Dai Zifeng, Wang Yuting, Du Yuzheng, Hou Linru, Li Yufen, Ma Kaixuan, Yan Qinfeng, Wen Jian, Dong Xinlei, Chen Xiaolin, Zhang Lili
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Front Neurol. 2025 May 8;16:1575970. doi: 10.3389/fneur.2025.1575970. eCollection 2025.
Researchers have increasingly focused on the efficacy of acupuncture therapy (AT) combine with rehabilitation therapy (RT) for post-stroke urinary incontinence (PSUI). This study aims to fully assess the efficacy of AT plus related RT in treating PSUI.
We systematically searched eight databases from their inception to March 2025 for randomized controlled trials (RCTs) evaluating AT plus related RT for PSUI. Stata 18.0 was utilized for the meta-analyses.
Thirty-six studies involving 2,796 subjects were included, with AT plus related RT performed in the treatment group. The total effective rate of AT plus RT was significantly higher than that of RT or AT alone [RR = 1.23, 95% CI (1.19, 1.28), < 0.001]. AT plus RT was also superior to related RT or related AT in improving maximum bladder capacity [WMD = 44.93, 95% CI (32.00, 57.87), < 0.001]; increasing maximum urinary flow rate [WMD = 2.64, 95% CI (1.27, 4.01), < 0.001], mean urine output per time [WMD = 44.30, 95% CI (20.31, 68.29), < 0.001], and pelvic floor muscle strength (including fast [WMD = 2.64, 95% CI (1.04, 4.25), = 0.001], slow [WMD = 6.09, 95% CI (3.44, 8.75), < 0.001], and complex muscle fibers [WMD = 5.46, 95% CI (3.60, 7.32), < 0.001]); and reducing the residual urine volume [WMD = -20.84, 95% CI (-27.53, -14.14), = 0.001], maximal detrusor pressure [WMD = -10.6, 95% CI (-12.72, -8.55), = 0.001], frequency of 24-h UI [WMD = -1.40, 95% CI (-1.92, -0.88), < 0.001], and frequency of 24-h urination [WMD = -3.76, 95% CI (-4.87, -2.66), < 0.001]. Moreover, AT plus RT significantly reduced scores on the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) [WMD = -2.40, 95% CI (-2.93, -1.83), < 0.001]. While reductions were also observed in the quality of life (QOL) score [WMD = -0.72, 95% CI (-1.64, 0.20), = 0.127] and the National Institutes of Health Stroke Scale (NIHSS) score [WMD = -3.51, 95% CI (-8.20, 1.18), = 0.143], these did not reach statistical significance. Additionally, AT plus RT significantly increased the Incontinence Quality of Life Scale (I-QOL) score [WMD = 11.71, 95% CI (8.10, 15.33), < 0.001] and the Barthel index (BI) score [WMD = 6.92, 95% CI (-0.22, 14.05), = 0.058].
AT plus RT outperforms related RT or related AT in improving clinical efficacy and bladder function in PSUI patients. However, the number of included studies on AT plus RT remains limited, highlighting the need for more high-quality RCTs are needed to validate the findings.
https://www.crd.york.ac.uk/prospero/, identifier [CRD42024588520].
研究人员越来越关注针刺疗法（AT）联合康复治疗（RT）对中风后尿失禁（PSUI）的疗效。本研究旨在全面评估AT联合相关RT治疗PSUI的疗效。
我们系统检索了8个数据库，从其创建至2025年3月，以查找评估AT联合相关RT治疗PSUI的随机对照试验（RCT）。使用Stata 18.0进行荟萃分析。
纳入36项研究，共2796名受试者，治疗组采用AT联合相关RT。AT联合RT的总有效率显著高于单独使用RT或AT [RR = 1.23，95% CI（1.19，1.28），< 0.001]。在改善最大膀胱容量方面，AT联合RT也优于相关RT或相关AT [WMD = 44.93，95% CI（32.00，57.87），< 0.001]；增加最大尿流率[WMD = 2.64，95% CI（1.27，4.01）, < 0.001]、每次平均尿量[WMD = 44.30，95% CI（20.31，68.29），< 0.001]以及盆底肌肉力量（包括快肌[WMD = 2.64，95% CI（1.04，4.25），= 0.001]、慢肌[WMD = 6.09，95% CI（3.44，8.75），< 0.001]和复合肌纤维[WMD = 5.46，95% CI（3.60，7.32），< 0.001]）；并减少残余尿量[WMD = -20.84，95% CI（-27.53，-14.
