电针治疗中风后尿失禁临床疗效的Meta分析

A Meta-analysis on Effectiveness of Electro- acupuncture on Post-stroke Urinary Incontinence

目的:利用Meta分析评价电针治疗中风后尿失禁的临床疗效。方法:计算机检索Cochrane Library、PubMed、CNKI、VIP、Wanfang数据库,并对论文后的参考文献做补充检索,时间从建库(刊)到2014年9月。收集电针对比阳性药物、安慰剂或空白对照(或电针+A干预对比A干预)治疗中风后尿失禁的临床随机对照试验(RCT)。评价纳入研究的质量,对临床异质性较小的文献采用RevMan5.2.11软件进行Meta分析,否则进行定性分析。结果:共纳入16篇文献,共1377例患者纳入本次研究。15篇研究同质性较好,Meta分析结果显示,合并效应量OR=5.63,95%CI[3.35,9.47],P<0.01,差异有统计学意义,提示电针治疗中风后尿失禁临床疗效优于对照组,可认为电针治疗中风后尿失禁相比其它疗法疗效更高。漏斗图显示研究对象分布不对称,提示存在一定发表偏倚的可能。结论:电针治疗中风后尿失禁在总体疗效方面显示出较其它治疗更加有效的倾向,尚需更多高质量研究以增加证据的强度。

Objective：To evaluate the effectiveness of electro-acupuncture （ EA） on post-stroke urinary in-continence （ PSUI） by Meta -analysis.Methods：Clinical randomized controlled trials of EA for PSUI were searched from database of Cochrane library, PubMed, CNKI, VIP and WanFang, and further retrieval was car-ried out concerning the reference of the related paper.Trials that EA was compared with positive drug, place-bo, or blank （or both EA and A intervention were compared with A intervention） were collected.Quality as-sessment and Meta-analysis would be made by using software RevMan5.2.11 for the included studies while the studies were of small clinical heterogeneity .If the studies’ heterogeneity was significant, qualitative analysis would be made.Results：A total of 16 studies involving 1377 cases were included in the study, with 15 better research homogeneity.Meta-analysis showed that the combined effect of the amount of OR=5.63,95%CI [3.35,9.47],P〈0.01, and the difference was statistically significant, suggesting that EA treatment for PSUI had a better clinical efficacy than that in the control group.Thus EA treatment for PSUI could be considered to be with higher efficacy compared with other therapies.Funnel chart showed an asymmetry distribution of the re-search object, suggesting that there was a possibility of publication bias.Conclusion： EA treatment for PSUI shows a tendency that it is more effective than other treatments in terms of overall clinical efficacy, however, more high-quality researches in order to increase the strength of the evidence are still needed.