| [Objective]Systematic evaluation method was adopted to evaluate the efficacy and safety of acupuncture treatment for stress urinary incontinence(SUI).And by comparing the efficacy of different acupuncture points for SUI,to clarified the effect of the Pudendal nerve-related acupoints.So as to provide evidence-based medical basis for acupuncture treatment of SUI.[Methods]CNKI,Wanfang,VIP,CBMdisc,PubMed,EMBASE,The Cochrane Library,and Web of Science were searched from the construction of the library to January,2023 by co mputer to obtain randomized controlled clinical trials on acupuncture treatment for SUI.Relev ant clinical journals were manually searched until January,2023.Search the Chinese clinical tr ial Registry and ClinicalTrials.gov.Trace the references of relevant papers to supplement the r esearch acquisition.The Endnote X9 software was used to deduplicate and screen the literatur es.The Jadad scale and the Cochrane bias risk assessment tool were used to evaluate the qualit y of the included studies.RevMan5.4.1 software was used for Meta-analysis on total effective rate,1h pad test urine leakage,ICIQ-UI SF score,and frequency of urinary incontinence in 24 h.The GRADE profiler software was used to grade the quality of evidence.Perform subgroup analysis on the above outcomes according to whether use the Pudendal nerve-related acupoint s.Descripe adverse events.[Results]A total of 26 studies with 2784 patients were included.According to the evalua tion of Jadad scale,7 of the included studies were of high quality,19 were of low quality.Acc ording to the Cochrane bias risk assessment tool,2 studies were of low risk of bias,2 were of unclear risk of bias,22 were of high risk of bias.The results of meta-analysis showed that:①Total effective rate:The curative effect of acupuncture treatment and acupuncture combined w ith rehabilitation therapy was superior to that of rehabilitation therapy alone(P<0.05),and the re was no difference between whether to choose the Pudendal nerve-related acupoints(P>0.05).②1h pad test urine leakage:acupuncture was superior to sham acupuncture and rehabilitation therapy in the improvement of SUI urine leakage.Pudendal nerve-related acupoints was supe rior to no pudendal nerve-related acupoint(P<0.05).Electroacupuncture stimulation of puden dal nerve-related acupoint selection was superior to filiform needle stimulation of pudendal ne rve-related acupoint selection(P<0.05).③ICIQ-UI SF score:the score improvement of acup uncture was better than sham acupuncture and rehabilitation therapy.Acupuncture combined r ehabilitation was better than rehabilitation therapy alone(P<0.05).There was no difference bet ween whether to choose the Pudendal nerve-related acupoints(P>0.05).④The frequency of u rinary incontinence in 24h:acupuncture therapy was better than sham acupuncture and rehabil itation therapy(P<0.05).There was no significant difference between acupuncture combined with rehabilitation and rehabilitation therapy(P>0.05).⑤Adverse events:The incidence of ac upuncture therapy was about 2.01%,and of acupuncture combined with rehabilitation therapy was 2.16%.The symptoms were mild and could be relieved by themselves.There are few repo rts on rehabilitation therapy alone,and no adverse events have been reported.Grade evidence quality level was mostly low or very low.[Conclusion]The curative effect of acupuncture in the treatment of SUI is better than sham acupuncture and rehabilitation therapy.The combined use of acupuncture and rehabilitation therapy is better than rehabilitation therapy alone.Electroacupuncture stimulation of pudendal nerve related acupoints has a better effect in improving urine leakage.In terms of safety,no adverse reactions were found in rehabilitation therapy,while acupuncture therapy had mild adverse reactions,and both of them were safe.Since the quality of the included studies was generally not high,the conclusions still need to be further verified by large-scale,multi-center RCTS. |
PDF Full Text Request