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针灸治疗间质性膀胱炎/膀胱疼痛综合征的研究方法:一项范围综述

Research Methodology in Acupuncture for Managing Interstitial Cystitis/Bladder Pain Syndrome: A Scoping Review.

作者信息

Infantes Rosales Miguel Ángel, Mesías Pesqueira Ángeles, Castellanos Díaz Astrid, Díaz Mohedo Esther

机构信息

University of Málaga, Málaga, Spain.

出版信息

Neurourol Urodyn. 2025 Jun;44(5):1054-1063. doi: 10.1002/nau.70061. Epub 2025 May 2.

Abstract

BACKGROUND

Acupuncture and moxibustion are being explored as complementary therapies with promising potential in managing interstitial cystitis/bladder pain syndrome (IC/BPS). While some studies indicate possible benefits, their scientific basis and clinical efficacy remain subjects of debate, partly due to methodological flaws in study designs involving acupuncture and related modalities, which warrant further attention and discussion. The main objective is to analyze and evaluate the research methodologies used in existing literature on acupuncture for managing IC/BPS, providing insight into the methodological challenges and opportunities in this field.

MATERIALS AND METHODS

National Library of Medicine (PubMed), Allied and Complementary Medicine Database (AMED), Cochrane Library, Excerpta Medica database (EMBASE), Web of Sciences (WOS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulated Index in Nursing and Allied Health Literature (CINAHL), Scopus, SPORTDiscus, Epistemonikos, and Physiotherapy Evidence Database (PEDro) were searched from their inception to August 2024. Data were extracted based on the study designs, primary outcome measures, adverse events (AEs), and participants' subjective views.

RESULTS

All the experimental studies (27.3%, 6 of 22) were randomized controlled trials (RCTs), but only 2 full texts were accessible. Of the 4 RCTs, 3 involved rats. Observational research (50%) included case reports (27.3%), cohort studies (9.1%), and theoretical studies (4.5%). Additionally, reviews (22.7%) were included. The main languages were English (77.3%), Chinese (13.6%), Japanese (4.5%), and Russian (4.5%). The most frequently reported outcome was pain, followed by quality-of-life impact (symptom burden), urinary frequency and urgency, nocturia, and bladder capacity. AEs were reported in only 5 articles, all of which concluded that these effects were not significant and that acupuncture could be considered a safe and relatively noninvasive technique. One review found a risk of 1 AE/76 000 patients, with the most common side effects being minor, such as bleeding or bruising.

CONCLUSION

Current evidence on acupuncture for interstitial cystitis is limited in quality, with studies often compromised by biases, small sample sizes, and lack of standardized protocols. Acupuncture is frequently part of multimodal treatments, aligning with Traditional Chinese Medicine's holistic approach to balance physical, mental, and emotional health. More high-quality experimental research is needed, focusing on standardized protocols and participant experiences to better evaluate its efficacy and safety.

摘要

背景

针灸正作为一种辅助疗法进行探索,在治疗间质性膀胱炎/膀胱疼痛综合征(IC/BPS)方面具有潜在的应用前景。虽然一些研究表明可能存在益处,但其科学依据和临床疗效仍存在争议,部分原因是涉及针灸及相关疗法的研究设计存在方法学缺陷,这值得进一步关注和讨论。主要目的是分析和评估现有关于针灸治疗IC/BPS的文献中所使用的研究方法,深入了解该领域的方法学挑战和机遇。

材料与方法

检索了美国国立医学图书馆(PubMed)、联合与补充医学数据库(AMED)、考克兰图书馆、医学文摘数据库(EMBASE)、科学网(WOS)、医学文献分析与联机检索系统(MEDLINE)、护理及相关健康文献累积索引(CINAHL)、Scopus、体育与健康科学数据库(SPORTDiscus)、Epistemonikos以及物理治疗证据数据库(PEDro),检索时间范围从建库至2024年8月。根据研究设计、主要结局指标、不良事件(AE)以及参与者的主观观点提取数据。

结果

所有实验研究(22项中的6项,占27.3%)均为随机对照试验(RCT),但仅有2篇全文可获取。在4项RCT中,3项涉及大鼠。观察性研究(占50%)包括病例报告(占27.3%)、队列研究(占9.1%)和理论研究(占4.5%)。此外,还纳入了综述(占22.7%)。主要语言为英语(占77.3%)、中文(占13.6%)、日语(占4.5%)和俄语(占4.5%)。最常报告的结局是疼痛,其次是对生活质量的影响(症状负担)、尿频和尿急、夜尿症以及膀胱容量。仅有5篇文章报告了不良事件,所有文章均得出这些影响不显著的结论,并且认为针灸可被视为一种安全且相对无创的技术。一篇综述发现每76000名患者中有1例不良事件风险,最常见的副作用较小,如出血或瘀伤。

结论

目前关于针灸治疗间质性膀胱炎的证据质量有限,研究常因偏倚、样本量小以及缺乏标准化方案而受到影响。针灸通常是多模式治疗的一部分,这与中医平衡身体、心理和情绪健康的整体方法相一致。需要更多高质量的实验研究,重点关注标准化方案和参与者体验,以更好地评估其疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89b2/12164251/8ece7c1b82f9/NAU-44-1054-g001.jpg

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