膀胱内注入二甲基亚砜治疗间质性膀胱炎/膀胱疼痛综合征的疗效与安全性:一项系统评价和荟萃分析

The Efficacy and Safety of Dimethyl Sulfoxide Into the Bladder for the Treatment of Interstitial Cystitis/Bladder Pain Syndrome: A Systematic Review and Meta-Analysis.

作者信息

Li Hai-Rui, Shen Si-Hong, Gao Xiao-Shuai, Peng Liao, Luo De-Yi

机构信息

Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

出版信息

Neurourol Urodyn. 2025 Jun;44(5):1036-1046. doi: 10.1002/nau.70036. Epub 2025 Apr 10.

Abstract

OBJECTIVE

To investigate the efficacy and safety of intravesical DMSO instillation for the treatment of interstitial cystitis/bladder pain syndrome.

METHOD

The following databases were searched for relevant studies: PubMed, EMBASE, MEDLINE, Cochrane Library, and Web of Science (updated August 10, 2024). All studies on intravesical DMSO met the inclusion criteria and were evaluated using various quality assessment methods based on the type of study. Data were then analyzed using Review Manager 5.4 (Cochrane Collaboration software). The primary outcomes and indicators included the Interstitial Cystitis Symptom Index, the Interstitial Cystitis Problem Index, and Pain Scores. The secondary outcomes were bladder diary metrics and Pelvic Pain and Urgency/Frequency Symptom Scale (PUF).

RESULTS

This systematic review and meta-analysis included 5 randomized controlled trials and 9 single-arm or cohort studies, involving 554 patients. The combined statistics indicated an average pretreatment Interstitial Cystitis Symptom Index score was 14.27, an average Interstitial Cystitis Problem Index Score was 12.72, and an average Pain Score was 7.06. Compared to pretreatment values, the results indicated that the Interstitial Cystitis Symptom Index score decreased by 5.59 (95% CI: -6.68 to -4.50, p < 0.00001), the Interstitial Cystitis Problem Index score decreased by 5.14 (95% CI: -6.45 to -3.83, p < 0.00001), and the Pain Score decreased by 3.27 (95% CI: -3.95 to -2.60, p < 0.00001). Additionally, the overall incidence rate of adverse events in patients was 37.6%. Although 37% of cases had adverse events, the majority were considered mild and acceptable.

CONCLUSION

Evidence-based statistical analysis of the literature on intravesical DMSO treatment for interstitial cystitis/bladder pain syndrome indicates that this therapy is both effective and safe. Therefore, intravesical DMSO instillation can be considered a standard treatment method for interstitial cystitis/bladder pain syndrome.

摘要

目的

探讨膀胱内灌注二甲基亚砜(DMSO)治疗间质性膀胱炎/膀胱疼痛综合征的疗效和安全性。

方法

检索以下数据库以查找相关研究:PubMed、EMBASE、MEDLINE、Cochrane图书馆和科学网(更新于2024年8月10日)。所有关于膀胱内灌注DMSO的研究均符合纳入标准,并根据研究类型使用各种质量评估方法进行评估。然后使用Review Manager 5.4(Cochrane协作软件)对数据进行分析。主要结局和指标包括间质性膀胱炎症状指数、间质性膀胱炎问题指数和疼痛评分。次要结局为膀胱日记指标以及盆腔疼痛与尿急/尿频症状量表(PUF)。

结果

本系统评价和荟萃分析纳入了5项随机对照试验和9项单臂或队列研究,涉及554例患者。综合统计表明,治疗前间质性膀胱炎症状指数平均评分为14.27,间质性膀胱炎问题指数平均评分为12.72,疼痛平均评分为7.06。与治疗前值相比,结果表明间质性膀胱炎症状指数评分降低了5.59(95%置信区间:-6.68至-4.50,p<0.00001),间质性膀胱炎问题指数评分降低了5.14(95%置信区间:-6.45至-3.83,p<0.00001),疼痛评分降低了3.27(95%置信区间:-3.95至-2.60,p<0.00001)。此外,患者不良事件的总体发生率为37.6%。虽然37%的病例发生了不良事件,但大多数被认为是轻微且可接受的。

结论

对膀胱内灌注DMSO治疗间质性膀胱炎/膀胱疼痛综合征的文献进行循证统计分析表明,该疗法既有效又安全。因此,膀胱内灌注DMSO可被视为间质性膀胱炎/膀胱疼痛综合征的标准治疗方法。

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