Yan Huilei, Wang Yunhui, Sun Rong, Cui Yuanshan
Department of Urology, Liaocheng People's Hospital, Liaocheng, China.
Urol Int. 2017;99(1):6-13. doi: 10.1159/000449390. Epub 2016 Oct 20.
The purpose of this meta-analysis was to evaluate the efficacy of antimuscarinics alone or in combination with alpha-blockers for the treatment of ureteral stent-related symptoms.
The databases MEDLINE, EMBASE, PubMed, the Cochrane Controlled Trial Register of Controlled Trials from 2000 to February 2016 were searched to identify randomized controlled trials that referred to the use of a combination of antimuscarinics and alpha-blockers for the treatment of ureteral stent-related symptoms. A systematic review and meta-analysis was conducted.
Seven publications involving 710 patients were included in the meta-analysis. In the analysis, we found significantly improved total International Prostate Symptom Score, quality of life, body pain and work performance score of the Ureteral Stent Symptom Questionnaire (USSQ) in the combination group compared with antimuscarinics alone (p = 0.00001, p = 0.00001, p = 0.00001 and p = 0.004, respectively). Antimuscarinics alone versus the control group showed significant improvement in urinary symptom, body pain and general health score of USSQ (p = 0.002, p = 0.00001 and p = 0.003, respectively).
Our meta-analysis shows the beneficial effect of antimuscarinics alone in reducing stent-related symptoms. The combined use of antimuscarinics and alpha-blockers results in additive favorable effects in patients with ureteral stent-related symptoms compared with antimuscarinics monotherapy. The alpha-blockers may enhance the efficacy of the antimuscarinics, which is beneficial for the treatment of ureteral stent-related symptoms.
本荟萃分析旨在评估抗毒蕈碱药物单独使用或与α受体阻滞剂联合使用治疗输尿管支架相关症状的疗效。
检索MEDLINE、EMBASE、PubMed以及2000年至2016年2月的Cochrane对照试验注册库，以确定提及使用抗毒蕈碱药物与α受体阻滞剂联合治疗输尿管支架相关症状的随机对照试验。进行了系统评价和荟萃分析。
荟萃分析纳入了7篇涉及710例患者的文献。分析发现，与单独使用抗毒蕈碱药物相比，联合治疗组的国际前列腺症状总评分、生活质量、身体疼痛及输尿管支架症状问卷（USSQ）的工作表现评分均有显著改善（分别为p = 0.00001、p = 0.00001、p = 0.00001和p = 0.004）。单独使用抗毒蕈碱药物与对照组相比，USSQ的尿路症状、身体疼痛及总体健康评分有显著改善（分别为p = 0.002、p = 0.00001和p = 0.003）。
我们的荟萃分析表明，单独使用抗毒蕈碱药物对减轻支架相关症状有益。与抗毒蕈碱药物单药治疗相比，抗毒蕈碱药物与α受体阻滞剂联合使用对输尿管支架相关症状患者产生相加的有利效果。α受体阻滞剂可能增强抗毒蕈碱药物的疗效，这对治疗输尿管支架相关症状有益。
