Comparison of efficacy between Tamsulosin and Finasteride on symptomatic Benign Prostatic Hyperplasia

This prospective study was done to compare the efficacy of Tamsulosin and Finasteride for the medical treatment of symptomatic Benign Prostatic Hyperplasia (BPH) at the surgery and urology outpatient department of Mymensingh Medical College Hospital during the period from January 2003 to December 2004. Closely matched 70 patients in the age range of 50-80 years presented with lower urinary tract symptoms and clinically diagnosed as BPH were selected in the present study. Among them, 36 patients (Group I) and 34 patients (Group II) were treated with Tamsulosin (0.4 mg once daily) and Finasteride (5 mg once daily) for a duration of 06 months respectively. The efficacy of two drugs was compared on the basis of IPSS and Qmax. The base-line parameters of both groups were statistically insignificant. A significant improvement of IPSS and Qmax was found after 06 months of treatment in both groups (P<0.001). A significant improvement of IPSS Qmax was found in both groups (p<0.001) during follow-up at 1st, 2nd, 4th and 6th month. It was also observed that Tamsulosin improved the IPSS and Qmax more quickly than Finasteride.     

哈乐与托特罗定联合应用治疗前列腺增生伴下尿路症状患者的初步研究

目的：观察α1肾上腺素能受体阻滞剂哈乐与抗胆碱药托特罗定联合应用对良性前列腺增生（BPH）伴下尿路症状（LUTS）患者的临床疗效。方法：对80例BPH伴LUTS病人采用随机、对照研究,分为治疗组和对照组,治疗组口服哈乐（200mg/qd）＋托特罗定（1mg/bid）,对照组口服哈乐（200mg/qd）。观察患者服药前、服药3周后,国际前列腺症状评分（IPSS）以及尿流动力学指标,如最大尿流率（UMAX）,膀胱残余尿量和患者症状改善率。结果：治疗3周后,联合用药组UMAX、膀胱残余尿量和患者症状改善率均优于单独用药组,差异有统计学意义（P〈0.01）。结论：哈乐与托特罗定联合应用较单纯使用哈乐可显著改善BPH伴LUTS患者的症状,其疗效可靠,安全可行。     

α受体阻滞剂治疗良性前列腺增生症的疗效比较

目的评价坦索罗新与特拉唑嗪治疗前列腺增生的效果和对血压影响的差异。方法将我院门诊治疗的前列腺增生患者随机分为2组,分别接受坦索罗新（每日0.4mg）和特拉唑嗪（每日4mg）治疗,评价治疗1个月后2组患者IPSS评分、血压和副作用发生率的差异。结果治疗1个月后特拉唑嗪组IPSS评分要显著优于坦索罗新组（42.50%vs34.29%,P〈0.05）,但特拉唑嗪组有2例患者出现头晕、恶心等不适。结论不同α受体阻滞剂对前列腺增生症的效果存在差异,特拉唑嗪的治疗效果更好,坦索罗新对血压的影响更小,相对更安全。     

通癃启闭汤联合坦索罗辛治疗前列腺增生症的临床观察

目的观察通癃启闭汤联合坦索罗辛治疗良性前列腺增生（BPH）引起下尿路症状及伴膀胱活动过度的临床疗效和安全性。方法将77例BPH患者随机分为对照组和治疗组。对照组33例,口服盐酸坦索罗辛缓释胶囊0．2mg,每晚1次;治疗组44例,在对照组治疗基础上,加服自拟中药方通癃启闭汤,每天1剂,分早晚2次服。观察两组分别在治疗前和治疗12周后行国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）、膀胱残余尿量（PRV）、前列腺体积（PV）及血清总前列腺特异性抗原（t—PSA）的变化,并对出现的不良反应进行记录。结果治疗组总有效率为93．18％,对照组为75．76％,两组比较,差异有统计学意义（P〈0．05）;且治疗组在减轻患者的IPSS、改善QOL、提高Qmax和减少PRV等方面,疗效均明显优于对照组（P〈0．05）;治疗组PV和t—PSA下降幅度大于对照组,但差异无统计学意义（P〉0．05）。结论通癃启闭汤联合坦索罗辛治疗BPH可以显著改善患者主观症状及客观指标,且作用安全、有效。     

