尿路石の通過を容易にするための医療療法:メタ分析
John M Hollingsworth1, Mary A M Rogers, Samuel R Kaufman
1Department of Urology, Ann Arbor Veterans Affairs Health Services Research & Development Center of Excellence, Ann Arbor, MI, USA.
Lancet (London, England)
|October 3, 2006
まとめ
アルファブロッカーやカルシウムチャネルブロッカーのような治療法は,尿路石の通過率を大幅に増加させます. これらの治療法は,腎臓石を患っている多くの患者にとって,手術の代替手段となる可能性があります.
科学分野:
- 泌尿器科 泌尿器科とは
- 薬理学 薬理学とは
- 根拠に基づいた医学は,証拠に基づいた医療です.
背景:
- 尿路石の通過に対する医療療法が十分に活用されていない.
- 効果的な医療療法によって,尿路結石の治療選択肢を拡大することができる.
- この研究では,石の通路における特定の薬剤クラスの有効性を評価しています.
研究 の 目的:
- 尿路石疾患に対するアルファ阻害剤とカルシウムチャネル阻害剤に関するランダム化対照試験 (RCT) を体系的にレビューする.
- 石の通過を容易にするためのこれらの医療療法の有効性を評価する.
主な方法:
- 主要なデータベース (MEDLINE,EMBASE,CINAHL) で検索し,2005年7月までの会議要約を検索しました.
- 尿路石に対するアルファ阻害剤やカルシウム管阻害剤を使用したRCTも含まれています.
- メタアナリシスを用いた9つの試験 (693人の患者) のデータをプールした.
主要な成果:
- アルファ阻害剤とカルシウムチャネル阻害剤は,石の通過を65%増加させました (RR 1.65).
- 特定の薬剤のクラスは,アルファ阻害薬 (1.54) とステロイドを含むカルシウムチャネル阻害薬 (1.90) とともに,有意な総合リスク比を示した.
- 治療に必要な人数は4人であり,高い効率性を示しています.
結論:
- アルファブロッカーまたはカルシウムチャネルブロッカーによる医療療法は,尿路石の通過を容易にするための有効な選択肢です.
- これらの治療法は,患者が外科的介入を避けるのに役立ちます.
- 効果を確認するために,さらに高品質のRCTを推奨します.
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