针刺治疗压力性尿失禁疗效国内文献的系统评价

目的：系统评价国内针刺治疗压力性尿失禁的疗效。方法：计算机检索CNKI、万方数据库、维普数据库，手工检索《中国针灸》等杂志及相关会议论文。检索时间截止至2013年11月，获取所有涉及针刺治疗压力性尿失禁的随机和半随机对照试验，由两名评价员独立提取资料并进行方法学评估。利用RevMan5．0软件对相关信息进行Meta分析和失安全数分析，漏斗图分析发表偏倚。结果：纳入10个随机对照试验，共669例压力性尿失禁患者。 Meta分析结果示，针刺与安慰剂比较的OR＝3．05，95％CI1．59，5．84]；针刺与西药比较的OR＝9．14，95％ CI4．77，17．53]；针刺与盆底肌训练比较的OR＝4．00，95％CI2．51，6．39]。针刺组均优于对照组，失安全数分析显示评价结果较为稳定；漏斗图图形左右基本对称，发表偏倚不大。结论：针刺治疗压力性尿失禁有效，且优于西药和盆底肌训练，但仍需更多高质量的随机双盲对照试验来进一步证实针刺治疗压力性尿失禁的疗效。

Systematic Review of Domestic Literature of Therapeutic Effect of Acupuncture on Stress Urinary Incontinence

Objective：To evaluate the therapeutic effect of acupuncture in the treatment of stress urinary incon-tinence in China.Methods：Retrieve related papers from CNKI, WANFANG, VIP database by computer, from conference papers and magazines like “Chinese acupuncture” by hand.The retrieval time ended in November 2013 ,and two independent evaluator extracted data from obtained all random and half randomized controlled tri-als for the treatment of stress urinary incontinence by acupuncture, and assess the methodology.RevMan5.0 software was used to do Meta analysis and security number analysis and funnel chart analysis publication bias. Results：A total of 10 trials involving 669 patients.Meta-analysis showed that the total effective rate in the treatment group was better than that in the control group： acupuncture versus placebo （ OR=3.05,95% CI 1.59,5.84]）, acupuncture versus medicine（OR=9.14,95%CI4.77,17.53]）, acupuncture versus pel-vic muscle exercise（OR=4.00,95%CI2.51,6.39]）.Fail-safe number analysis showed that the evaluation results were stable.Funnel figure graphics were around the basic symmetry, and the publication bias was not big.Conclusion：Acupuncture in the treatment of stress urinary incontinence is effective, and superior to west-ern medicine and pelvic muscle exercise.However, more high-quality randomized double-blind controlled trials are needed to confirm the curative effect of acupuncture in the treatment of stress urinary incontinence.