Efficacy and safety of combined therapy with terazosin and tolteradine for patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: a prospective study

Background The primary objectives of the treatment for the lower urinary tract symptoms （LUTS） associated with benign prostatic hyperplasia （BPH） are to produce rapid, sustained, and safe improvements in the symptoms that affect the quality of life in the majority of men over 50. In this study, we evaluated the efficacy and safety of the combined therapy with terazosin （α1-adrenergic receptor antagonist） and tolterodine （anticholinergic agent） for LUTS associated with BPH. Methods This combination study included 69 patients diagnosed with LUTS associated with BPH based on the International Prostate Symptom Scores （IPSS）, urinary flow rate, prostate volume, urinary residual, and their serum prostate-specific antigen levels. Initially, 191 patients were treated with terazosin 2 mg once daily for one week. Those patients with continued LUTS after the initial treatment were allocated randomly into two groups： terazosin group （n=-36） in which patients were treated with terazosin 2 mg once daily for six weeks, and combination group （n=33） in which patients were treated with both terazosin 2 mg once daily and tolterodine 2 mg twice daily for 6 weeks. Results The IPSS were significantly improved in both groups after treatment, and the reduction of IPSS in the combination group was significantly greater than that in the terazosin group （P〈0.01）. A decrease in urgency, frequency and nocturia were the main contributory factors causing the reduction of IPSS in the combination group. The differences about the peak urinary flow rate and the residual urine from the baseline values were noted in both groups after treatment but were not significant between the two groups. The incidence of adverse effects in the combination group was higher than that in the terazosin group. As expected the most common adverse effect was mouth dryness which was associated with anticholinergic drugs such as tolterodine. Conclusions Patients with LUTS associated BPH appear the improved IPSS after combined therapy with terazosin and tolterodine. This study, although short term and limited numbers of patients, provides evidence that the combined therapy with terazosin plus tolterodine is a good approach for meeting the objectives of rapid, sustained, and safe improvements in the LUTS associated with BPH. And the profile of patients in this study might be used as the indication of such combined therapy for LUTS associated with BPH without urodynamic evaluation.     

坦索罗辛联合经尿道前列腺等离子电切术对前列腺增生患者生活质量及性功能的影响

  目的   探讨经尿道前列腺等离子电切术(transurethral plasmakinetic resection of prostate,TUPKRP)联合口服坦索罗辛对前列腺增生患者生活质量及性功能的影响。   方法   选取2018年6月—2020年1月期间蚌埠市第三人民医院泌尿外科收治的前列腺增生患者80例,采用随机数字表法分成治疗组(40例)和对照组(40例)。治疗组行TUPKRP联合口服坦索罗辛治疗,对照组仅行TUPKRP治疗。比较2组治疗前、治疗后6个月生活质量[国际前列腺生活质量评分(QOL)、国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、剩余尿量(RUV)、夜间排尿次数)]、性功能[国际勃起功能指数(IIEF-5)]及并发症发生率。   结果   2组治疗前QOL、IPSS、Qmax、RUV及IIEF-5比较差异无统计学意义(均P＞0.05);治疗后6个月,治疗组和对照组IIEF-5为(19.35±4.16)分和(17.03±3.52)分,2组QOL、IPSS、Qmax、RUV及IIEF-5均较治疗前改善,治疗组IPSS、QOL、Qmax及IIEF-5评分优于对照组;治疗组夜尿次数[(1.13±0.88)次]少于对照组[(1.65±0.86)次],治疗组并发症发生率低于对照组,差异均有统计学意义(均P＜0.05)。   结论   坦索罗辛联合TUPKRP治疗前列腺增生患者有利于改善术后排尿、生活质量及性功能,值得临床推广应用。       

