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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/79069完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 杜裕康 | zh_TW |
| dc.contributor.advisor | Yu-Kang Tu | en |
| dc.contributor.author | 陳柏誠 | zh_TW |
| dc.contributor.author | Po-Cheng Chen | en |
| dc.date.accessioned | 2021-07-11T15:41:26Z | - |
| dc.date.available | 2024-02-28 | - |
| dc.date.copyright | 2018-10-09 | - |
| dc.date.issued | 2018 | - |
| dc.date.submitted | 2002-01-01 | - |
| dc.identifier.citation | Reference：
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BJU Int 116, 450-459 (2015). 6. Roehrborn CG, Siami P, Barkin J, Damiao R, Major-Walker K, Nandy I, Morrill BB, Gagnier RP, Montorsi F, Comb ATSG, The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol 57, 123-131 (2010). 7. Favilla V, Russo GI, Privitera S, Castelli T, Giardina R, Calogero AE, Condorelli RA, La Vignera S, Cimino S, Morgia G, Impact of combination therapy 5-alpha reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: a systematic review with meta-analysis. Aging Male 19, 175-181 (2016). 8. Filson CP, Hollingsworth JM, Clemens JQ, Wei JT, The efficacy and safety of combined therapy with alpha-blockers and anticholinergics for men with benign prostatic hyperplasia: a meta-analysis. J Urol 190, 2153-2160 (2013). 9. Kim HJ, Sun HY, Choi H, Park JY, Bae JH, Doo SW, Yang WJ, Song YS, Ko YM, Kim JH, Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis. PLoS One 12, e0169248 (2017). 10. Partin AW, Wein AJ, Kavoussi LR, Peters CA, Campbell-Walsh Urology E-Book. (Elsevier Health Sciences, 2015). 11. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods G, Cochrane Statistical Methods G, The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 343, d5928 (2011). 12. Kaplan SA, Gonzalez RR, Te AE, Combination of alfuzosin and sildenafil is superior to monotherapy in treating lower urinary tract symptoms and erectile dysfunction. Eur Urol 51, 1717-1723 (2007). 13. Ozturk MI, Kalkan S, Koca O, Gunes M, Akyuz M, Karaman MI, Efficacy of alfuzosin and sildenafil combination in male patients with lower urinary tract symptoms. Andrologia 44 Suppl 1, 791-795 (2012). 14. Abolyosr A, Elsagheer GA, Abdel-Kader MS, Hassan AM, Abou-Zeid AM, Evaluation of the effect of sildenafil and/or doxazosin on Benign prostatic hyperplasia-related lower urinary tract symptoms and erectile dysfunction. Urol Ann 5, 237-240 (2013). 15. Tuncel A, Nalcacioglu V, Ener K, Aslan Y, Aydin O, Atan A, Sildenafil citrate and tamsulosin combination is not superior to monotherapy in treating lower urinary tract symptoms and erectile dysfunction. World J Urol 28, 17-22 (2010). 16. Fawzi A, Kamel M, Salem E, Desoky E, Omran M, Elgalaly H, Sakr A, Maarouf A, Khalil S, Sildenafil citrate in combination with tamsulosin versus tamsulosin monotherapy for management of male lower urinary tract symptoms due to benign prostatic hyperplasia: A randomised, double-blind, placebo-controlled trial. Arab J Urol 15, 53-59 (2017). 17. Bechara A, Romano S, Casabe A, Haime S, Dedola P, Hernandez C, Rey H, Comparative efficacy assessment of tamsulosin vs. tamsulosin plus tadalafil in the treatment of LUTS/BPH. Pilot study. J Sex Med 5, 2170-2178 (2008). 