目的 系统评价不同中医外治法干预卒中后神经源性膀胱(PSNB)的临床效果.方法 计算机检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献服务系统、Web of Science、The Cochrane Library、Embase、PubMed等数据库,搜集公开发表的采用中医外治法干预PSNB的随机对照试验.经筛选文献、质量评价、提取资料后,使用STATA 17.0软件进行网状Meta分析.结果 最终纳入35篇文献,共涉及9种中医外治法.网状Meta分析结果显示,与常规治疗相比,艾灸+常规治疗、针刺+常规治疗、穴位贴敷+常规治疗、刮痧+常规治疗、艾灸+针刺+常规治疗、艾灸+耳穴疗法+常规治疗、艾灸+穴位贴敷+常规治疗的总有效率更高,耳穴疗法+常规治疗、艾灸+常规治疗、针刺+常规治疗、艾灸+针刺+常规治疗、艾灸+耳穴疗法+常规治疗、艾灸+穴位贴敷+常规治疗在改善PSNB患者残余尿量上效果更好,耳穴疗法+常规治疗、艾灸+常规治疗、针刺+常规治疗、艾灸+针刺+常规治疗、艾灸+穴位贴敷+常规治疗在改善PSNB患者膀胱安全容量上效果更好(P＜0.05).其中,艾灸+穴位贴敷+常规治疗在提高总有效率、改善膀胱安全容量方面效果最佳,艾灸+耳穴疗法+常规治疗在改善残余尿量方面效果最佳.结论 与常规治疗相比,采用不同中医外治法联合常规治疗干预PSNB可获得更好的治疗效果,更有效地减少残余尿量、增加膀胱安全容量,从而改善患者排尿情况,提高其生活质量.其中,在常规治疗基础上,艾灸+穴位贴敷在提高有效率、增加膀胱安全容量方面效果最佳,艾灸+耳穴疗法在改善残余尿量指标方面效果最佳.
Effect of different external treatments of Traditional Chinese Medicine for the intervention of post-stroke neurogenic bladder:a network Meta-analysis
Objective To systemically evaluate the clinical effect of different external treatments of Traditional Chinese Medicine for the intervention of post-stroke neurogenic bladder(PSNB).Methods The published randomized controlled trials of intervention of PSNB with external treatments of Traditional Chinese Medicine by retrieving the databases of China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,China Biomedical Literature Service System,Web of Science,The Cochrane Library,Embase,PubMed,etc.After literature screening,quality evaluation,data extracting,the network Meta-analysis was performed by using the STATA 17.0 software.Results A total of 35 literature was finally enrolled,concerning 9 external treatments of Traditional Chinese Medicine in total.The results of network Meta-analysis revealed that compared with routine treatment,moxa-moxibustion+routine treatment,acupuncture+routine treatment,acupoints sticking therapy+routine treatment,Guasha treatment+routine treatment,moxa-moxibustion+acupuncture+routine treatment,moxa-moxibustion+auricular therapy+routine treatment,moxa-moxibustion+acupoints sticking therapy+routine treatment exhibited higher total effective rates;moreover,auricular therapy+routine treatment,moxa-moxibustion+routine treatment,acupuncture+routine treatment,moxa-moxibustion+acupuncture+routine treatment,moxa-moxibustion+auricular therapy+routine treatment,moxa-moxibustion+acupoints sticking therapy+routine treatment yielded superior effect on ameliorating residual urine volume of PSNB patients;in addition,auricular therapy+routine treatment,moxa-moxibustion+routine treatment,acupuncture+routine treatment,moxa-moxibustion+acupuncture+routine treatment,moxa-moxibustion+acupoints sticking therapy+routine treatment interpreted superior effect on ameliorating bladder safe capacity of PSNB patients(P＜0.05),therein moxa-moxibustion+acupoints sticking therapy+routine treatment exhibited optimal total effect rate,and optimal improvement of bladder safe capacity,as well as moxa-moxibustion+auricular therapy+routine treatment yielded optimal effect on ameliorating residual urine volume.Conclusion Compared with routine treatment,employing different external treatments of Traditional Chinese Medicine combined with routine treatment for the intervention of PSNB can obtain superior therapeutic effect,and more effectively reduce residual urine volume,increase bladder safe capacity,so as to ameliorate urinating condition,and improve quality of life,therein on the basis of routine treatment,moxa-moxibustion combined with acupoints sticking therapy has optimal effect on increasing effective rate,and increasing bladder safe capacity,whereas moxa-moxibustion combined with auricular therapy yields optimal effect on ameliorating residual urine volume indices.
Cerebral stokeNeurogenic bladderExternal treatment of Traditional Chinese MedicineTherapeutic effectResidual urine volumeBladder safe capacityNetwork Meta-analysis
万方数据
维普