坦索罗辛联合索利那新对比坦索罗辛单药治疗下尿路症状有效性的Meta分析

目的 系统评价坦索罗辛联合索利那新对比单用坦索罗辛治疗前列腺增生症（benign prostatic hyperplasia,BPH）并发下尿路症状（lower urinary tract symptoms,LUTS）的有效性,为临床上BPH并发的难治性LUTS提供循证依据。方法 循证检索英文数据库如PubMed、Cochrane Library、EMBase等,以及中文数据库如CNKI、CBM、万方数据库等,手工检索国内相关杂志。提取数据,运用Review Manager 5.3进行数据统计。结果 根据制定的纳入及排除标准一共筛选出10项研究,共968例病例,经过基线检验,治疗前各组差异均无统计学意义。结果显示,坦索罗辛联合索利那新对比坦索罗辛单药治疗BPH所致的LUTS能更好的降低前列腺症状评分（IPSS）、膀胱过度活动评分（OABSS）及生活质量评分（QOL）,但在残余尿量（PVR）和最大尿流率（QMAX）方面,两种治疗方式的差异无统计学意义。结论 坦索罗辛联合索利那新在治疗BPH并发的LUTS症状、提高患者生活质量方面要优于坦索罗辛单药方案,并且不会增加排尿困难的风险。     

M-受体与α-受体阻滞剂联合用药治疗良性前列腺增生及下尿路症状的临床观察

目的 评价M-受体阻滞剂与α-受体阻滞剂联合用药治疗良性前列腺增生（BPH）下尿路症状（LUT）的有效性及安全性。方法 选择经1周特拉唑嗪治疗后,梗阻症状缓解,但刺激症状仍明显的BPH／LUT患者69例,主要的排除标准为最大尿流率（Qmax）〈10ml／s、残余尿〉50ml、前列腺体积〉50ml。随机分成两组,特拉唑嗪组给予特拉唑嗪治疗,联合用药组给予托特罗定与特拉唑嗪联合治疗。用药时间6周,评估内容包括总症状评分（IPSS）及梗阻症状评分及刺激症状评分、尿流率和残余尿量等,并登记不良事件。结果 两组间基础临床指标比较差异无统计学意义。用药6周后联合用药组IPSS评分由19．1±2．9降低到14．0±4．2,P〈0．001。刺激症状评分由13．2±3．2降至9．2±2．9,P〈0．001。特拉唑嗪组IPSS评分由18．5±3．2降低到17．3±4．1,P=0．033。刺激症状评分由12．7±3．1降至11．7±3．0,P=0．001。治疗后两组间比较显示：（1）联合用药组IPSS评分的改善优于特拉唑嗪组（-5．09 vs-1．19,P〈0．001）,联合用药组刺激评分的改善优于特拉唑嗪组（-4 vs-1,P〈0．001）,而梗阻症状评分的改善两组间差异无统计学意义（-1．09 vs-0．2,P〈0．168）。（2）治疗6周后两组间Qmax、残余尿差异无统计学意义。联合用药组无急性尿潴留和其他严重并发症发生。结论 托特罗定与α-受体阻滞剂联合应用于前列腺轻中度肥大、轻中度肥大的患者,可不同程度降低患者IPSS评分,其中以刺激症状评分的改善更明显。未见严重不良反应和急性尿潴留出现。     

保列治与哈乐佐助URSL治疗前列腺增生并膀胱结石20例

目的评价保列治与哈乐佐助气压弹道碎石（ureteroscopic lithotripsy,URSL）治疗Ⅱ度前列腺增生并膀胱结石的疗效。方法40例Ⅱ度前列腺增生并膀胱结石患者随机分为观察组和对照组。对照组：采用URSL及前列腺电切汽化治疗：观察组：采用保列治与哈乐佐助URSL治疗。结果治疗后两组患者IPSS评分、Qmax、前列腺体积均明显改善（P〈0．01）。观察组总副作用率为10．00％,低于对照组（55．00％）,差异有统计学意义（P〈0．01）。结论保列治与哈乐佐助URSL治疗Ⅱ度前列腺增生并膀胱结石患者疗效可靠,而且可以避开手术的危害,副作用小。     

