针刺联合中药方剂治疗女性膀胱过度活动症的meta分析

Meta-analysis of acupuncture combined with traditional Chinese medicine prescription in the treatment of female overactive bladder

目的 探究中医药治疗女性膀胱过度活动症(OAB)的有效性和安全性,采取循证医学进行科学的分析和论证,为临床治疗女性OAB提供依据。方法 计算机检索中国期刊全文数据库、中国生物医学文献数据库、维普数据库、万方数据库、PubMed、Embase、Cochrane Liberary,纳入中医药治疗女性OAB的随机对照试验,采用Review Manager 5.3软件进行meta分析。结果 共检索出339篇文献,最终纳入7篇随机对照试验研究,共521例OAB患者。meta分析显示针刺联合中药方剂治疗OAB患者能明显减少排尿次数[均方差(MD)=-1.42,95%置信区间(95%CI)(-3.48,0.64),P=018]及尿急次数[MD=-0.41,95%CI(-0.59,-0.24),P<0.000 01],提高女性患者生活质量[OABSS评分:MD=-0.55,95%CI(-2.35,1.25),P=0.55;IPSS评分:MD=-1.11,95%CI(-1.56,-0.67),P<0.000 01],不良反应分析结果显示采取中医药手段治疗女性OAB所致的不良反应更少[比值比=0.57,95%CI(0.34,0.96),P=0.03]。结论 针刺联合中药方剂治疗女性OAB的疗效优于单纯采取西医治疗手段,且不会增加不良反应发生率,安全性较高。

Objective To investigate the effectiveness and safety of traditional Chinese medicine in the treatment of female overactive bladder(OAB),evidence-based medicine is adopted to analysis and demonstration scientifically and provide evidence for clinical treatment of female OAB.Methods CNKI,CBM,VIP,Wanfang database, PubMed, Embase, and Cochrane Liberary were retrieved by computer, and the randomized controlled trials of traditional Chinese medicine for the treatment of female OAB were included, and data was analyzed by Review Manager 5.3 software.Results A total of 339 literatures were retrieved, and seven randomized controlled trials involving 521 patients with OAB were included.The meta analysis showed that acupuncture combined with traditional Chinese medicine could significantly reduce the frequency of urination [mean difference(MD)=-1.42,95% confidence interval(95%CI)(-3.48,0.64),P=0.18] and the frequency of urgent urination [MD=-0.41,95%CI(-0.59,-0.24),P<0.000 01],improve the quality of female patients life [OABSS score: MD=-0.55,95%CI(-2.35,1.25),P=0.55;IPSS score: MD=-1.11,95%CI(-1.56,-0.67),P<0.000 01],adverse reaction analysis showed that there were fewer adverse reactions caused by OAB in women treated with traditional Chinese medicine [odds ratio=0.57,95%CI(0.34,0.96),P=0.03].Conclusion The effect of acupuncture combined with traditional Chinese medicine prescription in the treatment of female OAB is better than that of western medicine alone, and will not increase the incidence of adverse reactions, with high safety.