Zhu De Ting, Feng Xiao Jun, Zhou Yun, Wu Jian Xian
Department of Rehabilitation Medicine, the Second Hospital of Anhui Medical University, Hefei, 230601 China.
Springerplus. 2016 Nov 29;5(1):2032. doi: 10.1186/s40064-016-3737-5. eCollection 2016.
To systematically evaluate the therapeutic effect of electrical stimulation (ES) on overactive bladder (OB).
We retrieved information by searching databases from PubMed, CBM-disc, The Cochrane Library, ScienceDirect (from Elsevier publishers) and Springer publishers up to March 2016. We looked for randomized controlled trials that studied ES in OB treatment with subject headings and keywords using literature searches and manual retrieval. References of included studies were reviewed. Literature was screened independently by two investigators according to inclusion and exclusion criteria. After extracting data and evaluating their quality, meta-analysis was undertaken with RevMan v5.2.
Ten randomized controlled trials involving 719 patients were included. Meta-analysis results demonstrated ES to have better effects for improving bladder compliance, reducing residual urine, and decreasing the frequency of enuresis in OB patients compared with the control group. ES elicited significantly better effects for diminishing the maximum detrusor pressure in children than in controls, but there was no significant difference in the maximum detrusor pressure between adults and controls. The therapeutic effect of ES combined with other therapies for increasing the maximum bladder capacity was better compared with other therapies alone. No significant difference was noted between ES alone and other therapies alone.
Based on current evidence, ES has certain effects on OBs. Severe adverse reactions are not observed. ES is safe, efficacious, and worthy of clinical use.
系统评价电刺激(ES)治疗膀胱过度活动症(OB)的疗效。
检索截至2016年3月的PubMed、中国生物医学文献数据库(CBM-disc)、考克兰图书馆、科学Direct(爱思唯尔出版社)和施普林格出版社等数据库中的信息。通过文献检索和手工检索,查找使用主题词和关键词研究ES治疗OB的随机对照试验。对纳入研究的参考文献进行综述。由两名研究者根据纳入和排除标准独立筛选文献。在提取数据并评估其质量后,使用RevMan v5.2进行荟萃分析。
纳入10项涉及719例患者的随机对照试验。荟萃分析结果表明,与对照组相比,ES在改善OB患者膀胱顺应性、减少残余尿量和降低遗尿频率方面具有更好的效果。ES在降低儿童最大逼尿肌压力方面的效果明显优于对照组,但成人与对照组在最大逼尿肌压力方面无显著差异。与单独使用其他疗法相比,ES联合其他疗法在增加最大膀胱容量方面的治疗效果更好。单独使用ES与单独使用其他疗法之间未观察到显著差异。
基于现有证据,ES对OB有一定疗效。未观察到严重不良反应。ES安全、有效,值得临床应用。