坦洛新缓释胶囊联合全雄激素阻断治疗晚期前列腺癌伴膀胱出口梗阻的疗效

目的：探讨坦洛新缓释胶囊与全雄激素阻断联合用于晚期前列腺癌伴膀胱出口梗阻的疗效。方法将68例晚期前列腺癌伴膀胱出口梗阻患者随机分为观察组与对照组。两组均接受全雄激素阻断治疗,观察组在此基础上口服坦洛新缓释胶囊0.2 mg,1次/d,疗程均为4个月。结果治疗4个月后,两组QOL及Qmax较治疗前明显上升,IPSS评分、RU和TPSA较治疗前明显减少（P〈0.05或P〈0.01）,且观察组IPSS、QOL、Qmax、RU改善幅度明显优于对照组（P〈0.05）。对照组未发生明显药物不良反应,观察组出现体位性头晕1例,症状较轻。结论坦洛新缓释胶囊联合雄激素阻断能迅速有效地改善晚期前列腺癌患者LUTS症状,提高患者的生活质量,安全、经济。     

爱普列特治疗良性前列腺增生症的疗效观察术

目的评价爱普列特治疗良性前列腺增生症的疗效和安全性。方法80例诊断为BPH的患者随机分为两组：试验组40例,服用爱普列特2次／d,每次5mg;对照组40例,服用保列治1次／d,每次5mg;疗程120d。以国际前列腺症状评分（IPSS）、最大尿流率（Qmax）、前列腺体积（Pv）、剩余尿量（PVR）及前列腺特异性抗原（PSA）的变化率评分来判断疗效。结果给药1个月后,爱普列特和保列治有效率分别为17．5％（7／40）、15．0％（6／40）;3个月后有效率分别为57．5％（23／40）、55．0％（22／40）;4个月后有效率分别为87．5％（35／40）、90．0％（36／40）;爱普列特治疗结果用方差齐性检验分析,除剩余尿量（PVR）P〉0．05外,其余均P〈0．05,两组相比差异均无统计学意义（P〉0．05）。不良反应发生率爱普列特组为7．5％（3／40）,保列治组为12．5％（5／40）,两者相比差异无统计学意义（P〉0．05）。结论爱普列特片是治疗良性前列腺增生症安全、有效的药物。     

Comparison of tamsulosin with extracorporeal shock wave lithotripsy in treating distal ureteral stones

Background Tamsulosin, an alpha-1 receptor antagonist, has been demonstrated effective in promoting distal ureteral stone passage and in reducing pain associated with stone expulsion. This study aimed to evaluate the effect of tamsulosin in comparison with nifedipine and extracorporeal shock wave lithotripsy （ESWL） on the expulsion rate of distal ureteral stones at different sizes. Methods We assigned 314 patients to three categories： Ⅰ, the stone with maximal diameter of 4.0-5.9 mm; Ⅱ, 6.0-7.9 mm, and Ⅲ, 8.0-9.9 mm. Patients in each category were randomly subdivided into three treatment subgroups： group A （nifedipine group）, group B （tamsulosin group）, and group C （ESWL group）. Stone-free rate and the dose of analgesics were recorded weekly during the 4-week follow-up period. Results Three hundred and three patients completed the study. The results showed that nifedipine and tamsulosin treatments promoted a small （4-8 mm, categories Ⅰ and Ⅱ） stone expulsive rate that was comparable with ESWL treatment. Nonetheless, when the stone diameter was 8.0-9.9 mm, ESWL showed a greater stone free rate than nifedipine and tamsulosin treatments; no significant difference existed between the latter two therapies. Although the ESWL treatment group required the least analgesics, tamsulosin treatments required less pain medication than nifedipine （P 〈0.05）. Conclusions Tamsulosin treatment is recommended for patients with the stone diameter smaller than 8 mm because of its feasibility, effectiveness and safety. ESWL is more appropriate than tamsulosin therapy for the patients whose stones are larger than 8 mm.     

