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Efficacy of Acupuncture in Children with Nocturnal Enuresis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

By Z.-T. Lv, W. Song, J. Wu, J. Yang, T. Wang, C.-H. Wu, F. Gao, X.-C. Yuan, J.-H. Liu, and M.Li

Evidence-based Complementary and Alternative Medicine, Volume 2015, 2015, Article number 320701

Editor’s comments:
Acupuncture is known as an “alternative treatment” for nocturnal enuresis. This leads to the following questions: How reproducible is the success of acupuncture treatment? What is the effect of the placebo effect? Are there any good randomized controlled trials? In this review article, the authors have included 21 randomized controlled trials with a total of 1590 patients. The main message of this review article is that none of the 21 RCTs have a high-quality methodology. None of the studies have focused on safety, on complications of acupuncture. There were only two studies comparing acupuncture versus placebo treatment and the results in these two studies are inconsistent. None of the studies compared acupuncture with desmopressin treatment or alarm treatment. In conclusion, there is a “suggestion” that acupuncture is more efficient than placebo in the treatment of nocturnal enuresis. However, only large-scale, randomized, controlled trials with high-quality methodology will be able to prove this “suggestion”.  

Abstract
 

Background:

Nocturnal enuresis (NE) is recognized as a widespread health problem in young children and adolescents. Clinical researches about acupuncturetherapy for nocturnal enuresis are increasing, while systematic reviews assessing the efficacy of acupuncture therapy are still lacking.

Objective:

This study aims to assess the effectiveness of acupuncture therapy for nocturnal enuresis.

Materials and Methods:

A comprehensive literature search of 8 databases was performed up to June 2014; randomized controlled trials which compared acupuncture therapy and placebo treatment or pharmacological therapy were identified. A meta-analysis was conducted.

Results:

This review included 21 RCTs and a total of 1590 subjects. The overall methodological qualities were low. The results of meta-analysis showed that acupuncture therapy was more effective for clinical efficacy when compared with placebo or pharmacological treatment. Adverse events associated with acupuncture therapy were not documented.

Conclusion:

Based on the findings of this study, we cautiously suggest that acupuncture therapy could improve the clinical efficacy. However, the beneficial effect of acupuncture might be overstated due to low methodological qualities. Rigorous high quality RCTs are urgently needed. 

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