穴位疗法联合体外冲击波碎石术治疗上尿路结石的Meta分析*

作者：付翊钧，许北勋，高 新，梁普照，阮永同

单位：广州中医药大学附属阳江中医院，广东 阳江 529500

引用：引用：付翊钧，许北勋，高新，梁普照，阮永同.穴位疗法联合体外冲击波碎石术治疗上尿路结石的Meta分析[J].中医药导报,2026,32(5):203-209.

DOI：10.13862/j.cn43-1446/r.2026.05.032

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摘要：

目的：系统评价穴位疗法联合体外冲击波碎石术（ESWL）治疗上尿路结石的临床疗效。方法：检索中国知网（CNKI）、维普中文期刊服务平台（CSTJ）、万方数据知识服务平台（Wanfang Data）、中国生物医学文献数据库（SinoMed）、Cochrane图书馆（Cochrane Library）、PubMed、荷兰医学文献数据库（Embase）和Web of Science等数据库，时间限定为自建库至2025年3月22日。由两名评价者分别进行文献筛选和资料提取，并对所纳入文献进行偏倚风险评价。采用Stata 16.0软件进行数据分析。结果：共纳入22项随机对照试验（RCT），包括2 338例上尿路结石患者，治疗方式包括针刺、艾灸、电针、耳穴、穴位贴敷等穴位疗法。穴位疗法联合ESWL在临床有效率方面显著高于对照组[OR=2.87，95%CI（2.06，4.02），Z=6.187，P<0.001]，结石排出时间显著缩短[MD=-0.76，95%CI（-0.95，-0.57），Z=-7.938，P<0.001]，1周结石清除率显著提高[OR=2.89，95%CI（1.95，4.30），Z=5.263，P<0.001]。结论：穴位疗法联合ESWL治疗上尿路结石可提高临床有效率及结石清除率，降低ESWL术中及术后的疼痛评分，疗效确切。但由于纳入文献数量和质量的限制，需要更多高质量的文献在后期验证这一结论。

关键词：上尿路结石；穴位疗法；体外冲击波碎石术；Meta分析

Abstract：

Objective: To systematically evaluate the clinical efficacy of acupoint therapy combined with extracorporeal shock wave lithotripsy (ESWL) in the treatment of upper urinary tract calculi. Methods: Databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CSTJ), Wanfang Data Knowledge Service Platform (Wanfang Data), Chinese Biomedical Literature Service System (SinoMed), Cochrane Library, PubMed, Excerpta Medica Database (Embase) and Web of Science were searched from the establishment of the databases to March 22, 2025. Literature screening and data extraction were conducted independently by two reviewers, and the risk of bias of the included studies was evaluated. Data analysis was performed using Stata 16.0 software. Results: A total of 22 randomized controlled trials (RCTs) were included, involving 2 338 patients with upper urinary tract calculi. Acupoint therapies included acupuncture, moxibustion, electroacupuncture, auricular acupoint application, acupoint sticking therapy, etc. Acupoint therapy combined with ESWL was associated with significantly higher clinical effective rate [OR=2.87, 95%CI(2.06, 4.02), Z=6.187, P<0.001], significantly shorter stone expulsion time [MD=-0.76, 95%CI(-0.95, -0.57), Z=-7.938, P<0.001), and significantly higher 1-week stone-free rate [OR=2.89, 95%CI(1.95, 4.30), Z=5.263, P<0.001] compared with the control group. Conclusion: Acupoint therapy combined with ESWL can improve the clinical effective rate and stone-free rate, and reduce pain scores during and after ESWL in the treatment of upper urinary tract calculi, with definite efficacy. However, due to the limitations in the quantity and quality of included literature, more high-quality studies are needed to verify this conclusion in the future.

Key words：upper urinary tract calculi; acupoint therapy; extracorporeal shock wave lithotripsy; Meta-analysis

发布时间：2026-05-24

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