灸法联合盆底肌训练治疗轻中度压力性尿失禁疗效的Meta分析

Meta-analysis of the therapeutic effect of moxibustion combined with pelvic floor muscle training in treatment of mild to moderate stress urinary incontinence

目的系统评价灸法联合盆底肌训练治疗轻中度压力性尿失禁的临床疗效,为临床更好的治疗轻中度压力性尿失禁提供指导方法。方法对万方数据知识服务平台、维普网、中国知网、中国生物医学文献检索、cochrane library、Web of Science、PubMed数据库进行检索,收集有关灸法联合盆底肌训练治疗轻中度压力性尿失禁的随机对照试验(RCT),检索时间从建库至2020年12月3日。采用RevMan5.2软件对纳入研究的文献进行Meta分析。结果共有10个RCT纳入研究,研究对象742例,其中对照组371例,采用盆底肌训练治疗;试验组371例,采用灸法联合盆底肌训练治疗。Meta分析显示:灸法联合盆底肌训练在提高患者临床治疗有效率、减少患者1 h尿垫试验漏尿量、降低患者ICIQ-SF量表评分、改善患者盆底肌Ⅰ类肌纤维肌力方面均优于单独盆底肌训练(P<0.05),研究结果较为稳定且可靠;但在减少患者24 h漏尿次数及改善患者盆底肌Ⅱ类肌纤维肌力方面,两组比较差异无统计学意义(P>0.05)。结论灸法联合盆底肌训练治疗轻中度压力性尿失禁可提高患者的临床疗效,加强盆底肌Ⅰ类肌纤维肌力,改善患者生活质量,减少患者的漏尿量。

Objective To systematically evaluate the clinical efficacy of moxibustion combined with pelvic floor muscle training in the treatment of mild to moderate stress urinary incontinence,and to provide method guidance for better clinical treatment of mild to moderate stress urinary incontinence.Methods Randomized controlled trials(RCTS)of moxibustion combined with pelvic floor muscle training in treatment of mild to moderate stress urinary incontinence were collected by searching Wanfang Data,VIP,CNKI,China Biology Medicine disc,Cochrane Library,Web of Science and PubMed databases.The retrieval time is from database construction to December 3,2020.RevMan5.2 software was used for meta-analysis of the included literatures.Results A total of 10 randomized controlled trials were included in this study,including 742 subjects,371 in the control group and 371 in the moxibustion combined with pelvic floor muscle training treatment group.Meta-analysis showed that:moxibustion combined with pelvic floor muscle training was superior to pelvic floor muscle training alone in improving clinical effective rate,reducing urine leakage in 1-h pad test,reducing ICIQ-SF scale score,and improving typeⅠfiber muscle strength of pelvic floor muscle(P<0.05),and the study results were stable and reliable.However,there was no statistical significance in reducing the number of 24 h urine leakage and improving the typeⅡfiber strength of pelvic floor muscle between the two groups(P>0.05).Conclusion Moxibustion combined with pelvic floor muscle training can improve the clinical efficacy,typeⅠfiber strength of pelvic floor muscle and quality of life of patients with mild to moderate stress urinary incontinence,and reduce urinary leakage of patients.