目的比较口服抗胆碱能药与新型β3受体激动药治疗女性OAB患者的药物安全性。方法通过检索PubMed、Embase、Web of Science和Cochrane Library数据库,筛选自各数据库建库以来至2020年2月28日有关口服抗胆碱能药与新型β3受体激动药治疗女...目的比较口服抗胆碱能药与新型β3受体激动药治疗女性OAB患者的药物安全性。方法通过检索PubMed、Embase、Web of Science和Cochrane Library数据库,筛选自各数据库建库以来至2020年2月28日有关口服抗胆碱能药与新型β3受体激动药治疗女性OAB患者国外相关文献,提取疗效、不良反应指标,基于频率学对各药物的疗效及安全性进行优劣排序,并通过多变量Meta分析进一步对新型β3受体激动药的各种不良反应进行分析。结果本研究共检索1487篇相关文献,最终纳入13篇随机对照试验文献,包含3339例OAB患者。经非一致性检验无统计学意义,并基于频率学网状Meta分析对疗效及安全性进行排序。结果显示,索利那新疗效最好,其他依次为达非那新、米拉贝隆、安慰剂、索拉贝隆,疗效最差的为托特罗定;安全性最高的是米拉贝隆,其他依次为索拉贝隆、安慰剂、托特罗定、索利那新、达非那新。结论新型β3受体激动药米拉贝隆可作为OAB患者的首选治疗药物,米拉贝隆在确保安全性的同时,疗效仅次于索利那新及达非那新。但在应用新型β3受体激动药治疗OAB患者时应结合患者的身体素质综合,考虑对女性患者心、脑血管方面的影响。展开更多
【目的】基于数据挖掘技术探讨针灸治疗膀胱过度活动症的穴位配伍及方案优化。【方法】系统检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方中国学术期刊数据库(Wanfang)、中国生物医学文献数据库(SinoMed)、美国生...【目的】基于数据挖掘技术探讨针灸治疗膀胱过度活动症的穴位配伍及方案优化。【方法】系统检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方中国学术期刊数据库(Wanfang)、中国生物医学文献数据库(SinoMed)、美国生物医学文献数据库(PubMed)、科学引文索引(Web of Science)等各大数据库从2013年3月1日至2024年4月30日收录的有关针灸治疗膀胱过度活动症临床研究类文献,构建结构化数据库,采用频次统计、层次聚类及Apriori算法,从经络分布、穴位配伍、治疗方式等维度解析针灸治疗膀胱过度活动症的临床应用规律。【结果】共纳入92项研究,包含87个有效处方。核心穴位涉及12条经脉、53个腧穴及9个耳穴,高频腧穴集中于任脉(关元、中极)与膀胱经(肾俞),耳穴以神门、膀胱、肾为主。足太阳膀胱经的腧穴应用频次最高,选穴部位集中在下腹部,以交会穴为主。聚类分析显示两大核心组合:关元-中极-气海-三阴交-足三里-阴陵泉-太溪;次髎-会阳-肾俞-膀胱俞-中髎。关联规则揭示关元→中极、肾俞→膀胱俞等11组强关联配对。干预方法以针刺、艾灸、电针为主。主要以膀胱过度活动症评分表作为主要疗效评价指标。【结论】针灸治疗膀胱过度活动症呈现“腰腹联合,远近配穴”的立体化方案特征。该研究通过量化分析构建选穴方案,可为临床精准施治提供循证依据。展开更多
Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in thi...Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in this situation.Material and Methods:A literature search up to January 2025 was performed using PubMed,Google Scholar,and Embase to assess efficacy,safety,and predictors of adverse events(AE)related to BoNT-A.The risk of bias was assessed using the Risk of Bias 2(RoB 2)tool for randomized studies and the Critical Appraisal Skills Programme(CASP)checklist for cohort studies.The quality of the review was evaluated based on the Oxford criteria,following the Strengthening the Assessment of Narrative Review Articles(SANRA)guidelines,and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines for systematic reviews.Results:31 studies were included,involving 5410 patients.BoNT-A improves OAB symptoms even after reinjections.Higher doses do not enhance efficacy but increase AE.AE includes high post-void residual(PVR),clean intermittent self-catheterization(CISC),and Urinary Tract Infection(UTI).Predictors of CISC include age,male gender,hysterectomy,≥3 vaginal deliveries,mixed incontinence,prior mid-urethral sling(MUS),high PVR,low Pressure at Pdet at First Micturition(PIP1)in women,low Bladder Compliance Index(BCI)in men,and high Bladder Outlet Obstruction Index(BOOI).Diabetes and heart failure increase PVR.UTIs are more frequent in women and men with benign prostatic hyperplasia,with CISC increasing the risk fivefold.Severe complications are rare.Predictors of poor response include male gender,high BOOI,low urinary flow,and diabetes.Discussion:BoNT-A is effective for OAB,especially for incontinence.AE is dose-dependent and limits treatment adherence.Their link with poor response remains unclear.Conclusion:BoNT-A effectively treats refractory idiopathic OAB,improving symptoms and quality of life with repeated injections.展开更多
