中國慢性前列腺炎治療的有效性和安全性系統評價_《中國循證醫學雜志》

作者：

楊明根 ,  趙曉昆 , 王新君

中南大學湘雅二醫院泌尿外科（長沙 410011）;

關鍵詞：

慢性前列腺炎隨機對照試驗 Meta分析

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目的　系統評價我國慢性前列腺炎 (chronic prostatitis,CP) 治療的有效性與安全性。
方法　計算機檢索 MEDLINE(1966~2007.5)、EMbase (1988~2007.5)、中國生物醫學文獻光盤數據 (1979~2007.5）、中國生物醫學期刊文獻數據庫（CMCC, 1979~2007.5）、CNKI數字圖書館（1979~2007.5），手工檢索《中華泌尿外科雜志》等 5 種相關雜志，納入與 CP 治療有效性和安全性有關的臨床隨機對照試驗，并追索已納入文獻的參考文獻。由兩名系統評價員獨立進行文獻篩查、質量評價和資料提取，并交叉核對，意見不一致時通過討論或向專家咨詢解決。Meta 分析采用RevMan 4.2軟件。
結果　共初檢出412篇文獻，經篩選后最后納入 9篇RCT （917例）進行分析。Meta分析結果顯示：與安慰劑相比，前列安栓、翁瀝通、川參通、α受體阻滯劑、黃酮哌酯、舍尼通均能減少NIH-CPSI總計得分[RR1.99，95 ％ CI（1.60，2.48）；RR2.76 95 ％ CI(2.13，3.57)；RR2.49， 95 ％ CI(1.24，4.97)WMD -5.90，95％ CI（-8.12，-3.68）；WMD -2.50，95％ CI（-4.85，-0.15）；WMD -6.07，95％ CI(-7.92，-4.22)]。α 受體阻滯劑、翁瀝通、黃酮哌酯、舍尼通與安慰劑比較，也能降低疼痛評分。
結論　藥物干預治療能一定程度上改善 CP 患者總的 NIH-CPSI 評分和總體癥狀，但不能改善所有癥狀；今后的臨床研究需選擇適宜樣本量和最佳療程，并進行隨訪；同時提高國內原始研究質量，開展高質量臨床研究非常重要。

引用本文： 楊明根,趙曉昆,王新君. 中國慢性前列腺炎治療的有效性和安全性系統評價. 中國循證醫學雜志, 2007, 07(10): 737-742. doi: 復制

