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针刺治疗慢性前列腺炎/慢性盆腔疼痛综合征的系统评价

Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

作者信息

Qin Zongshi, Wu Jiani, Zhou Jing, Liu Zhishun

机构信息

From the Department of Acupuncture (ZQ, JW, JZ, ZL), Guang'anmen Hospital, China Academy of Chinese Medical Sciences; and Beijing University of Chinese Medicine (ZQ, JZ), Beijing, China.

出版信息

Medicine (Baltimore). 2016 Mar;95(11):e3095. doi: 10.1097/MD.0000000000003095.

Abstract

Acupuncture is a promising therapy for relieving symptoms in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which affects >15% of adult men worldwide. The aim of the study was to assess the effects and safety of the use of acupuncture for CP/CPPS. MEDLINE, EMBASE, CENTRAL, Web of Science, CBM, CNKI, Wang-Fang Database, JCRM, and CiNii were searched from their inception through 30 November 2015. Grey literature databases and websites were also searched. No language limits were applied. Only randomized controlled trials (RCTs) with CP/CPPS treated by acupuncture were included. Two reviewers extracted data and assessed the risk of bias of RCTs using the Cochrane Risk of Bias Tools, respectively. Seven trials were included, involving 471 participants. The result of meta-analysis indicated that compared with sham acupuncture (MD: -6.09 [95%CI: -8.12 to -5.68]) and medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) (MD: -4.57 [95%CI: -7.58 to -1.56]), acupuncture was more effective at decreasing the total NIH-CPSI score. Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine. Overall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity. Acupuncture is associated with rare and slightly adverse events. Protocol registration PROSPERO CRD42015027522.

摘要

针灸是一种有望缓解慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)症状的疗法,该疾病影响着全球超过15%的成年男性。本研究的目的是评估针灸治疗CP/CPPS的疗效和安全性。检索了MEDLINE、EMBASE、CENTRAL、Web of Science、CBM、CNKI、万方数据库、JCRM和CiNii,检索时间从各数据库建库至2015年11月30日。还检索了灰色文献数据库和网站。未设语言限制。仅纳入了采用针灸治疗CP/CPPS的随机对照试验(RCT)。两名评价员分别提取数据,并使用Cochrane偏倚风险工具评估RCT的偏倚风险。共纳入7项试验,涉及471名参与者。荟萃分析结果表明,与假针灸(MD:-6.09 [95%CI:-8.12至-5.68])和药物(左氧氟沙星、布洛芬和坦索罗辛)(MD:-4.57 [95%CI:-7.58至-1.56])相比,针灸在降低NIH-CPSI总分方面更有效。真针灸在改善症状(疼痛、排尿)和生活质量(Qof)领域子评分方面优于假针灸。与假针灸和药物相比,针灸在改善整体评估方面似乎更有效。两项试验发现,针灸与假针灸在降低IPSS评分方面无显著差异。与药物相比,针灸在改善症状和Qof领域方面未显示出更有利的效果。总体而言,目前的证据支持针灸作为治疗CP/CPPS所致症状的有效疗法,尤其是在缓解疼痛方面。基于荟萃分析,针灸在改善症状和Qof方面优于假针灸。针灸在长期疗效上可能与药物(左氧氟沙星、布洛芬和坦索罗辛)相似,但由于纳入试验中的高偏倚风险以及潜在的异质性,证据有限。针灸与罕见且轻微的不良事件相关。方案注册号:PROSPERO CRD42015027522。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29b2/4839929/7222f442c4bd/medi-95-e3095-g002.jpg

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