一例初診老年前列腺增生患者的循證治療_《中國循證醫學雜志》

作者：

陳化磊 ,  李世文 , 王行環 , 鄭新民 , 丁協剛

武漢大學中南醫院泌尿外科（武漢?430071）;

關鍵詞：

前列腺增生老年患者循證治療隨機對照試驗

DOI：

10.7507/1672-2531.20090163

視頻：

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目的　借助循證醫學的方法為1例初診老年前列腺增生患者確定治療目標和治療方案。
方法　在充分評估患者情況后，提出臨床問題，從Cochrane Library、中國生物醫學文獻數據庫、中國期刊網、PubMed、EMbase、ScienceDirect、Springer和ProQuest檢索相關證據，檢索時間截至2008年。評價證據的質量和適用性，據患者意愿制定治療方案，隨訪患者。
結果　共檢索出與不同問題相關的隨機對照試驗137篇，系統評價/Meta分析39篇。綜合分析檢索結果，為患者制訂了合理的治療方案。經1年隨訪證實，該方案適合患者。
結論　采用循證治療的方法，為初診老年前列腺增生患者確定合理的治療方案，可有效提高治療效果。

引用本文： 陳化磊,李世文,王行環,鄭新民,丁協剛. 一例初診老年前列腺增生患者的循證治療. 中國循證醫學雜志, 2009, 09(8): 924-928. doi: 10.7507/1672-2531.20090163 復制

1.	馬志方, 王東文, 馬騰驤, 等. 多沙唑嗪控釋片和坦索羅辛治療前列腺增生癥的對照研究. 天津醫學, 2005, 33(1): 22-24.
2.	MacDonald R, Timothy J. Alfuzosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia: a systematic review of efficacy and adverse effects. Urology, 2005, 66: 780-788.
3.	Ng CF, Wong A, Cheng CW, et al. Effect of vardenafil on blood pressure profile of patients with erectile dysfunction concomitantly treated with doxazosin gastrointestinal therapeutic system for benign prostatic hyperplasia. J Urol, 2008, 180(3): 1042-1046.
4.	Rosen R, Seftel A, Roehrborn CG. Effects of alfuzosin 10 mg once daily on sexual function in men treated for symptomatic benign prostatic hyperplasia. Int J Impot Res, 2007, 19(5): 480-485.
5.	袁穗榕, 胡建波. 鹽酸坦索羅辛治療前列腺增生癥的療效及安全性的臨床分析. 海峽藥學, 2005, 17(2): 98-100.
6.	華立新, 吳宏飛, 眭元庚, 等. 哈樂在良性前列腺增生伴急性尿潴留中的應用. 中華男科學, 2003, 9(7): 510-511.
7.	Prieto L, Romero J, López C, et al. Efficacy of doxazosin in the treatment of acute urinary retention due to benign prostate hyperplasia. Urol Int, 2008, 81(1): 66-71.
8.	任宇, 李寧寧, 葉璐, 等. 坦索羅辛和特拉唑嗪治療BPH的系統評價. Journal of Clinical Urology, 2006, 21(9): 692-697.
9.	RBLik Sprava, Roehrborn CG, et al. The longtermeffect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. Nurullaev, 2004, 3(1): 101-103.
10.	薛兆英, 韓文科, 金杰, 等. 愛普列特治療良性前列腺增生II期臨床研究. 中國臨床藥理學雜志, 2000, 16(6): 432-435.
11.	Boyle P, Gould AL, Roehrborn CG, et al. Prostate volume predicts outcome of benign prostate hyperplasia with finasteride:meta-analysis of randomized clinical trials. Urology, 1996, 48(3): 398-405.
12.	Lam JS, Romas NA, Lowe FC. Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up. Urology, 2003, 61(2): 354-358.
13.	Kaplan SA, Roehrborn CG, McConnell JD, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol, 2008, 180(3): 811-812.
14.	Roehrborn CG, McConnell JD, Lieber M, et al. Serum prostate-specific antigen concentration is a powerful predictorof acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS StudyGroup. Urology, 1999, 53: 473-480.
15.	Roehrborn CG. The potential of serum prostate-specific antigen as a predictor of clinical response in patients with lower urinary tract symptoms and benign prostatic hyperplasia. BJU Int, 2004, 93: 21-26.
16.	Crawford ED, Wilson SS, McConnell JD, et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol, 2006, 175: 1422-1427.
17.	黃遂斌, 魏繼剛, 章傳華, 等. 經尿道汽化電切術聯合微波治療前列腺增生癥. 中國康復雜志, 2007, 22(5): 352.
18.	Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ, 2008, 337-1662.
19.	堯凱, 王祥慧, 楊羅艷. 非那甾安與坦索羅辛治療良性前列腺增生癥療效對比. 中國男科學雜志, 2006, 20(6): 38-40.
20.	MacDonald R, Wilt TJ, Howe RW, et al. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int., 2004, 94(9): 1263-1270 .
21.	唐正嚴, 彭克亮, 丁見, 等. 保列治與哈樂治療前列腺增生的I臨床療效觀察. 中南大學學報 (醫學版), 2005, 30(6): 708-710.
22.	葉璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治療良性前列腺增生癥的安全性評價. 藥物不良反應志, 2005, 6: 411-417.
23.	熊鷹, 葉璐, 任宇, 等. 特拉唑嗪、非那司提和坦素羅辛治療良性前列腺增生癥的有效性評價.中國循證醫學雜志, 2005, 5(6): 448-454轉481.
24.	Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25ml or greater. J Urol, 2006, 175: 217-221.
25.	McConnell JD, Roehrborn CG, Bautista OM, et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003, 349(25): 2387-2398.
26.	Marberger M. The MTOPS Study: New Findings, New Insights, and Clinical Implications for the Management of BPH. European Urology Supplements, 2006, 5: 628-633.

