针灸治疗良性前列腺增生症：一项系统评价与荟萃分析。

Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis.

作者信息

Zhang Wei, Ma Liyan, Bauer Brent A, Liu Zhishun, Lu Yao

机构信息

Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Clinical Laboratory Center. Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

PLoS One. 2017 Apr 4;12(4):e0174586. doi: 10.1371/journal.pone.0174586. eCollection 2017.

DOI:10.1371/journal.pone.0174586

PMID:28376120

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5380320/

Abstract

PURPOSE

This systematic review and meta-analysis aims to assess the therapeutic and adverse effects of acupuncture for benign prostatic hyperplasia (BPH) in randomized controlled trials (RCTs).

METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Database, the China National Knowledge Infrastructure, the VIP Database and the Wanfang Database. Parallel-group RCTs of acupuncture for men with symptomatic BPH were included. Data from the included trials were extracted by two independent reviewers and were analyzed with The Cochrane Collaboration Review Manager software (RevMan 5.3.5) after risk of bias judgments. The primary outcome measure of this review was a change in urological symptoms.

RESULTS

Eight RCTs, which involved 661 men with BPH, were included. Follow-up varied from 4 weeks to 18 months. Pooling of the data from three trials that compared acupuncture with sham-acupuncture revealed that in the short term (4-6 weeks), acupuncture can significantly improve IPSS (MD -1.90, 95% CI -3.58 to -0.21). A sensitivity analysis of the short-term endpoint showed the same result (MD -3.01, 95% CI -5.19 to -0.84) with a borderline minimal clinical important difference (MCID). Qmax of the short-term endpoint indicated statistically positive beneficial effects of acupuncture (MD -1.78, 95%CI -3.43, -0.14). A meta-analysis after medium-term follow-up (12-18 weeks) indicated no significant effect on IPSS when the data from two trials were combined (MD -2.04, 95% CI -4.19, 0.10).

CONCLUSION

Statistically significant changes were observed in favor of acupuncture in moderate to severe BPH with respect to short-term follow-up endpoints. The clinical significance of these changes needs to be tested by further studies with rigorous designs and longer follow-up times.

TRIAL REGISTRATION NUMBER

PROSPERO CRD42014013645.

摘要

目的

本系统评价和荟萃分析旨在评估随机对照试验（RCT）中针刺治疗良性前列腺增生（BPH）的疗效和不良反应。

方法

我们检索了Cochrane图书馆中的Cochrane对照试验中心注册库（CENTRAL）、MEDLINE、EMBASE、中国生物医学数据库、中国知网、维普数据库和万方数据库。纳入针刺治疗有症状BPH男性的平行组RCT。由两名独立的研究者提取纳入试验的数据，并在进行偏倚风险判断后，使用Cochrane协作网综述管理软件（RevMan 5.3.5）进行分析。本综述的主要结局指标是泌尿系统症状的变化。

结果

纳入了8项RCT，涉及661例BPH男性。随访时间从4周至18个月不等。对三项比较针刺与假针刺的试验数据进行汇总分析显示，在短期内（4 - 6周），针刺可显著改善国际前列腺症状评分（IPSS）（MD -1.90，95%CI -3.58至-0.21）。对短期终点的敏感性分析显示了相同的结果（MD -3.01，95%CI -5.19至-0.84），具有临界最小临床重要差异（MCID）。短期终点的最大尿流率（Qmax）表明针刺具有统计学上的积极有益效果（MD -1.78，95%CI -3.43，-0.14）。中期随访（12 - 18周）后的荟萃分析表明，合并两项试验的数据时，对IPSS无显著影响（MD -2.04，95%CI -4.19，0.10）。