电针治疗脊髓损伤后神经源性膀胱的Meta分析*
作者:
作者单位:

(1.陕西中医药大学研究生院,陕西 咸阳 712046;2.西安市中医医院针灸科,陕西 西安 710021)

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R246

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收稿日期: 2019 - 06- 12
* 基金项目: 陕西省科技厅项目社会发展领域项目(2019SF-292);长安方氏头针流派传承工作室项目建设项目(陕中医药发[2018]40号);西安市方氏头针流派传承工作室建设项目(市卫计函[2018]699号);陕西省中医药管理局重点专科项目(陕中医药发[2012]55号);西安市医学重点学科、西安市医学优势专科项目(市卫发[2012]354号)
第一作者简介: 傅林辉(1994-),男,在读硕士研究生,研究方向:针灸治疗神经系统疾病。
△通信作者: 安军明,E-mail:1686237050@qq.com


Electroacupuncture Treatment for Neurogenic Bladder after Spinal Cord Injury:A Meta-analysis
Author:
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(1. Graduate School, Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, China; 2. Acupuncture Department, Xi'an Hospital of Traditional Chinese Medicine, Xi’an 710021, China)

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    摘要:

    目的系统评价电针治疗脊髓损伤后神经源性膀胱的疗效及安全性。方法 电子检索2019年6月1日前在The Cochrane Library、Clinical Trial、Pubmed、Google Schalor、中国知网(CNKI)、万方数据库(WF Data)和维普数据库(VIP Data)发表的电针治疗脊髓损伤后神经源性膀胱患者的临床随机对照试验(RCT)。由2名研究人员依据纳入标准与排除标准进行文献筛选、提取数据,采用RevMan5.3软件进行Meta分析。结果 最终纳入19项RCT研究,共1 356例患者。Meta分析结果显示:经电针治疗后,2组患者在临床有效率[RR=1.38,95%CI(1.22,1.56),P<0.000 01]、最大膀胱容量[MD=-41.86, 95%CI(25.07, 64.53),P<0.000 0]、最大尿流率[MD=1.15, 95%CI(0.40, 1.89),P=0.002]、最大尿道闭合压[MD=5.86, 95%CI(2.41, 9.32),P=0.000 9]、日平均排尿次数[MD=0.71, 95%CI(0.22, 2.31),P=0.57]差异具有统计学意义;当神经源性膀胱表现为尿失禁时,结果显示电针组对患者膀胱残余尿量的改善较为明显[MD=-14.32,95%CI(-23.56,-5.07),P=0.002];电针组不良反应事件的发生率与对照组相比差异无统计学意义[MD=0.71,95%CI(0.22,2.31),P=0.57]。结论 电针对脊髓损伤后神经源性膀胱有效,包括减少膀胱残余尿量、改善最大膀胱容量、最大尿流率、最大尿道闭合压、日平均排尿次数,且不会增加不良事件的发生。

    Abstract:

    Objective To systematically evaluate the effect and safety of electroacupuncture for neurogenic bladder after spinal cord injury. Methods Randomized controlled trials(RCTs) of electroacupuncture for neurogenic bladder after spinal cord injury was retrieved electronically in the Cochrane Library, Clinical Trial, Pubmed, Google Schalor, CNKI, WF Data,VIP Data before June 1, 2019. Meta-analysis was performed using RevMan 5.3 software after two researchs screened the literatures and extracted data based according to the inclusion and exclusion criteria. Results 19 RCTs involved totally 1 356 patients were included.Meta-analysis results showed that there were significant differences in clinical efficiency[RR=1.38, 95%CI(1.22, 1.56), P<0.000 01]、 maximum cystometric capacity[MD=-41.86, 95%CI(25.07, 64.53), P<0.000 0]、 maximum flow rate[MD=1.15, 95%CI(0.40, 1.89), P=0.002]、 maximum urethral closure pressure[MD=5.86, 95%CI(2.41, 9.32), P=0.000 9]、 average daily urination[MD=0.71, 95%CI(0.22, 2.31), P=0.57]; When neurogenic bladder showed urinary incontinence, the results showed that the electroacupuncture group significantly improved the residual urine volume of the bladder[MD=-14.32, 95%CI(-23.56, -5.07), P=0.002]; there was no statistically significant difference in the incidence of adverse events between the electroacupuncture group and the control group [MD=0.71, 95%CI (0.22, 2.31), P=0.57].Conclusion Electroacupuncture is effective for neurogenic bladder after spinal cord injury, including reducing bladder residual urine volume, improving the maximum bladder volume, the maximum urine flow rate, the maximum urethral closure pressure, and average daily urination, without increasing the occurrence of adverse events.

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