摘要
目的 采用贝叶斯网状Meta分析方法比较不同中成药治疗良性前列腺增生(BPH)的疗效及安全性差异。方法 计算机检索PubMed、Embase、Cochrane Library、CNKI、SinoMed、WanFang Data、VIP数据库,搜集关于中成药治疗BPH的随机对照试验(RCT),检索时限均从建库至2023年1月1日。由2名研究员独立筛选文献、提取资料并评估纳入研究的偏倚风险后,采用Stata 15.0、GeMTC 14.3软件进行贝叶斯网状Meta分析。结果 最终纳入51个RCT,涉及12种中成药,共4 927例患者。直接Meta分析结果显示,中成药联合常规西药在降低国际前列腺症状评分[MD=-4.44,95%CI(-5.09,-3.79),P <0.001]、改善最大尿流率[MD=3.16,95%CI(2.71,3.61),P <0.001]、减少残余尿量[MD=-8.27,95%CI(-9.62,-6.92),P <0.001]以及前列腺体积[MD=-3.89,95%CI(-4.60,-3.18),P <0.001]方面均优于常规西药。网状Meta分析结果显示,在降低国际前列腺症状评分方面,癃闭舒胶囊+常规西药疗效最佳;在改善最大尿流率方面,夏荔芪胶囊+常规西药疗效最佳;在减少残余尿量方面,泽桂癃爽胶囊+常规西药疗效最佳;在减小前列腺体积方面,热淋清颗粒+常规西药疗效最佳。在不良反应发生率方面,中成药联合常规西药组(8.27%)低于常规西药组(11.98%)。结论 现有证据表明,中成药联合常规西药在改善BPH的各种临床症状中整体优于常规西药,且安全性好。各种中成药有不同的治疗侧重点,在临床中可根据BPH患者具体症状进行个体化用药。受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。
Objective To compare the efficacy and safety of different Chinese patent medicines in the treatment of benign prostatic hyperplasia(BPH) by Bayesian network Meta-analysis.Methods PubMed,EMbase,Cochrane Library,CNKI,SinoMed,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of Chinese patent medicine in the treatment of BPH from inception to January 1,2023.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Bayesian network Meta-analysis was performed using Stata 15.0and GeMTC 14.3 software.Results A total of 51 RCTs involving 12 kinds of Chinese patent medicines and 4 927 patients were included.The results of direct Meta-analysis showed that Chinese patent medicine combined with conventional western medicine was superior to conventional western medicine alone in reducing international prostate symptom score(MD=-4.44,95%CI-5.09 to-3.79,P﹤0.001),improving maximum urinary flow rate(MD=3.16,95%CI 2.71 to 3.61,P﹤0.001),reducing residual urine volume(MD=-8.27,95%CI-9.62 to-6.92,P﹤0.001) and prostate volume(MD=-3.89,95%CI-4.60 to-3.18,P﹤0.001).The results of the network Meta-analysis showed that the Longbishu capsules combined with conventional western medicine had the best effect in reducing the international prostate symptom score.In terms of improving maximum urinary flow rate,Xialiqi capsules combined with conventional western medicine had the best effect.Zegui Longshuang capsules combined with conventional western medicine had the best effect in reducing residual urine volume.In terms of reducing prostate volume,Relinqing granules combined with conventional western medicine had the best effect.The incidence of adverse reactions in the Chinese patent medicine combined with conventional western medicine group(8.27%) was lower than that in the conventional western medicine group(11.98%).Conclusion The existing evidence shows that compared with conventional western medicine alone,Chinese patent medicine combined with conventional western medicine is better than conventional western medicine alone in improving various clinical symptoms of BPH,and has better safety.Various proprietary Chinese patent medicines have different therapeutic focuses,and individualized medication can be used according to the specific symptoms of BPH patients in clinical treatment.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.
作者
马嘉
邢建月
张宇鹏
刘光珍
MA Jia;XING Jianyue;ZHANG Yupeng;LIU Guangzhen(Second Department of Nephrology,Shanxi Provincial Hospital of Traditional Chinese Medicine,Taiyuan 030012,China;The First Clinical College of Shanxi University of Traditional Chinese Medicine,Taiyuan 030024,China)
出处
《药物流行病学杂志》
CAS
2024年第3期301-318,共18页
Chinese Journal of Pharmacoepidemiology
基金
国家中医药管理局科研专项(2020ZYLCYJ01)
国家中医药管理局刘光珍全国名中医传承工作室建设项目(国中医药人教函[2021]202号)
山西省重点研发计划项目(202102130501012)。
关键词
中成药
良性前列腺增生
贝叶斯网状Meta分析
随机对照试验
Chinese patent medicine
Benign prostate hyperplasia
Bayesian network Meta-analysis
Randomized controlled trial
作者简介
通信作者:刘光珍,硕士,教授,主任医师,博士研究生导师,Email:zyykxyj@foxmail.com。
