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电针治疗女性难治性膀胱过度活动症的有效性:一项随机对照临床试验的研究方案

Effectiveness of electroacupuncture for the treatment of refractory overactive bladder disease in women: study protocol for a randomised controlled clinical trial.

作者信息

Wang Huai-Yu, Ji Yuan, Zhang Shuo, Zhao Hong-Chao, Ding Yulong

机构信息

Beijing Fengtai Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China.

Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.

出版信息

BMJ Open. 2025 Jul 18;15(7):e101864. doi: 10.1136/bmjopen-2025-101864.

Abstract

INTRODUCTION

Overactive bladder (OAB) is a common condition, affecting approximately one-fifth to one-sixth of the world's population. The American Urological Association and the Society of Urodynamics, Female Pelvic Medicine and Genitourinary Reconstruction guidelines recommend sacral neuromodulation (SNM) as third-line treatment. Although SNM can relieve the symptoms of refractory OAB, several factors, including high cost and the high incidence of adverse effects, limit its large-scale clinical use. Moreover, patient acceptance is low. Acupuncture is an alternative approach for treating OAB that is minimally invasive and has few side effects. Clinical studies have shown that it can reduce the number of episodes of urination and urgent urination within 24 hours and improve the quality of life. However, clinical evidence on the effectiveness of electroacupuncture for treating refractory OAB is limited.

THE PRIMARY OBJECTIVE OF THIS STUDY

Is to assess the short-term effectiveness of electroacupuncture for improving the symptoms and quality of life of women with refractory OAB and to observe its long-term effects. A secondary objective is to assess whether electroacupuncture is more effective than conventional acupuncture for treating patients with refractory OAB.

METHODS AND ANALYSIS

The study is designed as a two-arm, parallel, participant-blinded randomised controlled trial (RCT). A total of 60 women between the ages of 18 years and 60 years who are experiencing refractory OAB will be randomly assigned to two groups: one receiving electroacupuncture and the other receiving conventional acupuncture. Each participant will undergo a treatment regimen lasting 4 weeks. During the initial 2 weeks, participants will receive five sessions of either electroacupuncture or conventional acupuncture per week, followed by three sessions per week during the subsequent 2 weeks. In total, each individual will receive 16 treatment sessions throughout the course of the study. The primary outcome measure will be the change in OAB Symptom Score (OABSS) over time between groups. The secondary outcome measures will include the OABSS, the Patient-Perceived Bladder Symptom Grading Scale, the Overactive Bladder Questionnaire, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale during the treatment and follow-up periods. Blinding and safety will also be assessed. Two-sided p values <0.05 will be considered statistically significant.

ETHICS AND DISSEMINATION

The study protocol was approved by the Institutional Review Board of Beijing Fengtai Hospital of Integrated Traditional and Western Medicine on 5 February 2024 (Approval No. 2024020101). The results will be disseminated through presentations at scientific conferences and peer-reviewed publications.

TRIAL REGISTRATION NUMBER

ChiCTR2400081448.

摘要

引言

膀胱过度活动症(OAB)是一种常见病症,影响着全球约五分之一至六分之一的人口。美国泌尿外科学会以及尿动力学、女性盆底医学与泌尿生殖重建学会的指南推荐骶神经调节(SNM)作为三线治疗方法。尽管SNM可缓解难治性OAB的症状,但包括高成本和高不良反应发生率在内的多种因素限制了其大规模临床应用。此外,患者接受度较低。针灸是治疗OAB的另一种方法,具有微创且副作用少的特点。临床研究表明,它可减少24小时内的排尿次数和尿急次数,并改善生活质量。然而,电针治疗难治性OAB有效性的临床证据有限。

本研究的主要目的

是评估电针改善难治性OAB女性症状和生活质量的短期有效性,并观察其长期效果。次要目的是评估电针治疗难治性OAB患者是否比传统针灸更有效。

方法与分析

本研究设计为双臂、平行、参与者盲法随机对照试验(RCT)。共有60名年龄在18岁至60岁之间的难治性OAB女性将被随机分为两组:一组接受电针治疗,另一组接受传统针灸治疗。每位参与者将接受为期4周的治疗方案。在最初的2周内,参与者每周将接受5次电针或传统针灸治疗,随后的2周内每周接受3次治疗。在整个研究过程中,每个人总共将接受16次治疗。主要结局指标将是两组之间OAB症状评分(OABSS)随时间的变化。次要结局指标将包括治疗期和随访期内的OABSS、患者感知膀胱症状分级量表、膀胱过度活动症问卷、自评焦虑量表和自评抑郁量表。还将评估盲法和安全性。双侧p值<0.05将被视为具有统计学意义。

伦理与传播

本研究方案于2024年2月5日获得北京丰台中西医结合医院伦理委员会批准(批准号:2024020101)。研究结果将通过在科学会议上的报告和同行评审出版物进行传播。

试验注册号

ChiCTR2400081448。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50d/12273082/84b5ffd5c66c/bmjopen-15-7-g001.jpg

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