针刺治疗良性前列腺增生症的系统评价

摘要

Objective:To evaluate the efficacy and security of acupuncture in treating benign prostatic hyperplasia (BPH).Methods:The randomized controlled trials (RCTs) of using acupuncture in treating BPH were collected from databases,such as CNKI,CBMdisc,VIP and Wangfang.After the necessary methodological quality evaluation of the selected studies and assessment of publication bias,the statics analysis was conducted by the software RevManS.3.Results:11 eligible reports were selected in this study,including 1268 cases.The meta-analysis results showed acupuncture in the treatment of BPH had higher effectiveness than the control groups,and acupuncture could significantly increase the total effective ratio [RR =1.29,95％ CI (1.18,1.41),P ＜ 0.00001],improve the IPSS [WMD =-3.80,95％ CI (-3.85,-3.75),P ＜ 0.00001],MFR [SMD =0.97,95％ CI (0.51,1.43),P＜0.00001],RU [WMD=-6.23,95％CI (-10.20,-2.44),P=0.001],QOL [WMD =-1.28,95％ CI (-1.52,-1.03),P ＜ 0.00001],and Prostate volume [WMD =-4.18,95％ CI (-4.44,-3.93),P ＜0.000301].Conclusions:Based on current evidence,acupuncture is safe and effective for treating BPH.However due to the quality disunity in the included RCTs,more RCTs with large sample size and high quality are needed to conduct the verification.%目的:系统评价针刺治疗良性前列腺增生症的临床效果及安全性.方法:检索CNKI数据库、中国生物医学文献数据库、VIP数据库、万方数据库,纳入针刺治疗良性前列腺增生症的随机对照研究(RCT),并进行方法学质量评价,采用RevMan5.3软件进行统计分析,并进行发表偏倚评估分析.结果:本研究共纳入11篇RCT文献,病例累计1268例.Meta分析结果显示:针刺治疗后治疗组总有效率高于对照组[RR=1.29,95％ CI(1.18,1.41),P＜0.00001],在改善国际前列腺症状评分量表(IPSS)[WMD=-3.80,95％ CI(-3.85,-3.75),P＜0.00001]、最大尿流率(MFR)[SMD=0.97,95％CI(0.51,1.43),P＜0.00001]、残余尿量(RU) [WMD=-6.23,95％CI(-10.20,-2.44),P=0.001]、生存质量量表(QOL)[WMD=-1.28,95％ CI(-1.52,-1.03),P＜0.00001]、前列腺体积[WMD=-4.18,95％ CI(-4.44,-3.93),P＜0.00001]等方面亦均高于对照组.结论:基于现有临床证据,针刺治疗良性前列腺增生症有效、安全,但因为纳入文章数量较少,研究质量相对较低,故此结论尚需要更多高质量、大样本临床随机对照试验加以证实.