Clinical efficacy of traditional Chinese medicine therapy for female stress urinary incontinence: a meta-analysis

Liu, Hui; Li, Yanan; Zheng, Han; Miao, Yiqun; Zhao, Shuliang; Sun, Wenting; Zhang, Yuanyuan

doi:10.1590/1980-220X-REEUSP-2023-0153en

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REVIEW • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0153en copy

Clinical efficacy of traditional Chinese medicine therapy for female stress urinary incontinence: a meta-analysis

Eficácia clínica da terapia da medicina tradicional chinesa para a incontinência urinária de esforço feminina: uma meta-análise

Eficacia clínica de la terapia de medicina tradicional china para la incontinencia urinaria de esfuerzo femenina: un metaanálisis

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

To investigate the efficacy of traditional Chinese medicine (TCM) in the treatment of female stress urinary incontinence (SUI).

Method:

PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang, and VIP databases were searched for articles published up to September 2022. Variables were analyzed using weighted mean difference (WMD), standardized mean difference (SMD), odds ratios (OR), and 95% confidence interval (CI).

Results:

Eight studies containing 744 patients were included in this study. The results demonstrate that TCM therapy had more advantages in improving the clinical outcome of SUI patients (OR = 2.90, 95%CI:1.92–4.37, P = 0.000), reducing the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) score (WMD = –2.41, 95%CI:–2.83– –1.98, P = 0.000), reducing 1-h urinary pad leakage urine volume (WMD = –1.86, 95%CI:–2.23– –1.49, P = 0.000) and increasing Maximum urethral closure pressure (MUCP) (SMD = 0.86, 95%CI: 0.61–1.11, P = 0.000).

Conclusion:

TCM therapy is effective in improving urinary incontinence symptoms, urodynamics, and quality of life in patients with SUI. This article provides a reference for the application of TCM therapy in women with urinary incontinence.

DESCRIPTORS
Acupuncture Therapy; Acupressure; Meta-analysis; Moxibustion; Urinary Incontinence

Study	Year	Study type	Participants	Controls	Outcomes
Tang et al.(¹⁴14. Tang CL, Dai DC, Zhu EF, Jin YY, Mei LF, Zhao GF. Observation on therapeutic effect of dog-day acupuncture and moxibustion combined with pelvic floor muscle exercises for treatment of female stress urinary incontinence. Zhongguo Zhenjiu. 2009;29(11):879–83. PubMed PMID: 19994685.)	2009	RCT	36 women were treated with Acupuncture, Moxibustion with tortoise shell and Pelvic floor muscle training	35 women were treated with Pelvic floor muscle training	①
Lou et al.(¹⁵15. Lou J, Ma CX, Liu JN. Clinical observation of biofeedback therapy combined with acupressure for postpartum stress urinary incontinence. Journal of Practical Traditional Chinese Medicine. 2018;34(10):1250–1.)	2018	RCT	54 women were treated with Acupressure and Pelvic floor muscle training	53 women were treated with Pelvic floor muscle training	③
Cao et al.(¹⁶16. Cao J, Li YX, Wang L, Yao HY. Clinical study on postpartum stress urinary incontinence with warm acupuncture combined with kegel pelvic floor rehabilitation training. Journal of Anhui University of Chinese Medicine. 2021;40(3):60–4. doi: http://dx.doi.org/10.3969/j.issn.2095-7246.2021.03.016 https://doi.org/10.3969/j.issn.2095-7246... )	2021	RCT	33 women were treated with Warming acupuncture-moxibustion and Pelvic floor muscle training	33 women were treated with Pelvic floor muscle training	③
Deng et al.(¹⁷17. Deng J, Feng BY, Chen XB, Feng SL. Clinical observation on electrothermic-needling moxibustion on back-shu points combined with pelvic floor muscle exercise in treating female stress urinary incontinence with spleen-kidney yang deficiency type. Journal of Guangzhou University of Traditional Chinese Medicine. 2020;37(8):1485–90. doi: http://dx.doi.org/10.13359/j.cnki.gzxbtcm.2020.08.014 https://doi.org/10.13359/j.cnki.gzxbtcm.... )	2020	RCT	30 women were treated with Electrothermic-needling moxibustion and Pelvic floor muscle training	30 women were treated with Pelvic floor muscle training	②
Yang et al.(¹⁸18. Yang QY, Sun YK, Lin ZT. Effect of moxibustion on postpartum urodynamics and pelvic floor function in puerperal women. Zhongguo Zhenjiu. 2021;41(8):883–6. PubMed PMID: 34369699.)	2021	RCT	75 women were treated with Moxibustion and Pelvic floor muscle training	75 women were treated with Pelvic floor muscle training	①④
Peng et al.(¹⁹19. Peng YB, Sun D, Huang JW, Na JW, Dong XH. Efficacy observation of the treatment of female stress urinary incontinence predominantly with moxibustion at back-shu and front-mu points. Shanghai J Acupunct Moxibustion. 2018;37(7):773–6. doi: http://dx.doi.org/10.13460/j.issn.1005-0957.2018.13.0095 https://doi.org/10.13460/j.issn.1005-095... )	2018	RCT	35 women were treated with Moxibustion and Pelvic floor muscle training	35 women were treated with Pelvic floor muscle training	①②③
Chen et al.(²⁰20. Chen YM. Observation on therapeutic effect of acupuncture and moxibustion regulating Ren and Du meridians on female stress urinary incontinence. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2020;29(14):1517–21.)	2020	RCT	80 women were treated with Acupuncture and Pelvic floor muscle training	80 women were treated with Pelvic floor muscle training	①②③④
Pan et al.(²¹21. Pan ZL, Tang M, Li MG. Observation on the clinical effect of tonifying spleen and kidney therapy on moderate stress urinary incontinence in middle-aged and elderly women based on spleen kidney treatment. Heilongjiang Science. 2021;12(8):48–50. doi: http://dx.doi.org/10.3969/j.issn.1674-8646.2021.08.018 https://doi.org/10.3969/j.issn.1674-8646... )	2021	RCT	30 women were treated with Tonifying Spleen and Kidney Therapy and Pelvic floor muscle training	30 women were treated with Pelvic floor muscle training	①②

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[1] Corresponding author: Yuanyuan Zhang Baotong West Street, 7166, Weifang 261053 – Shandong Province, China Yixue1068@163.com