非那雄胺联合坦洛新治疗良性前列腺增生症伴慢性前列腺炎疗效观察

[目的]观察非那雄胺联合坦洛新治疗BPH伴CP的临床疗效。[方法]选择BPH伴CP患者40例,口服非那雄胺(5mg/d)和坦洛新(0.2mg/d)3个月,在治疗前和治疗3个月后分别检查国际前列腺症状评分(IPSS)、尿流率、残余尿量、前列腺体积、前列腺液常规等指标。[结果]治疗后IPSS平均降低27.8%,最大尿流率平均升高37.0%,残余尿量平均减少39.4%,前列腺体积平均缩小18.4%,前列腺液中白细胞计数平均减少38.9%。前列腺液检查好转率60.0%,其中前列腺体积≥40ml组和<40ml组的前列腺液检查好转率分别为70.8%及43.7%,两组间比较差异有统计学意义(P<0.05)。[结论]非那雄胺联合坦洛新可有效治疗伴CP的BPH患者,对前列腺体积较大者效果更好。     

坦洛新联合托特罗定治疗逼尿肌不稳定前列腺增生的研究

目的:评价坦洛新联合托特罗定治疗前列腺增生(BPH)并逼尿肌不稳定的有效性及安全性。方法:采用随机分组法将80例患者随机分为2组各40例,联合用药组口服坦洛新0.2mg/次(1次/d)+托特罗定2mg/次(2次/d),对照组口服坦洛新0.2mg/次(1次/d),持续4周。比较2组治疗前、后平均IPSS、SSS、QOL评分以及尿流率、残余尿。结果:2组均无因药物副作用中途退出者。治疗前,联合用药组和对照组平均IPSS评分、SSS评分、QOL评分、尿流率以及残余尿量差别无统计学意义(P>0.05);治疗后2组平均IPSS、SSS、QOL评分分别为(11.3±1.9)分、(5.2±0.7)分(、1.9±0.4)分和(15.1±2.3)分、(9.8±2.4)分、(3.9±1.2)分,差别有统计学意义(P<0.01);平均尿流率和残余尿差别无统计学意义(P>0.05)。结论:坦洛新联合托特罗定可改善BPH逼尿肌不稳定患者的下尿路症状和生活质量。对于轻至中度膀胱出口梗阻(BOO)患者,应用托特罗定较安全。     

他达拉非联合坦索罗辛治疗男性下尿路症状合并勃起功能障碍疗效及安全性的Meta分析

背景　坦索罗辛与他达拉非（TAD）已广泛用于治疗下尿路症状（LUTS）和勃起功能障碍（ED）,但联合方案治疗男性LUTS合并ED的疗效与安全性仍存在争议。目的　系统评价TAD联合坦索罗辛与TAD单药治疗男性LUTS合并ED的疗效和安全性。方法　系统检索PubMed、EMBase、Cochrane Controlled Trials Register、中国生物医学文献数据库、中国知网、万方数据知识服务平台以及维普网,查找关于TAD联合坦索罗辛与TAD单药治疗男性LUTS合并ED疗效比较的研究,检索时限为建库至2020-02-29。提取第一作者姓名、发表年份、国家、研究类型、样本量、研究对象的年龄及体质指数、干预措施、药物剂量、随访时间、结局指标〔国际前列腺症状（IPSS）总评分、IPSS储尿期症状评分、IPSS排尿期症状评分、生活质量评分、最大尿流率、残余尿量以及国际勃起功能指数5（IIEF-5）评分、不良反应发生率（包括总不良反应发生率和头痛、肌痛、背痛、眩晕、鼻咽炎、射精功能障碍发生率）、因发生不良反应而终止治疗率〕等信息,并采用RevMan 5.3.0软件对数据进行评估和统计分析。结果　最终纳入6篇文献（均为高质量文献）,共包括776例患者,其中联合治疗组394例,TAD组382例。Meta分析结果显示,联合治疗组在降低IPSS总评分〔MD=-2.67,95%CI（-3.82,-1.50）,P<0.001〕、IPSS储尿期症状评分〔MD=-0.55,95%CI（-0.85,-0.26）,P=0.000 2〕、IPSS排尿期症状评分〔MD=-0.97,95%CI（-1.43,-0.51）,P<0.001〕、生活质量评分〔MD=-0.37,95%CI（-0.51,-0.23）,P<0.001〕,改善最大尿流率方面〔MD=1.45,95%CI（0.90,1.99）,P<0.000 01〕优于TAD组。两组残余尿量〔MD=-4.22,95%CI（-12.82,4.39）,P=0.34〕、IIEF-5评分〔MD=0.44,95%CI（-0.23,1.11）,P=0.19〕、总不良反应发生率〔OR=1.43,95%CI（0.98,2.08）,P=0.06〕、头痛发生率〔OR=1.34,95%CI（0.66,2.72）,P=0.42〕、肌痛发生率〔OR=1.56,95%CI（0.64,3.82）,P=0.33〕、背痛发生率〔OR=1.45,95%CI（0.40,5.22）,P=0.57〕、眩晕发生率〔OR=1.14,95%CI（0.27,4.76）,P=0.86〕、鼻咽炎发生率〔OR=0.47,95%CI（0.10,2.21）,P=0.34〕、射精功能障碍发生率〔OR=3.81,95%CI（0.44,32.97）,P=0.22〕、因发生不良反应而终止治疗率〔OR=1.44,95%CI（0.88,2.35）,P=0.15〕比较,差异无统计学意义。结论　与TAD单药相比,TAD联合坦索罗辛在改善患者LUTS方面的疗效更明显,但两者在改善ED和安全性方面没有明显的差异。对于同时存在LUTS合并ED的男性患者,可推荐使用TAD联合坦索罗辛方案。受纳入研究数量的限制,需要进一步的高质量的随机对照试验来证实这些发现。     

