Management of Chronic Prostatitis(CP) in China: A Meta-analysis of Randomized Controlled Trials (RCTs)_Chinese Journal of Evidence-Based Medicine

Authors：

Yang Minggen ,  Zhao Xiaokun , Wang Xinjun

Department of Urology, The Second Xiangya Hospital, Central South University, Changsha 410011, China;

Corresponding author：

Zhao Xiaokun, Email: hzhaoxiaokun50@163.com

Keywords：

Chronic prostatitis; Randomized controlled trials; Meta-analysis

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Objective 　To evaluate the efficacy and safety of the treatment of chronic prostatitis(CP) in China.
Methods 　We search the related original studies about the treatment for Chinese CP all over the world, and only included randomized controlled trials (RCTs). MEDLINE(1966-2007.5), PubMed (1966-2007.5), EMBASE(1988-2007.05), and four Chinese databases were electronically searched and 6 related journals were handsearched. The studies included in the references of eligible studies were additionally searched. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted the data from the eligible studies, with confirmation by cross-checking. Divergences of opinion were settled by discussion or consulted by the expert. Meta-analysis was performed by using Rev Man 4.2 software.
Results　 Nine original studies involving 917 participants met inclusion criteria. Compared withplacebo, prostant, Wenglitong, Chuanshentong, alpha-blockers, bioflabonoid and porstat could reduce the NIH-chronic prostatitis symptom index[RR1.99, 95% CI（1.60, 2.48）； RR2.76 95% CI(2.13，3.57)； RR2.49, 95% CI(1.24, 4.97)； WMD -5.90，95%CI（-8.12，-3.68）； WMD -2.50, 95%CI（-4.85，-0.15）；WMD -6.07， 95%CI(-7.92， -4.22)]. Alpha-blockers, Wengl itong, bioflabonoid and porstat can also reduce the symtom index of pain.
Conclusion 　Drug interventions could improve NIH-CPSI and total symptoms of CP in some degree, but can not improve all symptoms, future RCTs must use an appropriate sample size and optimal duration and follow-up of participants. It is important to improve the quality of internal original studies.

Citation： Yang Minggen,Zhao Xiaokun,Wang Xinjun. Management of Chronic Prostatitis(CP) in China: A Meta-analysis of Randomized Controlled Trials (RCTs). Chinese Journal of Evidence-Based Medicine, 2007, 07(10): 737-742. doi: Copy

