| Objective:The efficacy and safety of acupuncture in the treatment of urinary incontinence after stroke were systematically evaluated,and evidence was provided for clinical acupuncture in the treatment of urinary incontinence after stroke.Methods:Computer retrieval of Cochrane Library,Pubmed,Embase,Chinese biomedical Literature database,China Knowledge Network,Wanfang database,VIP databases;manual search Journal"Acupuncture Research","C hinese Acupuncture","Acupuncture Clinical Journal","S hanghai Acupuncture Journal",while retrieving grey or conference papers online through scientific papers and open grey.Retrieval time from the Build Library(journal)to December 31,2018.A clinical randomized controlled trial was collected for the treatment of urinary incontinence after stroke with acupuncture contrast positive drugs,placebo or blank control(or acupuncture with A intervention compared to A intervention).Using endnote X7 document management software to remove the weight,according to the inclusion,exclusion criteria to screen out the standards of the study,refer to the Cochrane Collaboration Network system Evaluator Manual for the quality evaluation of the included research,and the use of RevMan5.3 software for meta-analysis.First of all,the heterogeneity test,the use of P value and I2 statistical test,if the study is homogeneous,the fixed effect model is adopted,and if the heterogeneity is large,the stochastic effect model is used,and the sensitivity analysis of the study with large heterogeneity is carried out to identify the heterogeneity source.In the aspect of data merging,when the analysis index is two classification variables,the relative risk degree and its 95 confidence interval are used as their combined statistics,and when the analysis index is a continuous variable,the mean difference and its 95 confidence interval are used as their combined statistics.For publication bias,the Stata software is used for Egger inspection to make the results objective.Results:53 8 literatures were retrieved by computer,42 literatures were obtained by hand,0 articles of grey literature were retrieved,and 2 articles were supplemented and retrieved.After using endnote X7 software to eliminate 265 duplicate literatures,317 literatures were incorporated into the initial screening process,through reading topics,abstracts,excluding 270 literatures that were not relevant to this study,47 documents entered the two screening process,obtained and read the full text,according to the inclusion and exclusion criteria,and finally included in the literature 13 articles,including 0 English literature,a total of 1068 cases of patients.1.In the studies of the three acupuncture contrast Western medicine,acupuncture group can significantly reduce clinical inefficiency(P<0.01),heterogeneity and publication bias are low;in the studies of the two acupuncture contrast Western medicine,the acupuncture group could obviously improve the maximum capacity and residual urine volume of bladder(P<0.01),but there was heterogeneity and low publication bias in the study.2.In the studies of the four acupuncture contrast Traditional Chinese medicine,there was no statistical difference between acupuncture Group and Chinese Medicine group in reducing clinical inefficiency(P>0.05),high heterogeneity,after sensitivity analysis to eliminate the impact of heterogeneity on the study,the remaining three studies have homogeneity,it was suggested that the difference of clinical inefficiency between acupuncture group and Chinese Medicine group was statistically significant(p<0.05),and the publication bias was lower;and in the three acupuncture comparing Traditional Chinese medicine,the acupuncture group significantly improved the maximum bladder capacity(P<0.01),the heterogeneity of the study,and the low publication bias.3.In the three acupuncture combined with the routine comparison of God s routine,acupuncture combined with divine routine significantly reduced clinical inefficiency(P<0.01),there was heterogeneity between the studies,and the publication bias was low.4.In the studies of the two acupuncture combined with pelvic floor muscle exercise compared to pelvic floor muscle exercise,acupuncture combined with pelvic floor muscle exercise significantly reduced clinical inefficiency(P<0.01),heterogeneity and publication bias was low.5.Two of the thirteen studies reported adverse reactions,but no adverse events were observed;one reported urinary tract infections,and the results showed that the incidence of urinary tract infections in the treatment group(3.39%)was lower than in the control group(13.56%).Conclusion:1.Compared with Western medicine,acupuncture significantly reduces the clinical inefficiency of urinary incontinence after stroke,effectively improves the maximum bladder capacity and reduces the amount of residual urine.2.Compared with traditional Chinese medicine,acupuncture can reduce the clinical inefficiency of urinary incontinence after stroke and improve the maximum capacity of bladder.3.Compared with the routine in God,acupuncture combined with the routine of God significantly reduced the clinical inefficiency of urinary incontinence after stroke.4.Compared with pelvic floor muscle exercise,acupuncture combined with pelvic floor muscle exercise significantly reduced the clinical inefficiency of urinary incontinence after stroke5.Acupuncture has certain safety in the treatment of urinary incontinence after stroke6.Since the study incorporates a small number of RCTs and is not of high quality,more large samples and high-quality randomized controlled trials are needed for further support. |
PDF Full Text Request