The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangdong Provincial Academy of Chinese Medical Sciences and The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
BJOG. 2020 Nov;127(12):1459-1468. doi: 10.1111/1471-0528.16315. Epub 2020 Jun 3.
Increasing antibiotic resistance has motivated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (rUTI).
To conduct a systematic review of the current state of evidence of acupuncture for uncomplicated rUTI in women.
Nine databases (PubMed, Embase, CENTRAL, CINAHL, AMED, CBM, CNKI, CQVIP, Wanfang) were searched from inception to February 2019.
Randomised controlled trials (RCTs) evaluating the effects of acupuncture and related therapies for prophylaxis or treatment of uncomplicated rUTI in women were included.
Risk of bias was assessed, and the quality and strength of evidence evaluated using the GRADE framework. Results were reported as risk ratios (RR) for dichotomous outcomes or mean differences (MD) for continuous outcomes, with 95% confidence intervals (CI).
Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics (three studies, 170 participants, RR 1.92, 95% CI 1.31-2.81, I = 38%). The risk of UTI recurrence was lower with acupuncture than with no treatment (two studies, 135 participants, RR 0.39, 95% CI 0.26-0.58, I = 0%) and sham acupuncture (one study, 53 participants, RR 0.45, 95% CI 0.22-0.92).
Acupuncture appeared to be beneficial for treatment and prophylaxis of rUTIs, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture.
This review found that acupuncture may improve treatment and prevent recurrence of urinary tract infection in women.
抗生素耐药性的增加促使人们对非抗生素预防复发性尿路感染（rUTI）产生了兴趣。
对针灸治疗女性单纯性 rUTI 的现有证据进行系统评价。
从建库到 2019 年 2 月，检索了 9 个数据库（PubMed、Embase、CENTRAL、CINAHL、AMED、CBM、CNKI、CQVIP、Wanfang）。
纳入评估针灸和相关疗法预防或治疗女性单纯性 rUTI 的效果的随机对照试验（RCT）。
评估偏倚风险，并使用 GRADE 框架评估证据的质量和强度。结果以二分类结局的风险比（RR）或连续结局的均数差（MD）表示，置信区间（CI）为 95%。
纳入了 5 项 RCT，涉及 341 名参与者。研究的方法学质量和证据强度为低到中度。与抗生素相比，接受针灸治疗的患者获得复合治愈的机会更大（三项研究，170 名参与者，RR 1.92，95% CI 1.31-2.81，I² = 38%）。与未治疗（两项研究，135 名参与者，RR 0.39，95% CI 0.26-0.58，I² = 0%）和假针灸（一项研究，53 名参与者，RR 0.45，95% CI 0.22-0.92）相比，接受针灸治疗的患者尿路感染复发的风险较低。
针灸似乎对 rUTI 的治疗和预防有益，但要注意现有证据的局限性。鉴于抗生素耐药性的日益挑战，需要开展高质量的 RCT 来评估非药物干预措施，如针灸。
研究结果表明，针灸可能有助于改善女性尿路感染的治疗效果并预防其复发。
