针刺治疗膀胱过度活动症的系统评价

摘要

Objective It is to systematically evaluate the efficacy and safety of the treatment with acupuncture for overactive bladder syndrome ( OAB ) by evidence-hased medicine. Methods Key words such as acupuncture, electroacupuncture, body acupunture, scalp acupunture, laser acupunture, auricular acupunture, percussopunctator, acupressure, fluid acupunture, OAB , urgent micturition syndrome, frequent-urgent micturition syndrome were used to retrieval English and Chinese database such as MEDLINE, EMBASE, CBM to collect randomrized-controlled clinical trials including treatment group treated with acupuncture only or combined with other therapy and control group treated with medicine or blank. Micturition diary , urinal pad test, life quality questions were used as test indexes. Method quality evaluation. daia scavenge and analysis was respectively performed on by two evaluators. Meta analysis was done by RevMan 4. 2. Results 6 randomrized-controlled clinical trials about treatment for OAB with acupuncture were according to the collecting standard. Daily micturition f'requency degree effective rate WMD was 14.48( 95％ CI 7. 14 - 29. 38 ), effective scores of inferior urinary passage symptom WMD - 1. 21 ( 95％ CI - 1. 93 -0. 49 ), question scores of urinary incontinence WMD -2. 28( 95％ CI - 3. 10 - 1. 46 ). Conclusion The treatment with acupuncture for OAB is safe. Its improveMent for daily micturition frequency degree effective rate, effective scores of inferior urinary passage symptoM , question scores of urinary incontinence was better than that of control group, but its efficiency on other evaluating indexes of OAB still needs more study to explore.%目的 运用循证医学方法 系统评价针刺治疗膀胱过度活动症的有效性及安全性.方法 以针刺、电针、体针、头针、激光针、耳针、梅花针、耳穴压豆、水针和膀胱过度活动症、膀胱过度活动综合征、尿急综合征、尿频-尿急综合征等为主题词,检索Cochrane尿失禁组、临床试验资料库、Cochrane补充医学资料库、Cochrane图书馆中心数据库及MEDLINE、EMBASE等英文数据库和中国生物光盘数据库(CBM)等中文数据库,选择随机临床对照试验,即治疗组为针刺或其他疗法加针刺,对照组为药物或空白等,以排尿日记、尿垫测试、生活质量问卷等为测量指标.2个评价员独立地进行方法 学质量评价、数据提取和分析, 采用RevMan 4.2进行Meta分析.结果 6个针刺治疗膀胱过度活动症的随机对照试验符合纳入标准.日排尿频率等级有效率WMD为14.48(95%CI 7.14～29.38),下尿路症状影响评分WMD为-1.21(95%CI -1.93～-0.49),尿失禁问卷评分WMD为-2.28(95%CI -3.10～-1.46).结论 针刺治疗膀胱过度活动症是安全的.针刺疗法对改善膀胱过度活动症患者日排尿频率等级有效率、下尿路症状影响评分、尿失禁问卷评分较对照组有效,但针刺对膀胱过度活动症其他评价指标的有效性尚需要更多的研究阐明.