1. 馬志方, 王東文, 馬騰驤, 等. 多沙唑嗪控釋片和坦索羅辛治療前列腺增生癥的對照研究. 天津醫學, 2005, 33(1): 22-24.
2. MacDonald R, Timothy J. Alfuzosin for treatment of lower urinary tract symptoms compatible with benign prostatic hyperplasia: a systematic review of efficacy and adverse effects. Urology, 2005, 66: 780-788.
3. Ng CF, Wong A, Cheng CW, et al. Effect of vardenafil on blood pressure profile of patients with erectile dysfunction concomitantly treated with doxazosin gastrointestinal therapeutic system for benign prostatic hyperplasia. J Urol, 2008, 180(3): 1042-1046.
4. Rosen R, Seftel A, Roehrborn CG. Effects of alfuzosin 10 mg once daily on sexual function in men treated for symptomatic benign prostatic hyperplasia. Int J Impot Res, 2007, 19(5): 480-485.
5. 袁穗榕, 胡建波. 鹽酸坦索羅辛治療前列腺增生癥的療效及安全性的臨床分析. 海峽藥學, 2005, 17(2): 98-100.
6. 華立新, 吳宏飛, 眭元庚, 等. 哈樂在良性前列腺增生伴急性尿潴留中的應用. 中華男科學, 2003, 9(7): 510-511.
7. Prieto L, Romero J, López C, et al. Efficacy of doxazosin in the treatment of acute urinary retention due to benign prostate hyperplasia. Urol Int, 2008, 81(1): 66-71.
8. 任宇, 李寧寧, 葉璐, 等. 坦索羅辛和特拉唑嗪治療BPH的系統評價. Journal of Clinical Urology, 2006, 21(9): 692-697.
9. RBLik Sprava, Roehrborn CG, et al. The longtermeffect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. Nurullaev, 2004, 3(1): 101-103.
10. 薛兆英, 韓文科, 金杰, 等. 愛普列特治療良性前列腺增生II期臨床研究. 中國臨床藥理學雜志, 2000, 16(6): 432-435.
11. Boyle P, Gould AL, Roehrborn CG, et al. Prostate volume predicts outcome of benign prostate hyperplasia with finasteride:meta-analysis of randomized clinical trials. Urology, 1996, 48(3): 398-405.
12. Lam JS, Romas NA, Lowe FC. Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up. Urology, 2003, 61(2): 354-358.
13. Kaplan SA, Roehrborn CG, McConnell JD, et al. Long-term treatment with finasteride results in a clinically significant reduction in total prostate volume compared to placebo over the full range of baseline prostate sizes in men enrolled in the MTOPS trial. J Urol, 2008, 180(3): 811-812.
14. Roehrborn CG, McConnell JD, Lieber M, et al. Serum prostate-specific antigen concentration is a powerful predictorof acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS StudyGroup. Urology, 1999, 53: 473-480.
15. Roehrborn CG. The potential of serum prostate-specific antigen as a predictor of clinical response in patients with lower urinary tract symptoms and benign prostatic hyperplasia. BJU Int, 2004, 93: 21-26.
16. Crawford ED, Wilson SS, McConnell JD, et al. Baseline factors as predictors of clinical progression of benign prostatic hyperplasia in men treated with placebo. J Urol, 2006, 175: 1422-1427.
17. 黃遂斌, 魏繼剛, 章傳華, 等. 經尿道汽化電切術聯合微波治療前列腺增生癥. 中國康復雜志, 2007, 22(5): 352.
18. Lourenco T, Pickard R, Vale L, et al. Minimally invasive treatments for benign prostatic enlargement: systematic review of randomised controlled trials. BMJ, 2008, 337-1662.
19. 堯凱, 王祥慧, 楊羅艷. 非那甾安與坦索羅辛治療良性前列腺增生癥療效對比. 中國男科學雜志, 2006, 20(6): 38-40.
20. MacDonald R, Wilt TJ, Howe RW, et al. Doxazosin for treating lower urinary tract symptoms compatible with benign prostatic obstruction: a systematic review of efficacy and adverse effects. BJU Int., 2004, 94(9): 1263-1270 .
21. 唐正嚴, 彭克亮, 丁見, 等. 保列治與哈樂治療前列腺增生的I臨床療效觀察. 中南大學學報 (醫學版), 2005, 30(6): 708-710.
22. 葉璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治療良性前列腺增生癥的安全性評價. 藥物不良反應志, 2005, 6: 411-417.
23. 熊鷹, 葉璐, 任宇, 等. 特拉唑嗪、非那司提和坦素羅辛治療良性前列腺增生癥的有效性評價.中國循證醫學雜志, 2005, 5(6): 448-454轉481.
24. Kaplan SA, McConnell JD, Roehrborn CG, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25ml or greater. J Urol, 2006, 175: 217-221.
25. McConnell JD, Roehrborn CG, Bautista OM, et al. The longterm effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003, 349(25): 2387-2398.
26. Marberger M. The MTOPS Study: New Findings, New Insights, and Clinical Implications for the Management of BPH. European Urology Supplements, 2006, 5: 628-633.

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一例初診老年前列腺增生患者的循證治療

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《中國循證醫學雜志》

一例初診老年前列腺增生患者的循證治療

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