18. Barragán-Arteaga I, Reyes-Vallejo L, Combination therapy for the treatment of lower urinary tract symptoms in men. Revista Mexicana de Urología 76, 360-369 (2016). 19. Corona G, Tirabassi G, Santi D, Maseroli E, Gacci M, Dicuio M, Sforza A, Mannucci E, Maggi M, Sexual dysfunction in subjects treated with inhibitors of 5alpha-reductase for benign prostatic hyperplasia: a comprehensive review and meta-analysis. Andrology 5, 671-678 (2017). 20. Albisinni S, Biaou I, Marcelis Q, Aoun F, De Nunzio C, Roumeguere T, New medical treatments for lower urinary tract symptoms due to benign prostatic hyperplasia and future perspectives. BMC Urol 16, 58 (2016). 21. Giuliano F, Uckert S, Maggi M, Birder L, Kissel J, Viktrup L, The mechanism of action of phosphodiesterase type 5 inhibitors in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia. Eur Urol 63, 506-516 (2013). 22. Wang Y, Bao Y, Liu J, Duan L, Cui Y, Tadalafil 5 mg Once Daily Improves Lower Urinary Tract Symptoms and Erectile Dysfunction: A Systematic Review and Meta-analysis. Low Urin Tract Symptoms 10, 84-92 (2018). 23. McVary KT, Monnig W, Camps JL, Jr., Young JM, Tseng LJ, van den Ende G, Sildenafil citrate improves erectile function and urinary symptoms in men with erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized, double-blind trial. J Urol 177, 1071-1077 (2007). 24. Ko WJ, Han HH, Ham WS, Lee HW, Daily use of sildenafil 50mg at night effectively ameliorates nocturia in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia: an exploratory multicenter, double-blind, randomized, placebo-controlled study. Aging Male 20, 81-88 (2017). 25. Choi H, Kim HJ, Bae JH, Kim JH, Moon du G, Cheon J, Yeo JK, A Meta-Analysis of Long- Versus Short-Acting Phosphodiesterase 5 Inhibitors: Comparing Combination Use With alpha-Blockers and alpha-Blocker Monotherapy for Lower Urinary Tract Symptoms and Erectile Dysfunction. Int Neurourol J 19, 237-245 (2015). 26. Gacci M, Corona G, Salvi M, Vignozzi L, McVary KT, Kaplan SA, Roehrborn CG, Serni S, Mirone V, Carini M, Maggi M, A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol 61, 994-1003 (2012). 27. Liguori G, Trombetta C, De Giorgi G, Pomara G, Maio G, Vecchio D, Ocello G, Ollandini G, Bucci S, Belgrano E, Efficacy and safety of combined oral therapy with tadalafil and alfuzosin: an integrated approach to the management of patients with lower urinary tract symptoms and erectile dysfunction. Preliminary report. J Sex Med 6, 544-552 (2009). 28. Regadas RP, Reges R, Cerqueira JB, Sucupira DG, Josino IR, Nogueira EA, Jamacaru FV, de Moraes MO, Silva LF, Urodynamic effects of the combination of tamsulosin and daily tadalafil in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: a randomized, placebo-controlled clinical trial. Int Urol Nephrol 45, 39-43 (2013). 29. Kumar S, Kondareddy C, Ganesamoni R, Nanjappa B, Singh SK, Randomized Controlled Trial to Assess the Efficacy of the Combination Therapy of Alfuzosin and Tadalafil in Patients with Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Low Urin Tract Symptoms 6, 35-40 (2014). 30. Singh DV, Mete UK, Mandal AK, Singh SK, A comparative randomized prospective study to evaluate efficacy and safety of combination of tamsulosin and tadalafil vs. tamsulosin or tadalafil alone in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. J Sex Med 11, 187-196 (2014). 