中药联合体外冲击波碎石治疗输尿管结石疗效的Meta分析

目的:通过Meta分析,对中药联合体外冲击波碎石(ESWL)治疗输尿管结石的临床疗效进行分析。方法:收集1990年1月—2013年5月期间中药联合ESWL治疗输尿管结石的相关文献,纳入符合要求的随机对照试验。结果:共纳入13个随机对照研究,包括3171例输尿管结石。Meta分析结果显示:13个临床试验的研究资料具有良好的同质性(异质性检验P=0.99,I2=0%),OR合并=2.93,95%CI为(2.36,3.64),Z=9.71,P<0.00001,合并统计量效应值差异具有统计学意义,可以认为中药联合ESWL治疗输尿管结石的治愈率高于单纯ESWL治疗。其中有4个随机对照研究观察了ESWL后肾绞痛的发生率,包括706例输尿管结石。Meta分析结果显示:4个临床试验的研究资料具有良好的同质性(异质性检验P=0.58,I2=0%),RR合并=0.43,95%CI为(0.23,0.80),Z=2.64,P=0.008,合并统计量效应值差异具有统计学意义,可以认为中药联合ESWL治疗后肾绞痛发生率低于单纯ESWL治疗。结论:目前的证据支持:中药联合ESWL治疗输尿管结石的治愈率高于单纯ESWL治疗,且治疗后肾绞痛的发生率低于单纯ESWL治疗。

Efficacy of Chinese Herb Combined with ESWL for Ureteral Calculi: A Meta-analysis

Objective: To make a Meta- analysis of the clinical efficacy of traditional Chinese medicine combined with external shock wave lithotripsy( ESWL) for ureteral calculi. Methods: We collected randomized controlled trials about combining Chinese herb and ESWL for ureteral stones from January 1990 to May 2013. Results: A total of 13 randomized controlled studies,including 3 papers,171 cases. The Meta- analysis results showed that: research data of 13 clinical trials had good homogeneity( heterogeneity P = 0. 99,I2= 0%),OR merger = 2. 93,95% CI( 2. 36,3. 64),Z = 9. 71,P < 0. 00001,combined effect size statistic difference was statistically significant,it can be considered the cure rate of traditional Chinese medicine combined ESWL for ureteral stones was higher than that of ESWL,including four randomized controlled study researches,706 cases. The Meta- analysis results showed that: the research data of four clinical trials had good homogeneity( heterogeneity P = 0. 58,I2= 0%),RR merger = 0. 43, 95% CI( 0. 23,0. 80),Z = 2. 64,P = 0. 008,the combined effect size statistic difference was statistically significant,it can be considered the treatment of Chinese herb combined ESWL has lower incidence of renal colic after ESWL. Conclusion: The current evidence supports that the cure rate of Chinese herb combined with ESWL for ureteral stones is higher than that of ESWL and after treatment,the incidence of renal colic lower than that of ESWL.