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针刺疗法对慢性前列腺炎/慢性盆腔疼痛综合征的长期影响:系统评价与单臂荟萃分析

Long-term effects of acupuncture for chronic prostatitis/chronic pelvic pain syndrome: systematic review and single-arm meta-analyses.

作者信息

Qin Zongshi, Wu Jiani, Xu Chang, Sang Xiaopu, Li Xiao, Huang Guangrui, Liu Zhishun

机构信息

School of Life Sciences, Beijing University of Chinese Medicine, Beijing 100029, China.

Department of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.

出版信息

Ann Transl Med. 2019 Mar;7(6):113. doi: 10.21037/atm.2018.06.44.

Abstract

BACKGROUND

Cumulative evidences indicate that acupuncture may ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, the long-lasting effects of acupuncture on CP/CPPS has not been fully evaluated. The objective of this study is to assess the sustained effects of acupuncture on CP/CPPS.

METHODS

We searched PubMed, EMBASE, and CENTRAL databases for studies on the use of acupuncture in patients with CP/CPPS. Studies with long-term follow-up periods were included. Single-arm meta-analyses were performed using random-effects model. The primary outcome was the response rate at the end of follow-up period; the secondary outcomes were changes of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores at the end of follow-up, including total score and 3 sub-scores (pain, urinary, and quality of life).

RESULTS

Six studies with 310 patients were performed in data synthesis, among which four studies were randomized controlled trials (RCT) and two were case series studies. At the end of follow-up, the weighted "average" response rate was 68.4% (95% CI: 42.1% to 89.5%, n=226; I=93.5%); the change of NIH-CPSI total score were -14.8 (95% CI: -17.0 to -12.6, n=310; I=92.1%); the change of pain, urinary, and quality of life sub-scores were -6.0 (95% CI: -6.9 to -5.2, n=266; I=83.6%), -2.6 (95% CI: -3.2 to -2.0, n=266; I=87.9%), and -4.4 (95% CI: -6.2 to -2.6, n=266; I=98.7%), respectively. The source of heterogeneity could not be identified owing to insufficient studies.

CONCLUSIONS

Acupuncture may have clinically long-lasting benefits for CP/CPPS. However, current evidence is limited owing to insufficient data and significant heterogeneity. Further studies with larger sample size and long-term follow-up periods are warranted.

摘要

背景

越来越多的证据表明,针灸可能会改善慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)的症状。然而,针灸对CP/CPPS的长期疗效尚未得到充分评估。本研究的目的是评估针灸对CP/CPPS的持续影响。

方法

我们在PubMed、EMBASE和CENTRAL数据库中检索了关于CP/CPPS患者使用针灸的研究。纳入了具有长期随访期的研究。采用随机效应模型进行单臂荟萃分析。主要结局是随访期末的缓解率;次要结局是随访期末美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分的变化,包括总分和3个分项评分(疼痛、排尿和生活质量)。

结果

数据综合分析中纳入了6项研究,共310例患者,其中4项研究为随机对照试验(RCT),2项为病例系列研究。随访期末,加权“平均”缓解率为68.4%(95%CI:42.1%至89.5%,n = 226;I² = 93.5%);NIH-CPSI总分变化为-14.8(95%CI:-17.0至-12.6,n = 310;I² = 92.1%);疼痛、排尿和生活质量分项评分变化分别为-6.0(95%CI:-6.9至-5.2,n = 266;I² = 83.6%)、-2.6(95%CI:-3.2至-2.0,n = 266;I² = 87.9%)和-4.4(95%CI:-6.2至-2.6,n = 266;I² = 98.7%)。由于研究不足,无法确定异质性来源。

结论

针灸可能对CP/CPPS具有临床上的长期益处。然而,由于数据不足和显著的异质性,目前的证据有限。有必要进行样本量更大、随访期更长的进一步研究。

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