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目的对坦索罗辛联合体外冲击波碎石(ESWL)的治疗方法对上尿路结石(输尿管结石及肾结石)疗效评价分析。方法通过计算机检索PubMed、MEDLINE、万方数据库、CKNI数据库、维普数据库、Embase、Google数据库,收集相关外文随机对照试验,纳入符合研究并评价其方法学质量。使用统计学软件RevMan 4.2.2进行Meta分析。结果共纳入13个随机对照试验,7个在国外,6个在国内,共1322例患者。Meta分析结果表明:坦索罗辛联合ESWL较单用ESWL有更高的结石清除率[RR=1.29,95%CI(1.16,1.44)],其中6个试验分析提示试验组与对照组的结石清除时间无统计学差异[SMD=0.46,95%CI(-0.01,0.94)],3个试验分析提示试验组的疼痛评分比对照组较低[SMD=-1.02,95%CI(-1.27,-0.76)],9个试验分析提示试验组与对照组患者出现的不良反应无统计学差异[RR=3.51,95%CI(0.97,12.63)]。结论坦索罗辛联合ESWL比单用ESWL在治疗上尿路结石有更好的治疗效果,而且坦索罗辛联合ESWL可以减轻患者的疼痛,在一定程度上可以减少止痛药物的使用,试验中患者不良反应发生较少,患者耐受良好,表明坦索罗辛联合ESWL的安全性较好。
Objective To evaluate the efficacy of tamsulosin combined with extracorporeal shock wave lithotripsy (ESWL) in the treatment of upper urinary tract calculi (ureteral calculi and kidney stones). Methods PubMed, MEDLINE, Wanfang database, CKNI database, VIP database, Embase and Google database were searched by computer and related foreign language randomized controlled trials were collected and included in the study and evaluation of their methodology quality. Meta-analysis was performed using statistical software RevMan 4.2.2. Results A total of 13 randomized controlled trials were included, 7 were abroad and 6 were in the country with a total of 1322 patients. Meta-analysis showed that tamsulosin combined with ESWL had higher stone clearance rate than ESWL alone [RR = 1.29,95% CI (1.16,1.44)], of which six trials suggested that the stones in the test group and the control group There was no significant difference in clearance time between the two groups [SMD = 0.46,95% CI (-0.01,0.94)]. The three trials suggested that the pain score of the experimental group was lower than that of the control group [SMD = -1.02,95% CI -1.27, -0.76). Nine trials showed no significant difference in adverse reactions between the two groups [RR = 3.51, 95% CI (0.97, 12.63)]. Conclusion Tamsulosin combined with ESWL is superior to ESWL alone in the treatment of upper urinary calculi, and tamsulosin combined with ESWL can reduce the pain of patients and reduce the use of analgesic drugs to a certain extent Less adverse reactions in patients, patients were well tolerated, indicating that tamsulosin combined ESWL better security.