31. H. K, A. H-H, M. F-K, Comparing Monotherapy with Tadalafil or Tamsulosin and Their Combination Therapy in Men with Benign Prostatic Hyperplasia: A Randomized Clinical Trial. Urology Journal 13, 2920-2926 (2016). 32. Takeda M, Yokoyama O, Yoshida M, Nishizawa O, Hirata K, Nakaoka R, Takita Y, Murakami M, Safety and efficacy of the combination of once-daily tadalafil and alpha-1 blocker in Japanese men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: A randomized, placebo-controlled, cross-over study. Int J Urol 24, 539-547 (2017). 33. Gacci M, Vittori G, Tosi N, Siena G, Rossetti MA, Lapini A, Vignozzi L, Serni S, Maggi M, Carini M, A randomized, placebo-controlled study to assess safety and efficacy of vardenafil 10 mg and tamsulosin 0.4 mg vs. tamsulosin 0.4 mg alone in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Sex Med 9, 1624-1633 (2012). | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/79069 | - |
| dc.description.abstract | 研究背景與目的：
甲型阻斷劑是傳統治療攝護腺肥大引起的下泌尿道症狀的第一線藥物，然而有些病人在接受甲型阻斷劑之後症狀仍然沒有辦法達到理想的改善；攝護腺肥大的病人常常伴隨有勃起功能障礙的問題，第五型磷酸二酯酵素抑制劑可以同時治療攝護腺肥大以及勃起功能障礙。 本研究希望可以探討在攝護腺肥大引起的下泌尿道症狀病人，同時使用甲型阻斷劑及第五型磷酸二酯酵素抑制劑的效果是否優於單一使用甲型阻斷劑，如此一來在甲型阻斷劑無效的病人，便可以考慮加上第五型磷酸二酯酵素抑制劑，尤其是在那些伴隨有勃起功能障礙的病人。 研究方法： 本研究採用系統性回顧及統合分析，在Pubmed、Embase及Cochrane library等資料庫搜尋比較合併治療與單一使用甲型阻斷劑的隨機分派研究。目標族群為攝護腺肥大造成下泌尿道症狀的病人，實驗組為合併使用使用甲型阻斷劑及第五型磷酸二酯酵素抑制劑，而對照組為單一使用甲型阻斷劑，臨床結果為國際攝護腺症狀評分，最大尿流速，殘尿，國際勃起功能指標量表的分數。 統合分析採用隨機效應模型，而我們也進行了統合回歸來分析什麼樣的影響因子決定病人接受合併治療能夠得到最大的好處。 研究結果： 本研究收錄了13個隨機分派研究共1173位病人，相較於單一使用甲型阻斷劑，合併甲型阻斷劑及第五型磷酸二酯酵素抑制劑顯著可以改善國際攝護腺症狀評分的分數，平均可以多改善1.73分(95%CI: 1.1-2.35)，國際攝護腺症狀評分的排尿分數及儲尿分數也有顯著改善，平均可以多改善0.99分(95%CI: 0.54-1.44)及0.57分(95% CI: 0.03-1.1)；最大尿流速方面，合併治療組可以顯著多增加0.69cc/s (95%CI: 0.27 to 1.1)；此外，勃起功能問卷的分數在合併治療組亦顯著優於單一使用甲型阻斷劑。 在統合回歸分析方面，治療前的國際攝護腺症狀評分、最大尿流速、攝護腺體積、年齡、勃起功能問卷評分及第五型磷酸二酯酵素抑制劑的劑量都和國際攝護腺症狀評分的改善程度無關，本研究未發現顯著影響國際攝護腺症狀評分改善程度的因子。 結論： 合併甲型阻斷劑及第五型磷酸二酯酵素抑制劑在攝護腺肥大引起的下泌尿道症狀病人，相較單一使用甲型阻斷劑有更好的療效。 | zh_TW |
| dc.description.abstract | Purpose:
Alpha blockers are effective drugs for lower urinary tract symptoms (LUTS) caused by benign prostate hyperplasia (BPH). However, urinary symptoms may remain unresolved in some patients after taking alpha blockers. The prevalence of erectile dysfunction is higher in patients with lower urinary tract symptoms. Phosphodiesterase 5 inhibitors can improve both erectile dysfunction and lower urinary tract symptoms and therefore is useful for these patients. Our aim of this study is to evaluate whether combination therapy of alpha blockers and phosphodiesterase 5 inhibitor (PDE5i) is more effective than alpha blockers monotherapy for the treatment of LUTS in men. Material and methods: A systematic review and meta-analysis were undertaken to assess the difference between the combination therapy and alpha blockers monotherapy by searching published randomized controlled trials from electronic databases PubMed, Embase, and the Cochrane Library up to April, 2018. The PICO statement of our study searching is (1) Population: patients with LUTS/BPH; (2) Intervention: LUTS/BPH patients who received combination therapy of alpha blocker and PDE5i; (3) Comparison: LUTS/BPH patients who received alpha blocker therapy only; and (4) Outcome: International Prostate Symptom Score (IPSS), Qmax (peak uroflow rate), PVR (post voiding residual urine), and international