School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong.
School of Chinese Medicine, The University of Hong Kong, Hong Kong.
Acupunct Med. 2019 Dec;37(6):321-331. doi: 10.1136/acupmed-2017-011528. Epub 2019 Aug 21.
Overactive bladder is prevalent in adults over 40 years of age and its prevalence increases with age. The use of acupuncture in adults with overactive bladder is increasing globally. However, its effectiveness/efficacy and safety have not yet been confirmed.
To determine the effectiveness/efficacy and safety of acupuncture and to identify the pattern of commonly used traditional acupuncture points in the management of overactive bladder in adults.
Ten electronic English and Chinese language databases were systematically searched and two English together with four Chinese journals relevant to acupuncture were manually searched in libraries for randomised controlled trials (RCTs) of acupuncture for overactive bladder in adults from their inception to March 2017. The Cochrane risk of bias tool was used to assess the methodological quality of the RCTs. RevMan v.5.3 software was employed for data analysis.
Seven eligible trials involving 695 participants were included. Meta-analysis showed that acupuncture was comparable to drugs (tolterodine tartrate/solifenacin) in the reduction of micturition episodes over 24 hours (pooled standardised mean difference (SMD) 0.36, 95% CI -0.23 to 0.95; I=83%), increase in voided volume of each micturition episode (pooled SMD -0.15, 95% CI -0.36 to 0.05; I=0%), and reduction of overactive bladder symptom score (pooled SMD -0.23, 95% CI -1.30 to 0.85; I=91%). In addition, acupuncture was not significantly different compared with placebo in the reduction of overactive bladder symptom score (pooled SMD -2.36, 95% CI -5.64 to 0.93; I=97%). No serious adverse events were reported.
No significant differences in effectiveness or efficacy were found between acupuncture and drug or between verum and sham acupuncture, respectively. Further high-quality studies are required.
膀胱过度活动症在 40 岁以上成年人中较为常见，且其发病率随年龄增长而增加。在全球范围内，越来越多的成年人使用针灸治疗膀胱过度活动症。然而，其疗效和安全性尚未得到证实。
确定针灸治疗膀胱过度活动症的疗效和安全性，并确定成人膀胱过度活动症管理中常用传统针灸穴位的模式。
系统检索了 10 个英文和中文电子数据库，并手工检索了 2 个英文期刊和 4 个中文期刊，以获取关于成人针灸治疗膀胱过度活动症的随机对照试验（RCT），检索时间从建库至 2017 年 3 月。使用 Cochrane 偏倚风险工具评估 RCT 的方法学质量。采用 RevMan v.5.3 软件进行数据分析。
纳入了 7 项合格的试验，涉及 695 名参与者。Meta 分析显示，针灸在减少 24 小时内排尿次数（合并标准化均数差（SMD）0.36，95%置信区间（CI）-0.23 至 0.95；I=83%）、增加每次排尿量（合并 SMD -0.15，95%CI -0.36 至 0.05；I=0%）和降低膀胱过度活动症症状评分（合并 SMD -0.23，95%CI -1.30 至 0.85；I=91%）方面与药物（酒石酸托特罗定/索利那新）相当。此外，针灸在降低膀胱过度活动症症状评分方面与安慰剂相比无显著差异（合并 SMD -2.36，95%CI -5.64 至 0.93；I=97%）。未报告严重不良事件。
针灸与药物或真实与假针灸之间在疗效方面未发现显著差异。需要进一步开展高质量的研究。
