针刺或电针治疗OAB的安全性及有效性:一项系统综述和Meta分析

Safety and efficacy of acupuncture or electroacupuncture in treatment of OAB:A systematic review and meta-analysis

目的:运用循证医学的方法,系统评价针刺或电针治疗膀胱过度活动综合征(OAB)的有效性及安全性。方法:以“针刺”“电针”“膀胱过度活动综合症”“膀胱过度活动综合征”“尿急综合征”“尿频-尿急综合征”为关键词检索Cochran-Library及MEDLINE、EMBASE、CNKI等8个数据库,选择随机对照试验,即治疗组为针刺(电针)或其他疗法加针刺(电针),对照组为药物、空白或盆底肌训练或心理干预治疗等,以OABSS总评分、临床有效性等为测量指标。研究结果采用95%置信区间(CIs)的标准化均差(SMD)或95%置信区间(Cls)的标准化均差(MD)计算。2个评价员独立进行方法学质量评价、数据提取和分析,采用RevMan5.4进行系统评价与Meta分析。结果:本研究共纳入16篇文献,1301例患者。在这16项研究中,在针灸或电针组中只报道有1例不良事件为口干症状。针灸或电针治疗OAB的疗效和安全性值得肯定,并且优于托特罗定药物治疗(由于托特罗定具有良好的耐受性和安全性,本产品在第三届国际尿失禁咨询委员会会议上被推荐为A类药物用于治疗OAB)。由于大多数研究没有随访,无法确定长期疗效。

Objective:To systematically evaluate the efficacy and safety of acupuncture or electroacupuncture in the treatment of overactive bladder syndrome(OAB)by evidence-based medicine.Methods:Eight databases were searched for Acupuncture、Electroacupuncture、Acupuncture Therapy and Urinary Bladder,Overactive.Randomized controlled trials were selected,acupuncture(electroacupuncture)or other therapy plus acupuncture(electroacupuncture)in the intervention group,and drug or blank or pelvic floor muscle training or psychological intervention in the control group,with OABSS total score as the measurement indicators.Two reviewers extracted data at the same time independently.Study outcomes were calculated by standardized mean differences(SMD)with 95%confidence intervals(CIs)and mean difference(MD)with 95%(Cls).Finally,RevMan5.4 was used for systematic evaluation and meta-analysis.RESULTS:A total of 16 literatures and 1301 patients were included in this study.In the 16 studies,only one adverse event of dry mouth was reported in the acupuncture or electroacupuncture groups.The efficacy and safety of acupuncture or electroacupuncture for OAB were worthy of affirmation,and superior to tolterodine drug therapy(Due to tolterodine drug has good tolerability and safety,this product was recommended as Class A drug for the treatment of OAB at the Third Urinary Incontinence Advisory Committee Conference).As for most studies do not follow up,the long-term efficacy cannot be determined.