灸法治疗小儿遗尿症有效性的Meta分析和系统评价  

Meta-analysis and Systematic Evaluation of Moxibustion in the Treatment of Infantile Enuresis

作　　者：黄守强 徐海燕[1] 熊俊[2] 项洁 华芳慧 HUANG Shou-qiang;XU Hai-yan;XIONG Jun;XIANG Jie;HUA Fang-hui(Jiangxi University of Chinese Medicine,Nanchang,330004,China;The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang,330006,China.)

机构地区：[1]江西中医药大学,南昌330004 [2]江西中医药大学附属医院,南昌330006

出　　处：《江西中医药大学学报》2022年第4期28-35,共8页Journal of Jiangxi University of Chinese Medicine

基　　金：江西中医药大学校级项目(2014ZR031);江西省青年井冈学者奖励计划项目(赣教党字[2018]82号);江西中医药大学首批“1050”青年人才工程项目(5141900101)。

摘　　要：目的:系统评价灸法治疗小儿遗尿症(NE)的有效性。方法:计算机检索PubMed、EMbase、The Cochrane Library、CNKI、WF、CBM和VIP数据库,搜集灸法治疗NE的随机对照试验,检索截至2019年11月30日,选用Cochrane偏倚风险评估工具2.0对纳入文献进行质量评价,并采用RevMan 5.3软件进行Meta分析。结果:共纳入18篇文献,1346例患者。Meta分析结果示:①总有效率:灸法+西药vs西药[RR=1.56,95%CI(1.14,2.13),Z=2.80,P<0.05];灸法和针刺[RR=1.18,95%CI(1.07,1.32),Z=3.18,P<0.05];灸法+针刺和针刺[RR=1.24,95%CI(1.13,1.37),Z=4.43,P<0.0001]。②治愈率:灸法和针刺[RR=1.51,95%CI(1.16,1.97),Z=3.07,P<0.05];灸法+针刺和针刺[RR=1.46,95%CI(1.20,1.78),Z=3.80,P<0.05];灸法和中药[RR=1.96,95%CI(1.37,2.82),Z=3.66,P<0.05];灸法+中药和中药[RR=1.58,95%CI(1.27,1.97),Z=4.04,P<0.0001];灸法+行为疗法和行为疗法[RR=1.84,95%CI(1.03,3.30),Z=2.04,P<0.05]。③复发率:灸法+西药和西药[RR=1.59,95%CI(1.25,2.01),Z=3.80,P<0.05];灸法+中药和中药[RR=1.39,95%CI(1.02,1.88),Z=2.11,P<0.05]。结论:灸法治疗小儿遗尿症有其一定优势,在改善遗尿症状的同时有助于增强患儿体质,降低复发率。但文献质量普遍偏低,上述结果还需更多高质量的研究予以证实。Objective:To systematically evaluate the effectiveness of moxibustion in the treatment of pediatric enuresis(NE).Methods:PubMed,EMbase,The Cochrane Library,CNKI,WF,CBM and VIP databases were searched by computer to collect randomized controlled trials(RCT)of moxibustion for The treatment of enuresis in children.The retrieval time was up to November 30th,2019.Cochrane risk assessment tool 2.0 was used to evaluate The quality of The included literature,and RevMan 5.3 software was used for meta-analysis.Results:A total of 18 articles were included,including 1,346 patients.The results of Meta-analysis showed:total effective rate:moxibustion+western medicine vs western medicine[RR=1.56,95%CI(1.14,2.13),Z=2.80,P<0.05];Moxibustion vs acupuncture[RR=1.18,95%CI(1.07,1.32),Z=3.18,P<0.05];Moxibustion+acupuncture vs acupuncture[RR=1.24,95%CI(1.13,1.37),Z=4.43,P<0.0001].Cure rate:moxibustion vs acupuncture[RR=1.51,95%CI(1.16,1.97),Z=3.07,P<0.05];Moxibustion+acupuncture vs acupuncture[RR=1.46,95%CI(1.20,1.78),Z=3.80,P<0.05];Moxibustion vs traditional Chinese medicine[RR=1.96,95%CI(1.37,2.82),Z=3.66,P<0.05];Moxibustion+TCM vs TCM[RR=1.58,95%CI(1.27,1.97),Z=4.04,P<0.0001];Moxibustion+behavioral therapy vs behavioral therapy[RR=1.84,95%CI(1.03,3.30),Z=2.04,P<0.05].Recurrence rate:moxibustion+western medicine vs western medicine[RR=1.59,95%CI(1.25,2.01),Z=3.80,P<0.05];Moxibustion+TCM vs TCM[RR=1.39,95%CI(1.02,1.88),Z=2.11,P<0.05].Conclusion:Moxibustion has certain advantages in the treatment of enuresis in children.While improving the symptoms of enuresis,it helps to strengthen the physique of children and reduce the recurrence rate,but the quality is generally low.Therefore,the above results need to be confirmed by more high-quality studies.

关 键 词：小儿遗尿症 灸法 随机对照试验 系统评价 META分析 

分 类 号：R246.4[医药卫生—针灸推拿学]