1.	Lv M, Zhao ST, Wang JW, et al. Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis(NIH-Ⅲa): a prospective, placebo-controlled trial. Chinese Journal of Epidemiology, 2004; 25:169–172.
2.	Xu G, Lu J, Tang XD, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis :a multi center , randomized, double blinded, placebo controlled trial. Chinese Journal of Urology, 2002; 23(5): 296-298.
3.	Yin FY, Pang B, Wang P, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis. The Journal of Practical Medicine, 2002;.
4.	Li NC, Zhang K, Xiao H, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2003; 24(11) 59-62.
5.	Zhou ZM, Yang JH, Gao WX. The efficacy of Wenglitong in the treatment of chronic pelvic pain synptome. J North China Coal Medical College, 2003; 5(4): 431-432.
6.	Xu G, Ding Q, Gao XF, et al. The eff icacy and safety of Wenglitong in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2005; 26(11): 781.
7.	Wang W, He HX, Hu WL, et al. The efficacy and safety of intraprostatic injection of Chuanshentong for chronic abacterial prostatitis/chronic pelvic pain syndrome.National Journal of Andrology, 2004; 10(3): 182-184.
8.	Xi QL, Wang SG, Liu JH, et al. The efficacy and safety of Prostat in the treatment of chronic nonbacterial prostatitis：a randomized double-blind, placebo-controlled clinical trial. Journal of Clinical Research, 2006; 3:23-25.
9.	Ye ZQ, Lan RZ, Wang SG, et al. A clinical study of Prostat combined with an antibiotic for chronic nonbacterial prostatitis. 2006; 12(9): 807-810.
10.	Collins MM, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits[J]. J Urol, 1998; 159: 1224-1228.
11.	Nickel JC, Downey J, Hunter D, et al. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol, 2001; 165(3): 842-845.
12.	Wenninger K, Heiman JR, Rothman I, et al. Sickness impact of chronic nonbacterial prostatitis and its correlates. J Urol, 1996; 155(3): 965-968.
13.	Litwin MS, Mcnaughton-Collins M, Fowler FJ, et a1.The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. J Uml,1999; 162(2): 369-375.
14.	Nuckel JC, Nyberg LM, Hennenfent MI. Research guidelines for chronic prostatitis：consensus report from the first national institutes of health international prostatitis collaborative network. Urology, 1999; 54: 229.
15.	Jadad AR, Moore RA, Carroll D, et a1．Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996; 17(1):1-12.
16.	Kjaergard LL, Villumsen J, Gluud C. Quality of randomized clinical trials affects estimates of intervention efficacy. In: Ⅶ Cochrane Colloquium, Rome, 1999; 57.
17.	呂明, 趙升田, 王柬玫, 等. α-受體阻滯劑和生物類黃酮治療慢性非細菌性前列腺炎的隨機對照臨床試驗.中華流行病學雜志, 2004; 25:169-172.
18.	徐罡, 魯軍, 唐孝達 ,等. 前列安栓治療慢性前列腺炎:多中心雙盲隨機安慰劑對照試驗. 中華泌尿外科雜志, 2002; 5:39-41.
19.	殷鋒彥, 龐勃, 王鵬, 等. 前列安栓治療慢性前列腺炎療效觀察. 實用醫學雜志, 2002, 18(12): 1336-1337.
20.	李寧忱,張凱,肖何,等. 前列安栓治療慢性前列腺炎的安全性和有效性:隨機雙盲安慰劑對照試驗. 中華泌尿外科雜志,2003; 24(11): 59-62.
21.	周忠民, 楊紀華, 高偉興. 翁瀝通膠囊治療慢性骨盆疼痛綜合癥.華北煤炭醫學院學報, 2003; 5(4): 431-432.
22.	徐罡, 丁強, 高小峰, 等. 翁瀝通治療慢性前列腺炎:多中心隨機雙盲安慰劑對照試驗. 中華泌尿外科雜志, 2005; 26(11): 781.
23.	王尉, 何恢緒, 胡衛列,等. 前列腺內直接注射川參通治療慢性非細菌性前列腺炎/慢性骨盆疼痛綜合征. 中華男科學雜志, 2004; 10(3): 182-184.
24.	席啟林, 王少剛, 劉繼紅, 等. 舍尼通治療慢性非細菌性前列腺炎的有效性和安全性. 醫學臨床研究, 2006; 3: 23-25.
25.	葉章群, 藍儒竹, 王少剛, 等.舍尼通和抗生素聯合用藥治療慢性非細菌性前列腺炎臨床研究. 中華男科學雜志, 2006; 12(9): 807-810.
26.	(12): 1336-1337.