1.	Lv M, Zhao ST, Wang JW, et al. Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis(NIH-Ⅲa): a prospective, placebo-controlled trial. Chinese Journal of Epidemiology, 2004; 25:169–172.
2.	Xu G, Lu J, Tang XD, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis :a multi center , randomized, double blinded, placebo controlled trial. Chinese Journal of Urology, 2002; 23(5): 296-298.
3.	Yin FY, Pang B, Wang P, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis. The Journal of Practical Medicine, 2002;.
4.	Li NC, Zhang K, Xiao H, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2003; 24(11) 59-62.
5.	Zhou ZM, Yang JH, Gao WX. The efficacy of Wenglitong in the treatment of chronic pelvic pain synptome. J North China Coal Medical College, 2003; 5(4): 431-432.
6.	Xu G, Ding Q, Gao XF, et al. The eff icacy and safety of Wenglitong in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2005; 26(11): 781.
7.	Wang W, He HX, Hu WL, et al. The efficacy and safety of intraprostatic injection of Chuanshentong for chronic abacterial prostatitis/chronic pelvic pain syndrome.National Journal of Andrology, 2004; 10(3): 182-184.
8.	Xi QL, Wang SG, Liu JH, et al. The efficacy and safety of Prostat in the treatment of chronic nonbacterial prostatitis：a randomized double-blind, placebo-controlled clinical trial. Journal of Clinical Research, 2006; 3:23-25.
9.	Ye ZQ, Lan RZ, Wang SG, et al. A clinical study of Prostat combined with an antibiotic for chronic nonbacterial prostatitis. 2006; 12(9): 807-810.
10.	Collins MM, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits[J]. J Urol, 1998; 159: 1224-1228.
11.	Nickel JC, Downey J, Hunter D, et al. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol, 2001; 165(3): 842-845.
12.	Wenninger K, Heiman JR, Rothman I, et al. Sickness impact of chronic nonbacterial prostatitis and its correlates. J Urol, 1996; 155(3): 965-968.
13.	Litwin MS, Mcnaughton-Collins M, Fowler FJ, et a1.The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. J Uml,1999; 162(2): 369-375.
14.	Nuckel JC, Nyberg LM, Hennenfent MI. Research guidelines for chronic prostatitis：consensus report from the first national institutes of health international prostatitis collaborative network. Urology, 1999; 54: 229.
15.	Jadad AR, Moore RA, Carroll D, et a1．Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996; 17(1):1-12.
16.	Kjaergard LL, Villumsen J, Gluud C. Quality of randomized clinical trials affects estimates of intervention efficacy. In: Ⅶ Cochrane Colloquium, Rome, 1999; 57.
17.	吕明, 赵升田, 王柬玫, 等. α-受体阻滞剂和生物类黄酮治疗慢性非细菌性前列腺炎的随机对照临床试验.中华流行病学杂志, 2004; 25:169-172.
18.	徐罡, 鲁军, 唐孝达 ,等. 前列安栓治疗慢性前列腺炎:多中心双盲随机安慰剂对照试验. 中华泌尿外科杂志, 2002; 5:39-41.
19.	殷锋彦, 庞勃, 王鹏, 等. 前列安栓治疗慢性前列腺炎疗效观察. 实用医学杂志, 2002, 18(12): 1336-1337.
20.	李宁忱,张凯,肖何,等. 前列安栓治疗慢性前列腺炎的安全性和有效性:随机双盲安慰剂对照试验. 中华泌尿外科杂志,2003; 24(11): 59-62.
21.	周忠民, 杨纪华, 高伟兴. 翁沥通胶囊治疗慢性骨盆疼痛综合症.华北煤炭医学院学报, 2003; 5(4): 431-432.
22.	徐罡, 丁强, 高小峰, 等. 翁沥通治疗慢性前列腺炎:多中心随机双盲安慰剂对照试验. 中华泌尿外科杂志, 2005; 26(11): 781.
23.	王尉, 何恢绪, 胡卫列,等. 前列腺内直接注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征. 中华男科学杂志, 2004; 10(3): 182-184.
24.	席启林, 王少刚, 刘继红, 等. 舍尼通治疗慢性非细菌性前列腺炎的有效性和安全性. 医学临床研究, 2006; 3: 23-25.
25.	叶章群, 蓝儒竹, 王少刚, 等.舍尼通和抗生素联合用药治疗慢性非细菌性前列腺炎临床研究. 中华男科学杂志, 2006; 12(9): 807-810.
26.	(12): 1336-1337.

