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盐酸丙哌维林治疗成人膀胱过度活动症的疗效与安全性:一项系统评价与荟萃分析

Efficacy and Safety of Propiverine Hydrochloride for Overactive Bladder in Adult: a Systematic Review and Meta-analysis.

作者信息

Huang Wei, Zong Huantao, Zhou Xin, Wang Tao, Zhang Yong

机构信息

Department of Urology, Beijing Tian Tan Hospital, Capital Medical University, No. 6 Tiantan Xi Li, Dongcheng District Beijing, 100050 China.

出版信息

Indian J Surg. 2015 Dec;77(Suppl 3):1369-77. doi: 10.1007/s12262-015-1264-1. Epub 2015 Apr 4.

Abstract

We carried out a systematic review and meta-analysis to assess the efficacy and safety of propiverine for treating overactive bladder (OAB) in adult. A literature review was performed to identify all published randomized placebo-controlled trials (RCT) of propiverine for the treatment of OAB. The search included the following databases: PUBMED and EMBASE. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Ten publications involving nine different RCTs were used in the analysis. We found that propiverine was effective in treating OAB in our meta-analysis. The decrease in number of micturitions/24 h (P < 0.00001, the mean decrease was from 1.80 to 2.57) indicated that propiverine was more effective than the placebo. Propiverine also decrease the number of urgency, urgency incontinence, and nocturia and increase urine volume. However, the incidence of difficulty in voiding was higher with propiverine therapy compared with the placebo (P = 0.05, the mean percentage range from 0.34 to 4.93 %). The decrease of total international prostate symptom score (IPSS) (P < 0.0001, the mean decrease was from 12.5 to 16.1) indicated that propiverine add a1-adrenoceptor antagonist was more effective in decreasing the lower urinary tract symptom (LUTS). The combination therapy also decreases the voiding symptom and storage symptom scores and increases maximum flow rate. This meta-analysis shows that propiverine is a safe and effective treatment for OAB. The major adverse event associated with propiverine treatment was difficulty in voiding. Propiverine add a1-adrenoceptor antagonist was more effective in terms of decreasing difficulty in voiding.

摘要

我们进行了一项系统评价和荟萃分析,以评估丙哌维林治疗成人膀胱过度活动症(OAB)的疗效和安全性。进行文献检索以确定所有已发表的关于丙哌维林治疗OAB的随机安慰剂对照试验(RCT)。检索包括以下数据库:PUBMED和EMBASE。还对检索到的研究的参考文献列表进行了调查。进行了系统评价和荟萃分析。分析中使用了涉及9项不同RCT的10篇出版物。我们发现在荟萃分析中丙哌维林治疗OAB有效。24小时排尿次数减少(P < 0.00001,平均减少量从1.80降至2.57)表明丙哌维林比安慰剂更有效。丙哌维林还减少了尿急、急迫性尿失禁和夜尿次数,并增加了尿量。然而,与安慰剂相比,丙哌维林治疗时排尿困难的发生率更高(P = 0.05,平均百分比范围为0.34%至4.93%)。国际前列腺症状评分(IPSS)总分降低(P < 0.0001,平均降低量从12.5降至16.1)表明丙哌维林加α1肾上腺素能受体拮抗剂在减轻下尿路症状(LUTS)方面更有效。联合治疗还降低了排尿症状和储尿症状评分,并增加了最大尿流率。这项荟萃分析表明丙哌维林是一种治疗OAB的安全有效的药物。与丙哌维林治疗相关的主要不良事件是排尿困难。丙哌维林加α1肾上腺素能受体拮抗剂在减少排尿困难方面更有效。

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