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

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

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Sumário

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

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

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Investigar a eficácia da medicina tradicional chinesa (MTC) no tratamento da incontinência urinária de esforço (IUE) feminina.

Método:

Foram realizadas pesquisas de artigos publicados até setembro de 2022 nas bases de dados PubMed, Cochrane, Web of Science, Embase, CNKI, Wanfang e VIP. As variáveis foram analisadas por meio da diferença de média ponderada (DMP), da diferença média padronizada (DMP), da razão de chances (RC) e do intervalo de confiança (IC) de 95%.

Resultados:

Esta pesquisa envolveu oito estudos, contando com a participação de 744 pacientes. Os resultados indicam que a terapia da medicina tradicional chinesa (MTC) apresentou melhorias significativas nos resultados clínicos de pacientes com incontinência urinária de esforço (IUE) (RM = 2.90, IC de 95%: 1.92–4.37, P = 0.000), ao reduzir a pontuação do Questionário Internacional sobre a Incontinência Urinária – Versão Breve (ICIQ-SF) (Diferença de Média Ponderada = –2.41, IC de 95%: –2.83– –1.98, P = 0.000), assim como na diminuição do volume de urina na 1 hora de vazamento do absorvente urinário (Diferença de Média Ponderada = –1.86, IC de 95%: –2.23– –1.49, P = 0.000) e no aumento da pressão máxima de encerramento uretral (PMCU) (Diferença Média Padronizada = 0.86, IC de 95%: 0.61–1.11, P = 0.000).

Conclusão:

A terapia da medicina tradicional chinesa (MTC) é eficaz na melhoria dos sintomas da incontinência urinária, na urodinâmica e na qualidade de vida em pacientes com incontinência urinária de esforço (IUE). Este artigo fornece uma referência para a aplicação da terapia da MTC em mulheres com incontinência urinária.

DESCRITORES
Terapia com Acupuntura; Acupressão; Metanálise; Moxabustão; 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