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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、Cochranelibrary、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:ESWL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,ESWL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。
OBJECTIVE: To systematically evaluate the effect of tamsulosin on post-ESWL auxiliary stone in upper urinary calculi. Methods: The online databases of PubMed, Cochrane, EMBASE, Ovid, CNKI, Wanfang, Vip and so on were searched, and the references of the included articles were traced. The collection of ESWL related to upper urinary calculi was collected at home and abroad Randomized controlled trials (TSTs) of tamsulosin with adjuvant therapy. Two reviewers completed the screening, quality evaluation and data extraction independently, and Meta-analysis was performed using RevMan 5.0. Results: After screening, a total of 9 RCTs were included, with a total sample volume of 781 cases, including 393 cases of tamsulosin group and 388 cases of control group. Meta-analysis showed that tamsulosin-assisted paving-stone therapy after ESWL increased stone clearance [RR = 1.18,95% CI (1.10,1.28)] and decreased the incidence of renal colic [RR = 0.42, 95% CI (0.31,0.56)], the differences were statistically significant (P <0.05); but compared with the conservative treatment only control group, the row of stone time was no significant difference (P> 0.05). Conclusion: The available evidence shows that the tamsulosin-assisted paving-stone therapy after ESWL can effectively improve the stone clearance rate and reduce the incidence of renal colic. However, due to the poor quality of the included literature and the limited sample size, the above conclusion requires large sample and high quality clinical randomized controlled trials to provide better evidence-based evidence.