特拉唑嗪治疗慢性前列腺炎/慢性盆腔疼痛综合征的系统评价

目的 评价特拉唑嗪治疗慢性前列腺炎／慢性盆腔疼痛综合征（CP／CPPS）的疗效与安全性。方法 采用Cochrane系统评价方法，电子检索Embase、Pubmed等国内、外数据库。纳入特拉唑嗪与安慰剂或其他疗法比较治疗CP／CPPS男性患者的随机对照试验（RCT）。由两名评价员独立评价文献质量和提取资料，用Stata9．2软件进行Meta分析。结果 检索结果获得9个随机对照实验，其中只有4个RCTs（369例）被纳入。本系统评价的meta分析结果显示特拉唑嗪治疗CP／CPPS的疗效优于安慰剂，能有效地改善CP／CPPS患者的NIH症状指数总评分、生活质量、疼痛及排尿症状，但其不良反应也高于安慰剂。结论 根据现有的证据，可以认为特拉唑嗪有改善CP／CPPS症状的作用。但鉴于目前评价其疗效和安全性的随机对照试验及病例数较少，研究质量普遍不高，有必要进一步开展高质量、大样本随机对照试验评价其疗效和安全性。

Terazosin for chronic prostatitis/chronic pelvic pain syndrome:A systematic review of efficacy and adverse effects

Objective To examine the effectiveness and adverse effects of terazosin in the treatment of CP/CPPS.Methods Trials were identified from an electronic database search (Pubmed, Embase) for published and unpublished randomized controlled trials in any language comparing terazosin with placebo or other interventions for CP/CPPS,then extracted and evaluated independently by two authors;and reviewed in a meta-analysis.Men who met the National Institutes of Health (NIH) criteria for CP/CPPS were eligible for inclusion in this review.Exclusion criteria included:non RCTs studies;no blinded studies;previous treatment with antibiotics,terazosin or other alpha blockers;evidence of bacterial prostatitis or urinary tract infection;trials with treatment duration less than 2 weeks;and a total patients number less than 10 patients.Results We identified 9 randomized placebo-controlled trials,and only 4 ( including 369 men) met our inclusion criteria.The meta-analysis was taken using Stata version 9.2,and results were expressed as standardized mean difference (SMD and 95%CI) for continuous data,and RR with 95% CI for dichotomous data.Meta-analysis results of this systematic review of randomized controlled trials showed a statistically significant difference in favor of terazosin in post-treatment total score,quality of life score;pain and urinary symptoms score domains.For overall side effect,there was a statistically significant effect in favor of placebo compared with terazosin.Conclusions Available evidence shows modest effect of terazosin in reducing NIH-CPSI total score,pain symptoms,and improving quality of life of patients with CP/CPPS.There is a need for more well-designed trials,with larger patient groups and longer duration treatment to further determine the efficacy and adverse effects of terazosin in men with CP/CPPS.