文摘目的比较口服抗胆碱能药与新型β3受体激动药治疗女性OAB患者的药物安全性。方法通过检索PubMed、Embase、Web of Science和Cochrane Library数据库,筛选自各数据库建库以来至2020年2月28日有关口服抗胆碱能药与新型β3受体激动药治疗女性OAB患者国外相关文献,提取疗效、不良反应指标,基于频率学对各药物的疗效及安全性进行优劣排序,并通过多变量Meta分析进一步对新型β3受体激动药的各种不良反应进行分析。结果本研究共检索1487篇相关文献,最终纳入13篇随机对照试验文献,包含3339例OAB患者。经非一致性检验无统计学意义,并基于频率学网状Meta分析对疗效及安全性进行排序。结果显示,索利那新疗效最好,其他依次为达非那新、米拉贝隆、安慰剂、索拉贝隆,疗效最差的为托特罗定;安全性最高的是米拉贝隆,其他依次为索拉贝隆、安慰剂、托特罗定、索利那新、达非那新。结论新型β3受体激动药米拉贝隆可作为OAB患者的首选治疗药物,米拉贝隆在确保安全性的同时,疗效仅次于索利那新及达非那新。但在应用新型β3受体激动药治疗OAB患者时应结合患者的身体素质综合,考虑对女性患者心、脑血管方面的影响。
文摘【目的】基于数据挖掘技术探讨针灸治疗膀胱过度活动症的穴位配伍及方案优化。【方法】系统检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方中国学术期刊数据库(Wanfang)、中国生物医学文献数据库(SinoMed)、美国生物医学文献数据库(PubMed)、科学引文索引(Web of Science)等各大数据库从2013年3月1日至2024年4月30日收录的有关针灸治疗膀胱过度活动症临床研究类文献,构建结构化数据库,采用频次统计、层次聚类及Apriori算法,从经络分布、穴位配伍、治疗方式等维度解析针灸治疗膀胱过度活动症的临床应用规律。【结果】共纳入92项研究,包含87个有效处方。核心穴位涉及12条经脉、53个腧穴及9个耳穴,高频腧穴集中于任脉(关元、中极)与膀胱经(肾俞),耳穴以神门、膀胱、肾为主。足太阳膀胱经的腧穴应用频次最高,选穴部位集中在下腹部,以交会穴为主。聚类分析显示两大核心组合:关元-中极-气海-三阴交-足三里-阴陵泉-太溪;次髎-会阳-肾俞-膀胱俞-中髎。关联规则揭示关元→中极、肾俞→膀胱俞等11组强关联配对。干预方法以针刺、艾灸、电针为主。主要以膀胱过度活动症评分表作为主要疗效评价指标。【结论】针灸治疗膀胱过度活动症呈现“腰腹联合,远近配穴”的立体化方案特征。该研究通过量化分析构建选穴方案,可为临床精准施治提供循证依据。
文摘Introduction:When conservative treatments fail,botulinum toxin A(BoNT-A)is an option for refractory idiopathic overactive bladder(OAB).This review evaluates the efficacy,safety,and predictive factors for BoNT-A in this situation.Material and Methods:A literature search up to January 2025 was performed using PubMed,Google Scholar,and Embase to assess efficacy,safety,and predictors of adverse events(AE)related to BoNT-A.The risk of bias was assessed using the Risk of Bias 2(RoB 2)tool for randomized studies and the Critical Appraisal Skills Programme(CASP)checklist for cohort studies.The quality of the review was evaluated based on the Oxford criteria,following the Strengthening the Assessment of Narrative Review Articles(SANRA)guidelines,and by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines for systematic reviews.Results:31 studies were included,involving 5410 patients.BoNT-A improves OAB symptoms even after reinjections.Higher doses do not enhance efficacy but increase AE.AE includes high post-void residual(PVR),clean intermittent self-catheterization(CISC),and Urinary Tract Infection(UTI).Predictors of CISC include age,male gender,hysterectomy,≥3 vaginal deliveries,mixed incontinence,prior mid-urethral sling(MUS),high PVR,low Pressure at Pdet at First Micturition(PIP1)in women,low Bladder Compliance Index(BCI)in men,and high Bladder Outlet Obstruction Index(BOOI).Diabetes and heart failure increase PVR.UTIs are more frequent in women and men with benign prostatic hyperplasia,with CISC increasing the risk fivefold.Severe complications are rare.Predictors of poor response include male gender,high BOOI,low urinary flow,and diabetes.Discussion:BoNT-A is effective for OAB,especially for incontinence.AE is dose-dependent and limits treatment adherence.Their link with poor response remains unclear.Conclusion:BoNT-A effectively treats refractory idiopathic OAB,improving symptoms and quality of life with repeated injections.
