Lin Zhi-Xiu, Chan Ngai Ho Tony, Kwan Yiu-Keung, Chan Yu Tat, Zhang Hongwei, Tam Kam-Yuk Sylvia, Lai Mei Kwan, Lee Chun-Kam, Ngan Kit, Tsoi Stella Yin Yuen, Lau Yiu Wa, Xian Yan-Fang, Ching Jessica, Guo Yuanqi
School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR China.
Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR China.
Chin Med. 2020 Oct 8;15:108. doi: 10.1186/s13020-020-00388-w. eCollection 2020.
Around 15% of the Hong Kong population was found to suffer from overactive bladder (OAB), but the current available treatments, such as medication, behavioral therapy and physical therapy are unsatisfactory. Previous studies have suggested that acupuncture may have promising effect for OAB, but some limitations on the study design render the evidence questionable. This study aimed to evaluate the effectiveness and safety of acupuncture treatment for patients with OAB in Hong Kong.
One hundred patients with OAB were enrolled. The patients were randomized to receive either active acupuncture or sham needle intervention twice a week for 8 consecutive weeks, and had a follow-up consultation 12 weeks after the completion of acupuncture intervention. The primary outcome assessment was the 3-Day Voiding Diary, which records daytime and night-time urinary frequency and symptoms, at the baseline, the end of the 8-week intervention and 12 weeks after acupuncture intervention. Secondary outcomes included Urine NGF level, Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6), as well as Overactive Bladder Symptom Score (OABSS).
After 16 sessions of treatment, when compared with the baseline, both active and sham acupuncture significantly reduced the frequency of urgency urinary incontinence (UUI), daytime and night-time urinary frequency as well as the scores of IIQ-7, UDI-6 and OABSS. Moreover, the treatment effects could last for at least 3 months. However, no significant difference in frequency of UUI and daytime urinary frequency was found between the active and sham acupuncture groups. On the other hand, the night-time urinary frequency decreased more significantly during the treatment and follow-up in the active acupuncture group than in the sham control group after controlling baseline night-time urinary frequency. Urine NGF level could not be detected by ELISA method in our experiments.
This study suggests a beneficial effect of acupuncture on improving OAB symptoms. Both active and sham acupuncture treatment were able to improve the symptoms of frequency of urgency urinary incontinence, and the daytime and night-time urinary frequency, while only mild adverse effects were found. This project was unable to establish the specific effect of acupuncture for OAB. Chinese Clinical Trial Registry, ChiCTR-INR-16010048. Registered on 29 Nov 2016.
据发现,约15%的香港人口患有膀胱过度活动症(OAB),但目前可用的治疗方法,如药物治疗、行为疗法和物理治疗,效果并不理想。先前的研究表明,针灸对膀胱过度活动症可能有显著效果,但研究设计的一些局限性使证据存疑。本研究旨在评估针灸治疗香港膀胱过度活动症患者的有效性和安全性。
招募了100名膀胱过度活动症患者。患者被随机分为两组,分别接受每周两次的真针灸或假针刺干预,连续8周,并在针灸干预结束后12周进行随访咨询。主要结局评估是3天排尿日记,记录基线、8周干预结束时和针灸干预后12周的白天和夜间排尿频率及症状。次要结局包括尿神经生长因子(NGF)水平、尿失禁影响问卷(IIQ - 7)、泌尿生殖系统困扰量表(UDI - 6)以及膀胱过度活动症症状评分(OABSS)。
经过16次治疗后,与基线相比,真针灸和假针灸均显著降低了急迫性尿失禁(UUI)的频率、白天和夜间排尿频率以及IIQ - 7、UDI - 6和OABSS的评分。此外,治疗效果可持续至少3个月。然而,真针灸组和假针灸组在UUI频率和白天排尿频率方面没有显著差异。另一方面,在控制基线夜间排尿频率后,真针灸组在治疗和随访期间夜间排尿频率的下降比假针灸对照组更显著。在我们的实验中,ELISA方法无法检测到尿NGF水平。
本研究表明针灸对改善膀胱过度活动症症状有有益作用。真针灸和假针灸治疗均能改善急迫性尿失禁频率、白天和夜间排尿频率的症状,且仅发现轻微不良反应。本项目未能确定针灸对膀胱过度活动症的具体疗效。中国临床试验注册中心,ChiCTR - INR - 16010048。于2016年11月29日注册。