坦索罗辛对上尿路结石ESWL后辅助排石疗效Meta分析

目的：系统评价坦索罗辛对上尿路结石ESWL后辅助排石的疗效。方法：通过检索PubMed、Co—chranelibrary、EMBASE、Ovid、中国知网全文数据库（CNKI）、万方、维普等在线数据库，并追查已纳入文献的参考文献，系统收集国内外有关上尿路结石ESWL后使用坦索罗辛辅助排石治疗的随机对照试验（RCTs）。由两名评价者独立完成文献的筛选、质量评价和资料提取，使用RevMan5．0进行Meta分析。结果：经筛选，共纳入9个随机对照研究，总样本量781例，其中坦索罗辛组393例，对照组388例。Meta分析结果显示：ESWI。后给予坦索罗辛辅助排石治疗可提高结石清除率RR=1．18，95％CI（1．10，1．28）]，减少肾绞痛的发生率RR=0．42，95％CI（0．31，0．56）]，差异均有统计学意义（P〈0．05）；但与仅予保守治疗的对照组相比，排石时间差异无统计学意义（P〉0．05）。结论：现有证据表明，ESWI。后给予坦索罗辛辅助排石治疗可有效提高结石清除率，减少肾绞痛的发生率。但因纳入文献的质量不高及样本量有限，上述结论需要大样本及高质量的临床随机对照试验来提供更好的循证证据。

Efficacy of Tamsulosin as Adjuvant Therapy After ESWL with Upper Urinary Tract Stone: A Meta-Analysis

Objective:To systematically review and evaluate the effectiveness of tamsulosin in the treatment of renal and ureteric stone after extracorporeal shock wave lithotripsy(ESWL).Methods:We searched PubMed,Cochrane library,Embase,Ovid,CNKI,WanFang and VIP up to 2011.All randomized clinical trials in which tamsulosin was received after ESWL were included.Two reviewers independently assessed study quality and extracted data.All data were analysed using Rev Man 5.0.Results:Nine trials with a total of 781 patients met the inclusion criteria.The meta-analysis showed that there was a statistical difference between tamsulosin group and control group on stone clearance(RR=1.18,95%CI,1.10 to 1.28) and pain episodes rate(RR=0.42,95%CI,0.31 to 0.56).But,There was no statistical difference on expulsion time(WMD=-2.17,95%CI,-4.78to-0.44;P =0.10>0.05).Conclusions:Our results show that the treatment with tamsulosin after ESWL could improve the stone clearance and decrease the incidence of pain episodes effectively.Because of the limits of sample and quality, more large sample and high quality trials are required to make a definite clinical evidence to use tamsulosin after ESWL for upper urinary tract stone.