index of erectile function score (IIEF) of these patients. Random effect meta-analysis was undertaken to calculate the pooled effect size, and meta-regression was performed to identify potential factors associated with the difference in the treatment effects between the two therapeutic regimens. Results： A total of 13 randomized controlled studies with 1173 patients were included in our meta-analysis. Compared with alpha blocker monotherapy, the combination therapy obtained a significantly better improvement in IPSS (1.73, 95%CI: 1.1 to 2.35), IPSS voiding subscore (0.99, 95% CI: 0.54-1.44, IPSS storage subscore (0.57, 95% CI: 0.03-1.1), peak flow rate (0.69 cc/s, 95%CI: 0.27 to 1.1) and erectile function (IIEF5 3.84, 95%CI 1.55-6.12 and IIEF-EF 3.87 95%CI 2.27-5.46). Meta-regression showed that baseline IPSS, baseline peak flow rate, baseline prostate volume, age, baseline IIEF-EF score, baseline IIEF5 score and PDE5i dosage were not associated with the difference in IPSS improvement. Conclusion: Combination of alpha blockers and PDE5i has better therapeutic effects than alpha blocker monotherapy on lower urinary tract symptoms related to benign prostate hyperplasia. | en |
| dc.description.provenance | Made available in DSpace on 2021-07-11T15:41:26Z (GMT). No. of bitstreams: 1 ntu-107-P05849002-1.pdf: 2889401 bytes, checksum: 07cb0bf28b5d3849c4af3a5049b21047 (MD5) Previous issue date: 2018 | en |
| dc.description.tableofcontents | Catalog
口試委員會審定書…………………………………………………… i 誌謝…………………………………………………………………… ii 中文摘要……………………………………………………………… iii 英文摘要……………………………………………………………… v Catalog…………………………………………………………………vii List of figures and tables………………………………………………viii 1.Introduction ……………………………………………………….. 1 2.Material and method………………………………………………… 3 3.Result………………………………….……………………………. 5 4.Discussion…………………………………………………………….. 8 5.Reference………………………...………………………………….. 30 | - |
| dc.language.iso | en | - |
| dc.subject | 第五型磷酸二酯酵素抑制劑 | zh_TW |
| dc.subject | 甲型阻斷劑 | zh_TW |
| dc.subject | 下泌尿道症狀 | zh_TW |
| dc.subject | 攝護腺肥大 | zh_TW |
| dc.subject | phosphodiesterase 5 inhibitors | en |
| dc.subject | alpha blockers | en |
| dc.subject | lower urinary tract symptoms | en |
| dc.subject | benign prostate hyperplasia | en |
| dc.title | 對於攝護腺肥大造成的下泌尿道症狀，比較合併使用甲型阻斷劑及第五型磷酸二酯酵素抑制劑以及單一使用甲型阻斷劑：系統性回顧及統合分析研究 | zh_TW |
| dc.title | Combination of alpha blocker and phosphodiesterase 5 inhibitors versus alpha blocker monotherapy for lower urinary tract symptoms associated with benign prostate hyperplasia: a systematic review and meta-analysis | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 106-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 簡國龍;張宏江 | zh_TW |
| dc.contributor.oralexamcommittee | Kuo-Liong Chien;Hong-Chiang Chang | en |
| dc.subject.keyword | 甲型阻斷劑,第五型磷酸二酯酵素抑制劑,攝護腺肥大,下泌尿道症狀, | zh_TW |
| dc.subject.keyword | alpha blockers,phosphodiesterase 5 inhibitors,benign prostate hyperplasia,lower urinary tract symptoms, | en |
| dc.relation.page | 33 | - |
| dc.identifier.doi | 10.6342/NTU201802754 | - |
| dc.rights.note | 未授權 | - |
| dc.date.accepted | 2018-08-13 | - |
| dc.contributor.author-college | 公共衛生學院 | - |
| dc.contributor.author-dept | 流行病學與預防醫學研究所 | - |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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