Zhao Yuwei, Zhou Jing, Mo Qian, Wang Yang, Yu Jinna, Liu Zhishun
Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing University of Chinese Medicine, Beijing Guiyang College of Traditional Chinese Medicine, Guiyang, China.
Medicine (Baltimore). 2018 Feb;97(8):e9838. doi: 10.1097/MD.0000000000009838.
Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients' health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs.
We independently searched 9 databases from beginning to August 15, 2017. Two writers extracted data at the same time independently. Study outcomes were calculated by standardized mean differences (SMD) with 95% confidence intervals (CIs) and mean difference (MD) with 95% CIs.
Ten randomized controlled trials (RCTs) with 794 patients were included in this systematic review. The combined results showed that electroacupuncture (EA) may be more effective than sham electroacupuncture (sham EA) in improving the 24-hour nocturia episodes and EA may enhance tolterodine for relieving voiding symptoms and enhancing patients' quality of life. However, more trials with high quality and larger sample sizes will be needed in the future to provide sufficient evidence. Only 15 of 794 OAB patients from the included studies reported mild adverse reactions related to EA, therefore, acupuncture is safe for treating OAB.
Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.
膀胱过度活动症表现为尿急的发生,这会产生负面影响并降低患者的健康相关生活质量。本系统评价的目的是评估针刺治疗成人膀胱过度活动症(OAB)相对于假针刺、药物以及针刺加药物治疗的有效性和安全性。
我们独立检索了截至2017年8月15日的9个数据库。两位作者同时独立提取数据。研究结果通过具有95%置信区间(CI)的标准化均数差(SMD)和具有95%CI的均数差(MD)进行计算。
本系统评价纳入了10项随机对照试验(RCT),共794例患者。综合结果显示,电针(EA)在改善24小时夜尿次数方面可能比假电针(假EA)更有效,且EA可能增强托特罗定缓解排尿症状和提高患者生活质量的效果。然而,未来需要更多高质量、大样本量的试验来提供充分证据。纳入研究的794例OAB患者中只有15例报告了与EA相关的轻度不良反应,因此,针刺治疗OAB是安全的。
针刺可能对减少排尿次数、尿失禁次数和夜尿次数有作用。然而,证据不足表明单独使用针刺的效果或其在治疗OAB中对药物的附加效果。