1. Lv M, Zhao ST, Wang JW, et al. Alpha-blockers and bioflavonoids in men with chronic nonbacterial prostatitis(NIH-Ⅲa): a prospective, placebo-controlled trial. Chinese Journal of Epidemiology, 2004; 25:169–172.
2. Xu G, Lu J, Tang XD, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis :a multi center , randomized, double blinded, placebo controlled trial. Chinese Journal of Urology, 2002; 23(5): 296-298.
3. Yin FY, Pang B, Wang P, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis. The Journal of Practical Medicine, 2002;.
4. Li NC, Zhang K, Xiao H, et al. The efficacy and safety of Prostant in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2003; 24(11) 59-62.
5. Zhou ZM, Yang JH, Gao WX. The efficacy of Wenglitong in the treatment of chronic pelvic pain synptome. J North China Coal Medical College, 2003; 5(4): 431-432.
6. Xu G, Ding Q, Gao XF, et al. The eff icacy and safety of Wenglitong in the treatment of chronic prostatitis : a multicenter, randomized, double-blind, placebo-controlled clinical trial. Chinese Journal of Urology, 2005; 26(11): 781.
7. Wang W, He HX, Hu WL, et al. The efficacy and safety of intraprostatic injection of Chuanshentong for chronic abacterial prostatitis/chronic pelvic pain syndrome.National Journal of Andrology, 2004; 10(3): 182-184.
8. Xi QL, Wang SG, Liu JH, et al. The efficacy and safety of Prostat in the treatment of chronic nonbacterial prostatitis：a randomized double-blind, placebo-controlled clinical trial. Journal of Clinical Research, 2006; 3:23-25.
9. Ye ZQ, Lan RZ, Wang SG, et al. A clinical study of Prostat combined with an antibiotic for chronic nonbacterial prostatitis. 2006; 12(9): 807-810.
10. Collins MM, Stafford RS, O’Leary MP, et al. How common is prostatitis? A national survey of physician visits[J]. J Urol, 1998; 159: 1224-1228.
11. Nickel JC, Downey J, Hunter D, et al. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol, 2001; 165(3): 842-845.
12. Wenninger K, Heiman JR, Rothman I, et al. Sickness impact of chronic nonbacterial prostatitis and its correlates. J Urol, 1996; 155(3): 965-968.
13. Litwin MS, Mcnaughton-Collins M, Fowler FJ, et a1.The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. J Uml,1999; 162(2): 369-375.
14. Nuckel JC, Nyberg LM, Hennenfent MI. Research guidelines for chronic prostatitis：consensus report from the first national institutes of health international prostatitis collaborative network. Urology, 1999; 54: 229.
15. Jadad AR, Moore RA, Carroll D, et a1．Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials, 1996; 17(1):1-12.
16. Kjaergard LL, Villumsen J, Gluud C. Quality of randomized clinical trials affects estimates of intervention efficacy. In: Ⅶ Cochrane Colloquium, Rome, 1999; 57.
17. 吕明, 赵升田, 王柬玫, 等. α-受体阻滞剂和生物类黄酮治疗慢性非细菌性前列腺炎的随机对照临床试验.中华流行病学杂志, 2004; 25:169-172.
18. 徐罡, 鲁军, 唐孝达 ,等. 前列安栓治疗慢性前列腺炎:多中心双盲随机安慰剂对照试验. 中华泌尿外科杂志, 2002; 5:39-41.
19. 殷锋彦, 庞勃, 王鹏, 等. 前列安栓治疗慢性前列腺炎疗效观察. 实用医学杂志, 2002, 18(12): 1336-1337.
20. 李宁忱,张凯,肖何,等. 前列安栓治疗慢性前列腺炎的安全性和有效性:随机双盲安慰剂对照试验. 中华泌尿外科杂志,2003; 24(11): 59-62.
21. 周忠民, 杨纪华, 高伟兴. 翁沥通胶囊治疗慢性骨盆疼痛综合症.华北煤炭医学院学报, 2003; 5(4): 431-432.
22. 徐罡, 丁强, 高小峰, 等. 翁沥通治疗慢性前列腺炎:多中心随机双盲安慰剂对照试验. 中华泌尿外科杂志, 2005; 26(11): 781.
23. 王尉, 何恢绪, 胡卫列,等. 前列腺内直接注射川参通治疗慢性非细菌性前列腺炎/慢性骨盆疼痛综合征. 中华男科学杂志, 2004; 10(3): 182-184.
24. 席启林, 王少刚, 刘继红, 等. 舍尼通治疗慢性非细菌性前列腺炎的有效性和安全性. 医学临床研究, 2006; 3: 23-25.
25. 叶章群, 蓝儒竹, 王少刚, 等.舍尼通和抗生素联合用药治疗慢性非细菌性前列腺炎临床研究. 中华男科学杂志, 2006; 12(9): 807-810.
26. (12): 1336-1337.

Chinese Journal of Evidence-Based Medicine

Management of Chronic Prostatitis(CP) in China: A Meta-analysis of Randomized Controlled Trials (RCTs)

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