针灸治疗早泄疗效的Meta分析

目的系统评价针灸治疗早泄的疗效。方法计算机检索Cochrane图书馆临床对照试验注册中心CCTR（2011.4）、MEDLINE（1998～2011.4）、EMbase（1998～2011.4）、中国生物医学文献数据库CBM（1998～2011.4）、中国期刊全文数据库CNKI（1998～2010.4）、万方医学数据库（1998～2010.4）,并手工检索相关文献,纳入比较针灸与其它方法治疗早泄疗效的随机对照试验（RCT）。采用RevMan5.1软件进行统计分析。结果共纳入4个RCT进行分析,合计411例早泄患者。Meta分析显示：①针灸＋中药组治疗早泄的临床有效率稍高于单纯使用中药组[RR=1.50,95%CI（0.98～2.31）],但差异无统计学意义（P=0.06）。②一研究证实,针灸组治疗早泄的有效率明显高于帕罗西汀组[RR=1.29,95%CI（1.02～1.63）,P=0.03];而另两研究发现,针灸与帕罗西汀在改善患者性功能方面无统计学差异。③一研究证实,针灸治疗早泄疗效明显高于假针灸治疗（P〈0.05）。结论针灸治疗早泄疗效确切,且针灸操作简便,容易实行,创伤小,无明显毒副作用,值得临床推广运用。但因存在纳入研究数量较少,总体质量不高,各研究疗效评定标准不一致等易致偏倚的因素,影响论证真实性,期待更多高质量的多中心临床随机对照试验进一步验证。

Effectiveness of acupuncture in treatment of premature ejaculation:A Meta-analysis

Objective To evaluate the efficacy of acupuncture in patients with premature ejaculation.Methods We searched the Cochrane Central Register of Controlled Trials(CENTRAL)(Issue 4 of 12,Apr 2011),MEDLINE(1998 to April 2011),EMBASE(1998 to April 2011),the Chinese Biomedical Database(CBM)(1998 to April 2011),Chinese National Knowledge Infrastructure(CNKI)(1998 to 2010) and WanFang Database(1998 to April 2011),and We manually searched the relevant journals.All the RCTs confirmed to treat premature ejaculation with acupuncture and other methods were enrolled.The Cochrane Collaboration’s software RevMan 5.1 was used for meta-analysis.Results A total of 4 RCTs involving 411 patients with premature ejaculation were included.The results of meta-analysis showed that: ①The effective rate of acupuncture plus herbs was higher than herbs alone in treatment of premature ejaculation,but without statistically difference(P=0.06);②One study demonstrated that the effective rate of acupuncture was significantly higher than paroxetine,however,two studies found that the two methods had no difference in improving sexual function between two groups(Meta-analysis could not be conducted due to the missing data).③One study conformed than acupuncture was more effective than sham-acupuncture(P<0.05).Conclusion The present study showed that acupuncture was effective in treatment of premature ejaculation.Multi-factors which lead to bias affected the authenticity of our review,such as few-studies,low-quality and difference between outcome estimating,so further large-scale trials are required.