid treatment guidelines or published advice. It is a process of turning problems of clinical practice into well-defined questions and then finding and appraising available evidence and implementing it into clinical practice. In cases of LUTS suggestive of BPO, much evidence is available on the efficacy and tolerability of different treatment modalities in the short term, whereas long-term data on (cost)-effectiveness are rather scarce. From a patient's point of view, newer pharmacotherapeutic agents can be considered as an appropriate treatment option. alpha(1)-Adrenoceptor antagonists seem to be more efficacious than finasteride and within this group of drugs, selective alpha(1A)/alpha(1D)-adrenoceptor antagonists particularly show a favourable efficacy/tolerability ratio.
由于需要对提示良性前列腺增生的下尿路症状进行更合理的管理，循证医学正受到更多关注。治疗决策应基于科学证据，而非医生和患者的个人偏好。循证医学不仅仅是遵循严格的治疗指南或已发表的建议。它是一个将临床实践问题转化为明确问题，然后寻找和评估现有证据并将其应用于临床实践的过程。在提示良性前列腺增生的下尿路症状病例中，关于不同治疗方式短期疗效和耐受性的证据很多，而关于（成本）效益的长期数据则相当匮乏。从患者的角度来看，新型药物治疗剂可被视为一种合适的治疗选择。α1肾上腺素能受体拮抗剂似乎比非那雄胺更有效，在这类药物中，选择性α1A/α1D肾上腺素能受体拮抗剂尤其显示出良好的疗效/耐受性比。
