Zhong Yajing, Zeng Fanzhu, Li Jiaying, Yang Yunhua, Zhong Shuxian, Song Yang
School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China.
Evid Based Complement Alternat Med. 2018 Jul 26;2018:7612618. doi: 10.1155/2018/7612618. eCollection 2018.
This systematic review aimed at summarizing and evaluating the evidence from randomized controlled trials (RCTs) which used electroacupuncture (EA) to treat postoperative urinary retention (PUR).
We searched thirteen databases electronically through April 2018 without language restrictions. We included RCTs of women with PUR; other types of urinary retention or not-RCTs were excluded. Two independent reviewers extracted studies' characteristics, and disagreements were resolved by consensus. Data were pooled and expressed as standard mean difference (SMD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes, with 95% confidence interval (CI).
We found very low to moderate level of evidence that effects of less than or equal to a week were statistically significant: therapeutic effect improved (OR=4.21; 95%CI [3.04, 5.83]; P<0.00001), residual urine volume decreased (SMD=-13.24; 95%CI [-15.70, -10.78]; P<0.00001), bladder capacity increased (SMD=0.56; 95%CI [0.30, 0.83]; P<0.0001), and urinary flow rate improved (SMD=0.91; 95%CI [0.64, 1.18]; P<0.00001). Effect over a week was statistically significant as well. Therapeutic effect improved (OR=8.29; 95%CI [2.91, 24.25]; P<0.0001), residual urine volume decreased (SMD=-1.78; 95%CI [-2.66, -0.89]; P<0.0001), bladder capacity (SMD=0.92; 95%CI [0.61, 1.23]; P<0.00001) and urinary flow rate (SMD=1.69; 95%CI [0.59, 2.79]; P=0.003) increased, and first urination after surgery was earlier (SMD=-0.92; 95%CI [-1.37, -0.46]; P<0.0001), compared with physical exercise, medication, or no treatment.
The efficacy and safety of EA on key outcomes in women with PUR are statistically significant, but the level of most evidence was very low or low. More large-scale, long-term RCTs with rigorous methodological quality are needed.
本系统评价旨在总结和评估随机对照试验（RCT）中使用电针（EA）治疗术后尿潴留（PUR）的证据。
截至2018年4月，我们通过电子方式检索了13个数据库，无语言限制。我们纳入了患有PUR的女性的RCT；排除其他类型的尿潴留或非RCT研究。两名独立的评价者提取研究特征，分歧通过协商一致解决。数据进行合并，连续结局以标准均数差（SMD）表示，二分结局以比值比（OR）表示，并给出95%置信区间（CI）。
我们发现证据水平极低至中等，即小于或等于一周的治疗效果具有统计学意义：治疗效果改善（OR=4.21；95%CI[3.04,5.83]；P<0.00001），残余尿量减少（SMD=-13.24；95%CI[-15.70,-10.78]；P<0.00001），膀胱容量增加（SMD=0.56；95%CI[0.30,0.83]；P<0.0001），尿流率改善（SMD=0.91；95%CI[0.64,1.18]；P<0.00001）。超过一周的效果也具有统计学意义。与体育锻炼、药物治疗或不治疗相比，治疗效果改善（OR=8.29；95%CI[2.91,24.25]；P<0.0001），残余尿量减少（SMD=-1.78；95%CI[-2.66,-0.89]；P<0.0001），膀胱容量（SMD=0.92；95%CI[0.61,1.23]；P<0.00001）和尿流率（SMD=1.69；95%CI[0.59,2.79]；P=0.003）增加，术后首次排尿时间提前（SMD=-0.92；95%CI[-1.37,-0.46]；P<0.0001）。
EA治疗PUR女性关键结局的有效性和安全性具有统计学意义，但大多数证据水平极低或低。需要更多方法学质量严格的大规模、长期RCT。
