针刺治疗肛肠术后尿潴留的Meta分析与试验序贯分析  

Meta-analysis and Trial Sequential Analysis of Acupuncture in the Treatment of Urinary Retention After Anorectal Surgery

作　　者：代锐洁 谢天 李月 祝钰雯 吴文江[1] DAI Rui-Jie;XIE Tian;LI Yue;ZHU Yu-Wen;WU Wen-Jiang(Shenzhen Hospital of Guangzhou University of Chinese Medicine,Shenzhen 518034 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China)

机构地区：[1]广州中医药大学深圳医院,广东深圳518034 [2]广州中医药大学,广东广州510006

出　　处：《广州中医药大学学报》2023年第10期2575-2582,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市福田区卫生公益性科研资助项目(编号:FTW2020006)。

摘　　要：【目的】系统评价针刺治疗肛肠术后尿潴留的有效性及安全性。【方法】计算机检索美国生物医学信息检索系统(PubMed)、荷兰医学文摘(Embase)、中国知网(CNKI)、维普中文期刊(VIP)、万方期刊网(Wanfang)、中国生物医学文献数据库(CBM)等数据库中关于针刺治疗肛肠术后尿潴留的随机对照试验(RCT)文献,检索时限为数据库建库至2023年2月1日。由2名研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析,TSA 0.9.5.10Beta软件进行序贯试验分析。【结果】共纳入16篇RCT文献,涉及1127例患者,其中试验组587例,对照组540例。结果显示,试验组总有效率优于对照组[OR=4.81,95%CI(3.47,6.68),P<0.0001],试验组治疗后首次排尿时间较对照组明显缩短[MD=-6.84,95%CI(-11.87,-1.81),P=0.008],治疗后首次排尿量较对照组增多[MD=95.61,95%CI(75.91,115.31),P<0.00001],治疗后患者膀胱残余尿量较对照组减少[MD=-12.12,95%CI(-17.71,-6.53),P<0.00001]。试验序贯分析结果穿过传统界值与TSA界值,达到期望信息值,结果具有确切性。【结论】针刺治疗肛肠术后尿潴留的临床疗效优于常规西医治疗,能有效改善肛肠疾病患者术后尿潴留情况,促进膀胱尿液排出,安全性较高。但鉴于纳入研究数量及质量限制,结论有待更多高质量研究加以验证。Objective To systematically evaluate the effectiveness and safety of acupuncture in the treatment of urinary retention after anorectal surgery.Methods Computer searches of the literature on randomized controlled trials(RCTs)of acupuncture for urinary retention after anorectal surgery in PubMed,Embase,CNKI,VIP,Wanfang and CBM were conducted with a search time frame of database creation to February 1,2023.Metaanalysis was performed using RevMan 5.3 software and sequential trial analysis using TSA 0.9.5.10 Beta software after independent screening of the literature,extraction of information and evaluation of the risk of bias of the included studies by two researchers.Results A total of 16 RCTs involving 1127 patients were included,including587 cases in the trial group and 540 cases in the control group.The results showed that the overall effective rate was better in the trial group than the control group[OR=4.81,95%CI(3.47,6.68),P<0.0001],the time to first urination after treatment was significantly shortened in the trial group compared with the control group[MD=-6.84,95%CI(-11.87,-1.81),P=0.008],and the volume of first urination after treatment was increased compared with the control group[MD=95.61,95%CI(75.91,115.31),P<0.00001],and the bladder residual urine volume after treatment of the patients was lower than that of the control group[MD=-12.12,95%CI(-17.71,-6.53),P<0.00001].The results of the trial sequential analysis crossed the traditional and TSA boundaries to achieve the desired information value and the results were definitive.Conclusion The clinical efficacy of acupuncture in the treatment of post-operative urinary retention in anorectal disease is superior to the conventional western medicine,and it is effective in improving post-operative urinary retention and promoting bladder urine drainage in patients with anorectal disease with a high safety profile.However,in view of the limitation of the number and quality of included studies,the conclusion needs to be verified by more high-quality studies.

关 键 词：针刺 术后尿潴留 肛肠疾病 随机对照试验 Meta分析 试验序贯分析 

分 类 号：R246.9[医药卫生—针灸推拿学]