多沙唑嗪控释片短期服用对前列腺增生症患者下尿路症状及IPSS评分的影响

目的 评价前列腺增生(BPH)患者短期(3个月)服用多沙唑嗪控释片(可多华,Cardura XL)对下尿路症状,国际前列腺症状评分(IPSS)及生活质量(QOL)的影响.方法 选择2008年7月至2009年2月在北京朝阳医院泌尿科门诊就诊的80例前列腺增生患者,患者平均年龄70.5岁(62～82岁),短期内(3个月)、前瞻性的给予多沙唑嗪控释片(4 mg/d),分别记录治疗前、治疗后1、2、3个月患者的相应临床资料:包括IPSS、QOL、最大尿流率(Qmax),残余尿,血压及心率.对治疗前后的相应数据进行配对t检验,了解药物疗效及副作用.结果 80例患者均坚持完成3个月药物治疗.对治疗前及治疗后3个月未的最大尿流率(Qmax),残余尿,IPSS(刺激评分和梗阻评分),QOL,血压及心率进行分析,结果显示除心率以外(P=0.685),其他数据配对t检验结果差异均有统计学意义(均P＜0.001),进一步对治疗后1、3个月时的IPSS和QOL进行分析,结果显示IPSS及QOL随治疗时间延长有显著性改善(P＜0.001).16例(20%)患者存在一过性药物副作用:8例(10%)患者服药初期感到头痛,4例(5%)患者感到疲倦不适,4例(5%)患者感到眩晕,无患者中途脱落.结论 前列腺增生症患者短期内服用可多华能明显改善下尿路症状及生活质量,随着服药时间延长(1～3个月),IPSS和QOL可持续性改善,患者能较好耐受药物副作用.     

经尿道钬激光膀胱颈口切开联合坦洛新治疗小体积前列腺增生的疗效观察

目的：探讨经尿道2．1μm波长钬激光膀胱颈口切开联合坦洛新治疗小体积前列腺增生的疗效。方法对2009年8月～2012年12月收治的25例小体积前列腺增生患者,行经尿道2．1μm波长钬激光膀胱颈口切开术,同时术后服用盐酸坦洛新治疗。结果25例患者均顺利完成手术,平均手术时间18min,术后5d拔除尿管后均排尿通畅。治疗后的1周、4周及12周患者的平均国际前列腺症状评分（IPSS）、生活质量评分（QOL）及最大尿流率（Qmax）较治疗前比较差异显著有统计学意义（P＜0．05）。结论采用经尿道2．1μm波长钬激光膀胱颈口切开联合服用盐酸坦洛新治疗小体积前列腺增生效果显著,能够解除患者膀胱出口梗阻（ BOO）症状,改善患者生活质量,具有手术操作简单,患者创伤小,术后恢复快的优点。     

