Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Department of Health Sciences and Technology, Brain Research Institute, Swiss Federal Institute of Technology Zürich, University of Zürich, Zürich, Switzerland.
Neurourol Urodyn. 2019 Aug;38(6):1482-1491. doi: 10.1002/nau.24039. Epub 2019 May 16.
We aimed to systematically assess the evidence on the efficacy and safety of alpha-blockers in patients with multiple sclerosis (MS) suffering from neurogenic lower urinary tract dysfunction (NLUTD).
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to perform this systematic review. An electronic search of Cochrane register, Embase, Medline, Scopus (last search 3 March 2018) and screening of reference lists as well as reviews were used to identify the studies. Articles were included if they reported on efficacy/safety of alpha-blockers for the treatment of NLUTD in patients with MS.
After screening of 7'015 abstracts, three studies enrolling a total of 50 patients were included: one randomized, placebo-controlled, single-blind trial and two prospective cohort studies. Alpha-blocker treatment was successful in 50% to 96% of the patients. Pooling data from the three included studies, the relative risk for successful alpha-blocker treatment was 3.89 (95% confidence interval 2.7-7.0). The general safety profile of alpha-blockers was favorable with 8% of the patients reporting adverse events.
Alpha-blockers may be effective and safe for treating NLUTD in female and male patients with MS but the studies were small and the overall quality of evidence was low. To make definitive conclusions, well designed randomized controlled trials are highly warranted.
本系统评价旨在系统评估α-受体阻滞剂治疗多发性硬化（MS）合并神经源性下尿路功能障碍（NLUTD）患者的疗效和安全性。
采用系统评价的首选报告项目（PRISMA）声明进行本系统评价。通过 Cochrane 注册库、Embase、Medline、Scopus（最后一次检索日期为 2018 年 3 月 3 日）进行电子检索，并对参考文献列表和综述进行筛选，以确定研究。如果文章报告了α-受体阻滞剂治疗 MS 合并 NLUTD 患者的疗效/安全性，则将其纳入。
经过对 7015 篇摘要的筛选，纳入了 3 项共纳入 50 例患者的研究：1 项随机、安慰剂对照、单盲试验和 2 项前瞻性队列研究。α-受体阻滞剂治疗的成功率为 50%至 96%。对纳入的 3 项研究的数据进行汇总，成功接受α-受体阻滞剂治疗的相对风险为 3.89（95%置信区间 2.7-7.0）。α-受体阻滞剂的总体安全性良好，8%的患者报告了不良事件。
α-受体阻滞剂可能对治疗 MS 合并女性和男性 NLUTD 有效且安全，但研究规模较小，证据总体质量较低。为了得出明确的结论，非常需要进行精心设计的随机对照试验。
