維他命D補充對膀胱過動症的治療效果:文獻回顧及統合分析

背景：膀胱過動症（Overactive Bladder, OAB）是一種常見且令人困擾的疾病，尤其在老年人群中。傳統療法，包括行為治療和抗乙烯膽鹼劑(Antimuscarinic Drug)及 β3-腎上腺素受體促效劑(β3 agonist)等藥物治療，常常效果不穩定且伴隨副作用。近期證據顯示，維生素D因其免疫調節和神經肌肉調控特性，可能在膀胱過動症(OAB)的治療中具有治療潛力。方法：根據PRISMA準則進行系統性回顧和隨機對照試驗（RCT）統合分析。於2025年7月3日前，在PubMed、Embase和Cochrane Library中進行文獻檢索，納入評估維生素D補充對緩解膀胱過動症(OAB)症狀的研究。使用RevMan軟體計算合併勝算比（OR）及95%信賴區間（CI）。敏感性分析排除兒童人群及使用組合療法的研究。結果：共納入6項RCT，包含12,467名參與者。維生素D補充顯著降低膀胱過動症(OAB)症狀持續的可能性，相較於安慰劑或對照組（OR = 0.44，95% CI：0.26-0.75；p < 0.00001）。即使排除包括涉及兒童的研究，結果依然穩健（OR = 0.53，95% CI：0.35–0.79；p = 0.003）。針對僅限成人且使用單一療法的四項研究進行的敏感性分析，結果同樣顯示益處，且異質性較低（OR = 0.46，95% CI：0.32–0.66；I² = 28%）。結論：維生素D補充作為一種安全、非侵入性的輔助治療方法，在膀胱過動症(OAB)的治療中顯示出潛力，尤其對於維生素D缺乏的患者。然而，由於劑量、結果測量和研究設計的變異性，仍需進一步高品質的試驗來標準化治療方案並確認療效。

Background:Overactive bladder (OAB) is a prevalent and distressing condition, particularly in aging populations. Conventional therapies, including behavioral interventions and pharmacologic agents such as antimuscarinics and β3-adrenergic agonists, often yield inconsistent results and are limited by side effects. Recent evidence suggests that vitamin D, through its immunomodulatory and neuromuscular properties, may have therapeutic potential in OAB management.Methods:A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted according to PRISMA guidelines. Literature searches in PubMed, Embase, and the Cochrane Library were performed through July 3, 2025. Studies assessing vitamin D supplementation for OAB symptom relief were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using RevMan software. Sensitivity analyses excluded pediatric populations and studies using combination therapies.Results:Six RCTs comprising 12,467 participants were included. Vitamin D supplementation significantly reduced the odds of persistent OAB symptoms compared to placebo or control (OR = 0.44, 95% CI: 0.26–0.75; p < 0.00001). When studies excluding studies with children, results remained robust (OR = 0.53, 95% CI: 0.35–0.79; p = 0.003). Sensitivity analysis of four adult-only, monotherapy studies yielded consistent benefit with lower heterogeneity (OR = 0.46, 95% CI: 0.32–0.66; I² = 28%).Conclusion:Vitamin D supplementation shows promise as a safe, non-invasive adjunctive treatment for OAB, particularly in individuals with vitamin D deficiency. However, variability in dosing, outcome measures, and study designs warrants further high-quality trials to standardize protocols and confirm efficacy.