전립선비대증에서 알파차단제 사용에 대한 국내 발표 논문의 메타분석

Abstract

Purpose: Many reliable articles on the effectiveness of alpha blockers have been published. Evidence-based diagnostic guidelines and therapeutic guidelines for benign prostatic hypertrophy(BPH), which is one of the most common urological diseases, have been proposed in many foreign countries. This paper examines the efficacy of alpha blocker, a common therapeutic drug for BPH, in Korean patients through meta-analysis. Materials and Methods: From 1993 to 2001, the term 'BPH' and alpha blocker for BPH were used as key words to search for related articles in the Medical Research Information Center, the National Assembly Library of the Republic of Korea, the Korean Journal of Andrology and the Korean Journal of Urology. A total of 10 articles were selected as being suitable for evaluation and these articles were ranked with levels ranging from I to V, where level I indicated a large randomized controlled trial and level V indicated a non-controlled case accumulation study. Results: There were improvements for the symptom score(45.3%), and for the maximum urinary flow rate(36.0%). The reasons for patient drop-outs were follow-up loss for 60%, drug side effects for 11%, and ineffectiveness of drug for 6.8%. The common side effects were dizziness (4.2%), orthostatic hypotension(2.2%), and headache(1.7%). The blood pressure was sustained in the normotensive patients, wheareas BP showed a tendency to be reduced in hypertensive patients. Conclusions: Treatment with alpha blocker resulted in the BPH patients in all the studies receiving sustained benefit. Yet most of these papers were short-term, non randomized case-accumulation studies. However, BPH is a chronic disease that may worsen over time. Therefore, evaluation of long term tolerability and efficacy of alpha blocker is necessary.