电针治疗慢性前列腺炎/慢性盆腔疼痛综合征的有效性和安全性:17项随机对照试验的系统评价和meta分析  

Effect and safety of electroacupuncture in the treatment of chronic prostatitis / chronic pelvic pain syndrome:A systematic review and meta-analysis of 17 randomized controlled trials

作　　者：李俊涛[1] 李鲁豫 李霄[1] 刘峰 马苗苗 琚保军[1] LI Jun-tao;LI Lu-yu;LI Xiao;LIU Feng;MA Miao-miao;JU Bao-jun(Department of Andrology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;The First School of Clinical Medicine,Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第一附属医院男科,河南郑州450000 [2]河南中医药大学第一临床医学院,河南郑州450000

出　　处：《中华男科学杂志》2024年第10期921-930,共10页National Journal of Andrology

摘　　要：目的:近年来,大量随机对照试验(RCT)显示电针治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)有效。尽管如此,电针治疗CP/CPPS的临床证据尚未建立。因此,本研究系统评价了电针治疗CP/CPPS的疗效和安全性。方法:计算机检索CNKI、Wanfang Data、VIP、CBM、PubMed、Cochrane Library、Web of Science和Embase数据库中包括电针或联合治疗CP/CPPS的随机对照试验(RCT)。检索时限从建库至2024年8月。二分类资料用风险比(RR)表示,连续资料用均值差(MD)表示,均有95%置信区间(CI)。使用Revman (v.5.4)软件进行数据分析。每项研究的证据质量采用GRADE证据评估体系进行评估。结果:共纳入17项随机对照试验。实验组包括电针疗法、电针联合药物治疗、电针联合其他疗法(药物熏蒸)。对照组采用西医治疗或中药治疗。meta分析结果显示,电针治疗的临床有效率显著高于西医或单纯中药治疗[RR=1.25,95%CI (1.18~1.32),P<0.05],NIH-CPSI评分显著降低[MD=-4.56,95%CI (-5.01~-4.11),P<0.05],疼痛评分、排尿评分和生活质量评分均有显著改善,最大尿流率和平均尿流率增加。而且电针也不会增加不良反应的可能性。结论:中等质量的证据表明,电针作为CP/CPPS患者的补充和替代疗法是有益的,并且在改善患者的NIH-CPSI症状评分方面具有显著优势。然而,由于本研究的局限性,还需要高质量、大样本、多中心的RCT来进一步验证本研究的结果。Objective:To systematically evaluate the effect and safety of electroacupuncture in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Methods:We searched the major Chinese and English databases of CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of Science and Embase for randomized controlled trials(RCT) on electroacupuncture or combination therapy in the treatment of CP/CPPS published from the establishment of the databases to August 2024.The dichotomous data and continuous data were represented by risk ratio(RR) and mean difference(MD) respectively,both with 95% confidence interval(CI).We analyzed the data with the Revman(v.5.4) software and assessed the quality of the evidence in each RCT using the Grading of Recommendations Assessment,Development and Evaluation system(GRADE).Results:Totally 17 RCTs were identified,involving 1 404 cases of CP/CPPS treated by electroacupuncture or combination of electroacupuncture with medication or with other therapies(the trial group) or by medication with Western or Chinese drugs alone(the control group).Compared with the control group,the trial group showed a significantly higher rate of clinical effectiveness(RR = 1.25;95% CI:1.18-1.32;P < 0.05),decreased CPSI scores(MD =-4.56;95% CI:-5.01--4.11;P < 0.05),improved CPSI-pain,-urination and-quality of life scores,and increased maximum and average urinary flow rates.And electroacupuncture did not increase the likelihood of adverse reactions.Conclusion:Medium-quality evidence suggests that electroacupuncture is beneficial complementary and alternative therapy for CP/CPPS,with a significant advantage in improving the NIH-CPSI scores of the patients.However,more high-quality multi-centered RCTs with larger sample sizes are still needed to further verify the effect of electroacupuncture on CP/CPPS.

关 键 词：电针刺激 慢性前列腺炎 慢性盆腔疼痛综合征 META分析 随机对照试验 系统综述 

分 类 号：R697.3[医药卫生—泌尿科学]