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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 陳欣宏 | 以針灸治療成年女性膀胱過動症(RCT研究報告) | 2015/1/25 下午 05:12:24 | 0 |
| 原 文 | 題 目 | Acupuncture for overactive bladder in female adult: a randomized controlled trial |
| 作 者 | Yuan Zhengyong et al. | |
| 出 處 | World Journal of Urology | |
| 出版日期 | Published online: 16 November, 2014 | |
| 評 論 |
膀胱過動症(OAB)是一種嚴重影響病人生活品質的慢性疾病，它的症狀包括可能有尿急(urgency)、頻尿(frequency)、夜尿(nocturia)、或急迫性尿失禁(urge incontinence)。根據National Overactive Bladder Evaluation (NOBLE)研究，美國女性有16.9%的盛行率且隨著年齡增加而上升；而台灣的盛行率根據陳進典教授2003年發表於Neurourol Urodyn的報告約為18.6%，顯示OAB的治療的確是個重要的課題。由中國重慶醫科大學與都江堰醫學中心泌尿及傳統醫學部Yuan Zhengyong等人所發表在2014年World Journal of Urology的這篇RCT文章是一篇相當有趣及潛力無窮的研究，他們研究發現以針灸治療成年女性的膀胱過動症，與我們一般用抗蕈毒鹼劑(antimuscarinics)藥物治療，兩者都可以達到明顯改善急尿及頻尿的症狀。 從2010到2014年間，他們收集272位OAB女性病患，隨機分成針灸治療(N=136)及藥物治療(N=136)兩組，針灸組給予每週刺激SP6(脾經三陰交)，SP9(脾經陰陵泉)，KI3(腎經太溪)，及CV4(任脈關元)四個穴位，待得氣(Deqi)後留針20分鐘共四週；而藥物組則給予Tolterodine 2 mg每日兩次共四週，分析這兩組病患經治療後的急尿次數、急迫尿失禁次數、日間、夜間頻尿及每次排尿量共五項指標，結果發現兩組都可以明顯得到症狀的改善且在統計學上兩組差異很小(p<0.05)，另外兩組也都沒有產生明顯的副作用。這篇RCT的研究雖然可能有追蹤時間太短及針灸治療安慰效應存在的可能性，但減少藥物服用及改善病患生活品質的優點，應當可作為OAB女性病患另一個不錯的治療選項。 |
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| abstract |
PURPOSE: To assess the effectiveness of acupuncture in treating female adult with overactive bladder. MATERIALS AND METHODS: After we excluded other causes for storage symptoms, a total of 240 consecutive female patients with overactive bladder were enrolled and completed all aspects of this prospective randomized controlled trial, of which 118 cases were randomly assigned to receive a weekly acupuncture treatment (intervention group), while the other 122 cases were given a pharmacological treatment of oral tolterodine tartrate 2 mg twice daily (control group) for 4 weeks. Data on urgency, incontinence, micturition frequency, nocturia episodes and voided volume were collected and statistically analyzed before and after 4 weekly acupuncture treatments or 4 weeks pharmacological treatment using a 3-day micturition diary. RESULTS: The two groups of female patients with overactive bladder were given treatment with weekly acupuncture (n = 118), oral tolterodine tartrate (n = 122) for 4 weeks respectively. At weeks 4, subjects in both intervention and control groups had significant decreases in number of urinary urgency episodes, incontinence episodes, daytime frequency, nocturia episodes and increase in volume voided per micturition without a significant difference in the changes of overactive bladder symptoms between the groups. There were no serious adverse events during the study. CONCLUSIONS: This randomized controlled trial demonstrates that acupuncture is safe with significant improvements in patient assessment of overactive bladder symptoms and may be considered a clinically alternative treatment for overactive bladder in female adult. |
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