一例初诊老年前列腺增生患者的循证治疗_《中国循证医学杂志》

作者：

陈化磊 ,  李世文 , 王行环 , 郑新民 , 丁协刚

武汉大学中南医院泌尿外科（武汉?430071）;

关键词：

前列腺增生老年患者循证治疗随机对照试验

DOI：

10.7507/1672-2531.20090163

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　借助循证医学的方法为1例初诊老年前列腺增生患者确定治疗目标和治疗方案。
方法　在充分评估患者情况后，提出临床问题，从Cochrane Library、中国生物医学文献数据库、中国期刊网、PubMed、EMbase、ScienceDirect、Springer和ProQuest检索相关证据，检索时间截至2008年。评价证据的质量和适用性，据患者意愿制定治疗方案，随访患者。
结果　共检索出与不同问题相关的随机对照试验137篇，系统评价/Meta分析39篇。综合分析检索结果，为患者制订了合理的治疗方案。经1年随访证实，该方案适合患者。
结论　采用循证治疗的方法，为初诊老年前列腺增生患者确定合理的治疗方案，可有效提高治疗效果。

引用本文： 陈化磊,李世文,王行环,郑新民,丁协刚. 一例初诊老年前列腺增生患者的循证治疗. 中国循证医学杂志, 2009, 09(8): 924-928. doi: 10.7507/1672-2531.20090163 复制

1.	马志方, 王东文, 马腾骧, 等. 多沙唑嗪控释片和坦索罗辛治疗前列腺增生症的对照研究. 天津医学, 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. 盐酸坦索罗辛治疗前列腺增生症的疗效及安全性的临床分析. 海峡药学, 2005, 17(2): 98-100.
6.	华立新, 吴宏飞, 眭元庚, 等. 哈乐在良性前列腺增生伴急性尿潴留中的应用. 中华男科学, 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, 李宁宁, 叶璐, 等. 坦索罗辛和特拉唑嗪治疗BPH的系统评价. 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, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生II期临床研究. 中国临床药理学杂志, 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.	黄遂斌, 魏继刚, 章传华, 等. 经尿道汽化电切术联合微波治疗前列腺增生症. 中国康复杂志, 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.	尧凯, 王祥慧, 杨罗艳. 非那甾安与坦索罗辛治疗良性前列腺增生症疗效对比. 中国男科学杂志, 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.	唐正严, 彭克亮, 丁见, 等. 保列治与哈乐治疗前列腺增生的I临床疗效观察. 中南大学学报 (医学版), 2005, 30(6): 708-710.
22.	叶璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治疗良性前列腺增生症的安全性评价. 药物不良反应志, 2005, 6: 411-417.
23.	熊鹰, 叶璐, 任宇, 等. 特拉唑嗪、非那司提和坦素罗辛治疗良性前列腺增生症的有效性评价.中国循证医学杂志, 2005, 5(6): 448-454转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. 马志方, 王东文, 马腾骧, 等. 多沙唑嗪控释片和坦索罗辛治疗前列腺增生症的对照研究. 天津医学, 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. 盐酸坦索罗辛治疗前列腺增生症的疗效及安全性的临床分析. 海峡药学, 2005, 17(2): 98-100.
6. 华立新, 吴宏飞, 眭元庚, 等. 哈乐在良性前列腺增生伴急性尿潴留中的应用. 中华男科学, 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, 李宁宁, 叶璐, 等. 坦索罗辛和特拉唑嗪治疗BPH的系统评价. 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, 韩文科, 金杰, 等. 爱普列特治疗良性前列腺增生II期临床研究. 中国临床药理学杂志, 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. 黄遂斌, 魏继刚, 章传华, 等. 经尿道汽化电切术联合微波治疗前列腺增生症. 中国康复杂志, 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. 尧凯, 王祥慧, 杨罗艳. 非那甾安与坦索罗辛治疗良性前列腺增生症疗效对比. 中国男科学杂志, 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. 唐正严, 彭克亮, 丁见, 等. 保列治与哈乐治疗前列腺增生的I临床疗效观察. 中南大学学报 (医学版), 2005, 30(6): 708-710.
22. 叶璐, 任宇, 李懿, 等. 特拉唑嗪、坦洛新及非那雄胺治疗良性前列腺增生症的安全性评价. 药物不良反应志, 2005, 6: 411-417.
23. 熊鹰, 叶璐, 任宇, 等. 特拉唑嗪、非那司提和坦素罗辛治疗良性前列腺增生症的有效性评价.中国循证医学杂志, 2005, 5(6): 448-454转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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一例初诊老年前列腺增生患者的循证治疗

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《中国循证医学杂志》

一例初诊老年前列腺增生患者的循证治疗

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