LIU Jian-jun,GU Lei.Roles of tamsulosin in relief of renal colic and clearance of ureteral calculi:a meta-analysis of randomized controlled trials[J].同济大学学报（医学版）,2016,37(3):112-117, 128. [点击复制]
Roles of tamsulosin in relief of renal colic and clearance of ureteral calculi:a meta-analysis of randomized controlled trials
LIU Jian-jun,GU Lei
(Dept. of Intensive Care Unit, Shibei Hospital, Zhabei Disttrict, Shanghai 200443, China)
Abstract:
Objective To evaluate the roles of tamsulosin in decreasing incidence of recurrent renal colic and clearance of ureteral calculi. Methods PubMed, Embase, Cochrane, CBMdisc, CNKI and Wanfang database were searched from their establishment to May 2015 for collecting randomized controlled trials(RCTs) of tamsulosin in treatment of renal colic. Meanwhile, the enrolled references from those RCTs were retrieved manually. According to inclusion and exclusion criteria, two independent researchers screened RCTs and evaluated the quality. Then, a meta-analysis was conducted with RevMan 5.3. Results Thirteen RCTs of tamsulosin in treating ureteral calculi were included for meta-analysis, in which 656 patients in tamsulosin group and 655 patients in control group were involved. The results of meta-analyses showed that:(1) Compared with control group, tamsulosin reduced risk of recurrent renal colic significantly during drug therapy of ureteral calculi[RR=0.45,5%CI(0.31,0.65)]and the risk was decreased by 57% and 46% in lower ureteral calculi[RR=0.43,5%CI(0.27,0.67)]and upper ureteral calculi[RR=0.54,5%CI(0.34,0.85)], respectively.(2) Compared with control group, tamsulosin increased the clearance rate of ureteral calculi significantly[RR=1.67,5%CI(1.40,1.99)]. And the clearance rate of lower ureteral calculi was increased by 75%[RR=1.75,5%CI(1.45,2.13)], while there was no significant change for upper ureteral calculi.(3) Compared with control group, tamsulosin reduced clearance time of calculi significantly[MD=-4.45,5%CI(-5.20,-3.70)], and the clearance time was reduced by 3.75 and 2.20 days in lower ureteral calculi[MD=-4.75,5%CI(-5.77,-3.73)]and upper ureteral calculi[MD=-3.20,5%CI(-4.71,-1.69)], respectively. Conclusion The current evidence demonstrates that tamsulosin can decrease the incidence of recurrent renal colic and accelerate the clearance of ureteral calculi during drug therapy of ureteral calculi. Due to a small amount of original studies, it is suggested to prescribe tamsulosin with prudence. More RCTs with higher quality and larger samples are needed.
