Abstract
Objective:To evaluate the efficacy and safety of filiform-needle acupuncture(FA)in the treatment of poststroke urinary incontinence(PSUI).
Methods:All published papers in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chongqing VIP Database(VIP),Wanfang Data Knowledge Service Platform(Wanfang),and China Biology Medicine Disc(CBM)were retrieved by computer.The retrieval time was from each database's inception to December 9,2023.Meta-analysis and sensitivity analysis were performed using the Revman V5.4 software,and GARDE evaluation was performed using GRADEpro GDT.Dichotomous variables were analyzed by the relative risk(RR),and weighted mean difference(WMD)was used for continuous variables.Each effect size was expressed as a 95%confidence interval(CI).
Results:A total of 14 studies were included,comprising a total of 1 259 patients.The findings of the meta-analysis showed that the improvements of the maximum bladder capacity[WMD=64.63,95%CI(41.73,87.53),P<0.00001],72 h urination frequency[WMD=-5.27,95%CI(-6.40,-4.13),P<0.00001],and 72 h urinary incontinence frequency[WMD=-1.62,95%CI(-2.60,-0.64),P=0.001]in PSUI patients by FA were superior compared to conventional therapy.FA plus rehabilitation therapy(RT)was superior to RT alone in improving the maximum bladder capacity[WMD=35.17,95%CI(28.31,42.03),P<0.00001],the International Consultation on Incontinence questionnaire short form(ICI-Q-SF)score[WMD=-2.66,95%CI(-3.28,-2.05),P<0.00001],and incontinence quality of life questionnaire(I-QOL)score[WMD=8.07,95%CI(3.28,12.32),P=0.0002].The incidence of adverse reactions in FA was higher than that in RT[RR=21.62,95%CI(4.04,115.71),P=0.0003],but the severity was mild and did not affect the integrity of the treatment.
Conclusion:FA has better safety,and its improving effect on bladder urinary storage function and urinary incontinence symptoms in patients with PSUI is clear.Combined with RT,it can better improve the quality of life in the patients.However,more high-quality studies are still needed for further updates and verification.关键词
针刺疗法/中风后遗症/尿失禁/随机对照试验/系统评价/Meta分析Key words
Acupuncture Therapy/Poststroke Syndrome/Urinary Incontinence/Randomized Controlled Trial/Systematic Review/Meta Analysis分类
医药卫生