1. Lv M, Zhao ST, Wang JW, et al. Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis(NIH-Ⅲa): a prospective, placebo-controlled trial. Chinese Journal of Epidemiology, 2004; 25:169–172.
2. Xu G, Lu J, Tang XD, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis :a multi center , randomized, double blinded, placebo controlled trial. Chinese Journal of Urology, 2002; 23(5): 296-298.
3. Yin FY, Pang B, Wang P, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis. The Journal of Practical Medicine, 2002;.
4. Li NC, Zhang K, Xiao H, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2003; 24(11) 59-62.
5. Zhou ZM, Yang JH, Gao WX. The efficacy of Wenglitong in the treatment of chronic pelvic pain synptome. J North China Coal Medical College, 2003; 5(4): 431-432.
6. Xu G, Ding Q, Gao XF, et al. The eff icacy and safety of Wenglitong in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2005; 26(11): 781.
7. Wang W, He HX, Hu WL, et al. The efficacy and safety of intraprostatic injection of Chuanshentong for chronic abacterial prostatitis/chronic pelvic pain syndrome.National Journal of Andrology, 2004; 10(3): 182-184.
8. Xi QL, Wang SG, Liu JH, et al. The efficacy and safety of Prostat in the treatment of chronic nonbacterial prostatitis：a randomized double-blind, placebo-controlled clinical trial. Journal of Clinical Research, 2006; 3:23-25.
9. Ye ZQ, Lan RZ, Wang SG, et al. A clinical study of Prostat combined with an antibiotic for chronic nonbacterial prostatitis. 2006; 12(9): 807-810.
10. Collins MM, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits[J]. J Urol, 1998; 159: 1224-1228.
11. Nickel JC, Downey J, Hunter D, et al. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol, 2001; 165(3): 842-845.
12. Wenninger K, Heiman JR, Rothman I, et al. Sickness impact of chronic nonbacterial prostatitis and its correlates. J Urol, 1996; 155(3): 965-968.
13. Litwin MS, Mcnaughton-Collins M, Fowler FJ, et a1.The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. J Uml,1999; 162(2): 369-375.
14. Nuckel JC, Nyberg LM, Hennenfent MI. Research guidelines for chronic prostatitis：consensus report from the first national institutes of health international prostatitis collaborative network. Urology, 1999; 54: 229.
15. Jadad AR, Moore RA, Carroll D, et a1．Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996; 17(1):1-12.
16. Kjaergard LL, Villumsen J, Gluud C. Quality of randomized clinical trials affects estimates of intervention efficacy. In: Ⅶ Cochrane Colloquium, Rome, 1999; 57.
17. 呂明, 趙升田, 王柬玫, 等. α-受體阻滯劑和生物類黃酮治療慢性非細菌性前列腺炎的隨機對照臨床試驗.中華流行病學雜志, 2004; 25:169-172.
18. 徐罡, 魯軍, 唐孝達 ,等. 前列安栓治療慢性前列腺炎:多中心雙盲隨機安慰劑對照試驗. 中華泌尿外科雜志, 2002; 5:39-41.
19. 殷鋒彥, 龐勃, 王鵬, 等. 前列安栓治療慢性前列腺炎療效觀察. 實用醫學雜志, 2002, 18(12): 1336-1337.
20. 李寧忱,張凱,肖何,等. 前列安栓治療慢性前列腺炎的安全性和有效性:隨機雙盲安慰劑對照試驗. 中華泌尿外科雜志,2003; 24(11): 59-62.
21. 周忠民, 楊紀華, 高偉興. 翁瀝通膠囊治療慢性骨盆疼痛綜合癥.華北煤炭醫學院學報, 2003; 5(4): 431-432.
22. 徐罡, 丁強, 高小峰, 等. 翁瀝通治療慢性前列腺炎:多中心隨機雙盲安慰劑對照試驗. 中華泌尿外科雜志, 2005; 26(11): 781.
23. 王尉, 何恢緒, 胡衛列,等. 前列腺內直接注射川參通治療慢性非細菌性前列腺炎/慢性骨盆疼痛綜合征. 中華男科學雜志, 2004; 10(3): 182-184.
24. 席啟林, 王少剛, 劉繼紅, 等. 舍尼通治療慢性非細菌性前列腺炎的有效性和安全性. 醫學臨床研究, 2006; 3: 23-25.
25. 葉章群, 藍儒竹, 王少剛, 等.舍尼通和抗生素聯合用藥治療慢性非細菌性前列腺炎臨床研究. 中華男科學雜志, 2006; 12(9): 807-810.
26. (12): 1336-1337.

《中國循證醫學雜志》

中國慢性前列腺炎治療的有效性和安全性系統評價

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《中國循證醫學雜志》

中國慢性前列腺炎治療的有效性和安全性系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

摘要全文圖表視頻參考文獻施引文獻補充材料