非药物干预措施对慢性前列腺炎/慢性骨盆疼痛综合征患者疗效的网状meta分析  

Non-pharmacological interventions in chronic prostatitis/chronic pelvic pain syndrome:A network meta-analysis

作　　者：魏晓辉 马梦瑶 苏航 胡通 赵玉欣 刘兴朝 毕鸿雁[4] WEI Xiao-hui;MA Meng-yao;SU Hang;HU Tong;ZHAO Yu-xin;LIU Xing-chao;BI Hong-yan(Faculty of Rehabilitation Medicine,Shandong University of Chinese Medicine,Jinan,Shandong 250000,China;Faculty of Foreign Languages,Shandong University of Chinese Medicine,Jinan,Shandong 250000,China;China Power Construction Shandong No.1 Company,Jinan,Shandong 250000,China;Department of Rehabilitation Physiotherapy,The Affiliated Hospital of Shandong University of Chinese Medicine,Jinan,Shandong 250000,China)

机构地区：[1]山东中医药大学,康复医学院,山东济南250000 [2]山东中医药大学,外国语学院,山东济南250000 [3]中国电建山东一公司,山东济南250000 [4]山东中医药大学附属医院康复理疗科,山东济南250000

出　　处：《中华男科学杂志》2025年第3期234-245,共12页National Journal of Andrology

摘　　要：目的:评价冲击波、针灸、热疗、生物反馈疗法、神经电刺激、磁疗、超声波用于改善慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的疗效,为临床决策提供循证支持。方法:由2名研究者独立检索Pubmed、Web of Science、Embase、Cochrane Library、中国知网、万方数据、维普中文科技期刊全文数据库和中国生物医学文献数据库中关于干预措施对CP/CPPS患者影响的随机对照试验,检索时限从建库至2024年8月,并按照Cochrane系统评价手册对纳入文献进行质量评价并提取数据。应用RevMan5.3、R 4.33和Stata17软件进行网状meta分析。结果:最终纳入25篇文献,共1794例患者。网状meta分析结果显示:神经电刺激、冲击波疗法、生物反馈疗法、磁疗、超声波疗法、针灸在美国国立卫生研究院-慢性前列腺炎症状指数(NIH-CPSI)评分方面均优于常规药物治疗组和安慰剂对照组,差异均有统计学意义(P<0.05);神经电刺激和冲击波疗法均优于针灸、热疗(P<0.05);磁疗优于热疗,超声波疗法优于安慰剂对照组(P<0.05)。在治疗CP/CPPS的临床有效率方面,冲击波疗法、生物反馈疗法、神经电刺激、磁疗和超声波疗法的效果优于常规药物治疗和安慰剂对照,冲击波疗法优于神经电刺激、热疗、超声波疗法、磁疗和针灸。结论:根据网状meta分析和累积概率排名曲线下面积(SUCRA),在CP/CPPS患者的NIH-CPSI评分总分改善方面,神经电刺激具有优势;在改善CP/CPPS患者的疼痛症状方面,冲击波疗法具有优势;在治疗CP/CPPS的临床有效率方面,冲击波具有优势。但仍需要更多的高质量临床研究来验证此结论。Objective:To evaluate the efficacy of shockwave therapy,acupuncture,hyperthermia,biofeedback therapy,electrical nerve stimulation,magnetotherapy and ultrasound therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),and to provide evidence-based support for clinical decision-making.Methods:Two researchers independently searched PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang,VIP and Chinese Biomedical Literature databases for randomized controlled trials(RCTs)on the effects of different interventions on CP/CPPS from the establishment of the databases to August 2024.We evaluated the quality of the included literature and extracted the relevant data according to the Cochrane Handbook for Systematic Reviews of Interventions,followed by network meta-analysis using Revman 5.3,R 4.33 and Stata17 software.Results:A total of 25 RCTs involving 1794 cases were included.The results of network meta-analysis showed that electrical nerve stimulation,shockwave therapy,biofeedback therapy,magnetotherapy,ultrasound therapy and acupuncture were significantly superior to conventional medication and placebo in the total NIH-CPSI scores(P<0.05),and so were electrical nerve stimulation and shockwave therapy to acupuncture and hyperthermia(P<0.05),magnetic therapy to hyperthermia,and ultrasound therapy to placebo(P<0.05).Shockwave therapy,biofeedback therapy,electrical nerve stimulation,magnetotherapy and ultrasound therapy achieved remarkably better clinical efficacy than conventional medication and placebo in the treatment of CP/CPPS,and so did shockwave therapy than electrical nerve stimulation,hyperthermia,ultrasonic therapy,magnetotherapy and acupuncture.Conclusion:For the treatment of CP/CPPS,electrical nerve stimulation is advantageous over the other interventions in improving total NIH-CPSI scores,and shockwave therapy is advantageous in relieving pain symptoms and clinical efficacy.This conclusion,however,needs to be further verified by more high-quality clinical studies.

关 键 词：慢性前列腺炎/慢性骨盆疼痛综合征 非药物治疗 网状meta分析 

分 类 号：R697.33[医药卫生—泌尿科学]