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

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

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

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

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Investigar la eficacia de la medicina tradicional china (MTC) en el tratamiento de la incontinencia urinaria de esfuerzo (IUE) femenina.

Método:

Se llevaron a cabo búsquedas de artículos publicados hasta septiembre de 2022 en las bases de datos PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang y VIP. Las variables se analizaron mediante la diferencia de medias ponderada (DMP), la diferencia de medias estandarizada (DME), la razón de momios (RM) y el intervalo de confianza (IC) del 95%.

Resultados:

Este estudio incluyó ocho investigaciones con la participación de 744 pacientes. Los resultados indican que la terapia de medicina tradicional china (MTC) presentó mejoras significativas en los resultados clínicos de pacientes con incontinencia urinaria de esfuerzo (IUE) (RM = 2.90, IC del 95%: 1.92–4.37, P = 0.000), al reducir la puntuación del Cuestionario Internacional sobre la Incontinencia y su impacto en la calidad de vida (ICIQ-SF) (DMP = –2.41, IC del 95%: –2.83– –1.98, P = 0.000), así como la disminución del volumen de orina a la 1 hora de fuga de la almohadilla urinaria (DMP = –1.86, IC del 95%: –2.23– –1.49, P = 0.000) y el aumento de la presión de cierre uretral máxima (PCUM) (DME = 0.86, IC del 95%: 0.61–1.11, P = 0.000).

Conclusión:

La terapia de medicina tradicional china (MTC) resulta efectiva en la mejora de los síntomas de la incontinencia urinaria, la urodinámica y la calidad de vida en pacientes con incontinencia urinaria de esfuerzo (IUE). Este artículo ofrece una referencia para la aplicación de la terapia de MTC en mujeres con incontinencia urinaria.

DESCRIPTORES
Terapia de Acupuntura; Acupresión; Metaanálisis; Moxibustión; Incontinencia Urinaria

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