目的:本文对α-受体阻滞剂的作用进行了不同且更严格的研究,有时被昵称为“神奇药丸”,特别是对于结石病和药物治疗(MET)。
方法:进行非系统叙述性综述,从选定的文章中综合相关信息,批判性地评估他们的结论。有时对α受体阻滞剂有不同的看法,包括适合本主题的好奇心或其他有趣的细微差别,但始终保持敏锐的客观性和最重要的科学严谨性。
结论:α受体阻滞剂似乎是灵丹妙药,用于治疗各种非泌尿系统疾病和病症。泌尿外科应用包括良性前列腺增生的勃起功能障碍,从尿失禁到尿潴留,甚至促进尿路结石沿尿路通过。由于其多功能性,α-受体阻滞剂似乎是泌尿科药物的瑞士军刀。然而,α受体阻滞剂对MET的疗效,疼痛管理,或促进上呼吸道通道非常令人失望,带来不,或者在某些情况下,只有边际效益。他们的治疗结果远非重要或令人印象深刻,更不用说神奇了。定期性交是α受体阻滞剂的有效替代品,提供更快的输尿管结石排出率和减少对止痛药的需要。大多数支持α受体阻滞剂的研究都是基于单中心,动力不足,低质量的研究。这些低质量的研究对随后的几项荟萃分析产生了偏见,用低质量的数据污染他们,加强和延长这种错觉。这些结果强调了对大型,多中心,没有偏见,随机化,双盲,安慰剂对照试验,以防止未来一年可能困扰任何医学领域的妄想。
OBJECTIVE: The present paper takes a different and more critical look at the role of alpha-blockers, sometimes nicknamed as \"magical pills\", in particular for stone disease and medical expulsive therapy (MET).
METHODS: A non-systematic narrative review was performed, synthesizing pertinent information from selected articles, and critically evaluating their conclusions. Sometimes different views on alpha-blockers were laid bare, including curiosities or other entertaining nuances suitable to the present topic, but always maintaining sharp objectivity and the foremost scientific rigor.
CONCLUSIONS: Alpha-blockers seem to be a panacea, being used to treat a wide variety of non-urological diseases and conditions. Urological applications include erectile dysfunction to benign prostatic hyperplasia, from incontinence to urinary retention, or even to facilitate urinary stone passage along the urinary tract. Due to its versatility, alpha-blockers appear to be the Swiss army knife of urological medications. However, the efficacy of alpha-blockers for MET, pain management, or facilitating upper tract access is very disappointing, bringing no, or in some instances, only marginal benefits. Their treatment results are far from being significant or impressive let alone magical. Regular sexual intercourse is an effective alternative to alpha-blockers, providing faster ureteral stone expulsion rates and reducing the need for pain medication. Most of the research supporting alpha-blockers has been based on single-center, underpowered, low-quality studies. These low-quality studies biased several subsequent meta-analyses, contaminating them with their low-quality data, enhancing and prolonging this delusion. These results emphasize the need for large, multi-centric, unbiased, randomized, double-blinded, placebo-controlled trials to prevent future year-long delusions that may afflict any medical field.