Chronischer Harnwegsinfekt: ein respektables chinesisches systematisches Review bei magerer Ausbeute originaler Studien
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omas Ots Akupunktur, TCM, Psychosomatik, Graz, Österreich
Chronischer Harnwegsinfekt: ein respektables chinesisches systematisches Review bei magerer Ausbeute originaler Studien Originalpublikation Qin X, Coyle ME, Yang L, Liang J, Wang K, Guo X, Zhang AL, Mao W, Lu C, Xue CC, Liu X (2020) Acupuncture for recurrent urinary tract infection in women: a systematic review and meta-analysis. BJOG. https:// doi.org/10.1111/1471-0528.16315. Online ahead of print.
Abstract Background. Increasing antibiotic resistance has motivated interest in non-antibiotic prophylaxis of recurrent urinary tract infections (rUTI). Objectives. To conduct a systematic review of the current state of acupuncture for uncomplicated rUTI in women. Search strategy. Nine databases (PubMed, Embase, CENTRAL, CINAHL, AMED, CBM, CNKI, CQVIP, Wanfang) were searchedfrom inception to February 2019. Selection criteria. Randomised controlled trials (RCTs) evaluating the effects of acupuncture and related therapies for prophylaxis or treatment of uncomplicated rUTI in women were included. Data collection and analysis. Risk of bias was assessed, and the quality and strength of evidence evaluated using the GRADE framework. Results were reported as risk ratios (RR) for dichotomous outcomes or mean differences (MD) for continuous outcomes, with 95 % confidence intervals (CI). Main results. Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics (three studies, 170 participants, RR 1.92, 95 % CI 1.31–2.81, I2 = 38 %). The risk of UTI recurrence was lower with acupuncture than with no treatment (two studies, 135 participants, RR 0.39, 95 % CI 0.26–0.58, I2 = 0 %) and sham acupuncture (one study, 53 participants, RR 0.45, 95 % CI 0.22–0.92). Deutsche Zeitschrift für Akupunktur https://doi.org/10.1007/s42212-020-00311-2 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
Conclusions. Acupuncture appeared to be beneficial for treatment and prophylaxis of rUTIs, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture. Keywords. Acupuncture, prophylaxis, recurrent urinary tract infection, systematic review, treatment Zusammenfassung. Dieses chinesisch-australische systematische Review untersuchte den Effekt von Akupunktur und Moxibustion bei fünf randomisierten kontrollierten Studien (RCT) zur Behandlung von wiederkehrenden Harnwegsinfekten bei Frauen (rUTI). Bei akuten Harnwegsinfekten zeigten Akupunktur und Moxibustion (einmal Moxibustion plus chinesische Arzneitherapie [CAT]) bessere Ergebnisse als Antibiotika. Akupunktur zeigte sich in der Prophylaxe von wiederkehrenden Harnwegsinfekten besser als keine Therapie bzw. als Sham-Akupunktur.
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