Efficacy of Tamsulosin Alone or Combined with Antimuscarinic Drugs in the Treatment of Ureteral Stent- related Symptoms ：A Meta-analysis / 中国药房

ABSTRACT

OBJECTIVE：To systematically review the efficacy of tamsul osin a lone or combined with antimuscarinic drugs in the treatment of ureteral stent-related symptom （SRSs），and to provide evidence-based reference for the clinical treatment. METHODS：Retrieved from PubMed ，Embase，Cochrane Library ，CJFD，CBM，VIP and Wanfang database ，from the inception to Oct. 2019，RCTs about tamsulosin alone （monotherapy group ）or combined with antimuscarinic drugs （combination group ） versus placebo or blank control （control group ）in the treatment of SRSs were collected. After data extraction of included clinical studies met inclusion criteria ，their quality was evaluated with Cochrane collaborative network system evaluation manual 5.1.0，and Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS ：A total of 9 RCTs were included ，involving 932 patients. Meta-analysis results showed that after stent placement ，the urinary symptoms score [MD ＝－4.23，95％CI（－5.96， －2.51），P＜0.000 01]，body pain score [MD ＝－4.20，95％CI（－5.30，－3.10），P＜0.000 01]，general health score [MD ＝ － 1.36， 95％ CI（ － 1.75， － 0.98）， P＜0.000 01] in monotherapy group were significantly lower than control group with statistical significance ； there was no significantly 2805097532@qq.com difference in the work performance score [MD ＝0.19，95％CI（－0.99，1.37），P＝0.76]，sexual matters score [MD ＝－0.31 95％CI（－0.68，0.05），P＝0.09] in 2 groups. 4 weeks after the stent was removed ，the body pain score [MD ＝－0.64，95％CI（－0.84，－0.43），P＜0.000 01]，general health score [MD ＝ －0.28，95％CI（－0.41，－0.15），P＜0.000 01] ，urinary symptoms score [MD ＝－0.64，95％CI（－0.84，－0.43），P＜0.000 01] in monotherapy group were significantly lower than control group after stent placement ，with statistical significance ；there was no significantly difference in the work performance score [MD ＝0.31，95％CI（－0.22，0.84），P＝0.25] or sexual matters score [MD ＝ －0.31，95％CI＝（－0.68，0.05），P＝0.09] in 2 groups. The urinary symptoms score [MD ＝5.93，95％CI（2.83，9.02），P＝0.000 2]， body pain score [MD ＝3.49，95％CI（1.39，5.60），P＝0.001] and general health score [MD ＝2.96，95％CI（1.44，4.49），P＝0.000 1] in the monotherapy group were higher than the combination group ；there was no significantly difference in the work performance score [MD ＝1.53，95％CI（－0.12，3.18），P＝0.07] or sexual matters score [MD ＝0.46，95％CI（－1.03，1.96），P＝0.54] in 2 groups. CONCLUSIONS：Tamsulosin has a good therapeutic effect on SRSs ；its combination with antimuscarinic drugs can achieve better therapeutic efficacty.