经尿道反馈微波热疗在高危高龄良性前列腺增生患者中的应用

目的研究经尿道反馈式微波热疗(PLFT)治疗高危高龄良性前列腺增生症(BPH)患者的效果并探讨不良事件的发生。方法对68例高危BPH患者,采用PLFT个体化治疗方法,随访12个月。通过分析患者治疗基本参数、前列腺体积变化、IPSS、QOL、Qmax和残余尿来评价治疗效果。结果 68例患者中63例(92.6%)完成了随访,治疗前IPSS、QOL、Qmax和残余尿分别是(28.50±4.30)分、(5.25±0.72)分、(2.80±4.06)ml/s和(190.7±97.2)ml;PLFT治疗后12个月随访的IPSS、QOL、Qmax和残余尿分别是(11.20±3.50)、(1.40±1.30)、(14.60±2.80)ml/s和(34.6±21.2)ml。完成治疗的63例患者治疗前后上述指标差异有统计学意义。结论 PLFT治疗高危高龄BPH患者安全有效,可作为高危高龄BPH患者治疗的优先选择。     

Efficacy and safety of tamsulosin for the treatment of benign prostatic hyperplasia: a meta analysis

Background Pharmacological therapy has been considered as the first-line treatment for patients with uncomplicated benign prostatic hyperplasia （BPH）. The aim of this study was to evaluate the efficacy and safety of tamsulosin compared with a placebo for treating BPH. Methods The randomized placebo-controlled trials （RCT） of tamsulosin for the treatment of BPH from all over the world were searched. PubMed, Ovid, ScienceDirect, EBSCO, CBM, and CNKI were searched, as well as a manual search of four Chinese journals： Chinese Journal of Andrology, National Journal of Andrology, Chinese Journal of Urology, and Journal of Clinical Urologywas also performed. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergences of opinions were settled by discussion. Meta-analysis was processed by Rev Man 5.0 software, fail-safe number was performed by SASS.0 software. Results Seven RCTs involving 2455 men met the inclusion criteria. The basic characteristics of patients were comparable in all the studies. Comparing three common criteria： international prostate symptom score （IPSS）/Boyarsky symptom score, maximum flow rate （MFR）, quality of life （QOL）, tamsulosin was better than placebo at improving IPSS and MFR, with no significant difference in the QOL. Adverse events of tamsulosin also showed no significant difference from the placebo group （Z=1.62, P=0.10, OR=1.22, 95% Cl 0.96-1.54）. Conclusions Tamsulosin is better than placebo at improving IPSS and MFR. Adverse events of tamsuloisn show no significant difference compared with placebo. More high quality trials with larger samples and longer follow-up are proposed.     

双氯芬酸钠栓联合坦索罗辛治疗前列腺增生夜尿增多的疗效评估

目的评价双氯芬酸钠栓和坦索罗辛联合治疗前列腺增生患者夜尿增多的有效性和安全性。方法选择有明显夜尿增多症状的前列腺增生患者54例,随机分为两组,每组27例。对照组单服坦索罗辛（0．2mg,每天1次）,联合治疗组使用双氯芬酸钠栓（25mg,每天1次,睡前1h塞人直肠内）和坦索罗辛（0．2mg,每天1次）,疗程均为4周,评估内容包括国际前列腺症状评分（IPSS评分）、生活质量评估（QOL）及夜尿次数,并登记不良事件,每2周评估1次。结果治疗4周后,两组IPSS评分和QOL均较治疗前有明显改善（P〈0．05）。但对于夜尿状况,只有联合治疗组有明显疗效（P〈0．05）。两组比较,联合治疗组IPSS评分下降优于对照组（P〈0．05）,减少夜尿次数和改善生活质量优于对照组（P〈0．05）。两组无明显不良事件发生。结论双氯芬酸钠栓和坦索罗辛联合治疗前列腺患者夜尿增多。较单用坦索罗辛更为有效,且安全,无明显不良反应。