以實證觀點探討雷射針灸改善兒童夜間遺尿之成效

背景：夜間遺尿可能顯著衝擊兒童的健康，造成焦慮、憂鬱、負向自我感知、同儕關係問題、睡眠障礙及降低生活品質，針灸是一種有效改善兒童夜間遺尿的治療，然而，由於侵入性與疼痛的療程並不適用於兒童。目的：基於雷射針灸與針刺有相似療效的前提下，本文運用實證觀點探討雷射針灸改善兒童夜間遺尿之成效。方法：根據病人（兒童、夜間遺尿）及介入措施（雷射針灸）提出一個可回答的臨床問題。搜尋六個資料庫，包括PubMed、Embase、Medline、CINHAL、Cochrane Library及華藝線上圖書館，在資料庫中確認368篇文獻，最後，依據指定的納入及排除條件，取得2篇系統性文獻回顧及統合分析文章。結果：結果發現相較於假的雷射針灸、西藥、中藥、針刺及耳穴針刺，雷射針灸對於改善完全反應率或部分反應率可能有更好的或相似的成效；另外，相較於假的雷射針灸，雷射針灸能有效降低夜間遺尿次數。然而，依據建議強度的評估、發展與評價分級評核標準為非常低的證據品質。結論：雷射針灸可能有效改善兒童夜間遺尿之完全反應率、部分反應率及夜間遺尿次數，未來亟需更多的雙盲隨機控制試驗以提供高品質實證證據。

關鍵字

雷射針灸；兒童；夜間遺尿

並列摘要

Background: Nocturnal enuresis can significantly impact children's health, leading to anxiety, depression, negative self-perception, peer relationship problem, sleep disorders, and reduced quality of life. Acupuncture is an effective treatment for improving nocturnal enuresis in children. However, it is not suitable for children due to invasive and painful procedures. Purpose: Based on the premise that laser acupuncture has similar effects to needle acupuncture, this article aims to conduct evidence-based approach to investigate the effects of laser acupuncture improve nocturnal enuresis in children. Methods: Asking an answerable clinical question according to patient (children and nocturnal enuresis) and intervention (laser acupuncture). Six databases were searched, including PubMed, Embase, Medline, CINHAL, Cochrane Library, and Airiti Library. A total of 368 articles were identified in the databases. Finally, two systematic review and meta-analysis articles were obtained in accordance with the prespecified inclusion and exclusion criteria. Results: Laser acupuncture may have either better or similar effects in improving the full response rate or partial response rate as compared to sham laser acupuncture, western medicine, traditional Chinese medicine, acupuncture and auricular acupuncture. In addition, laser acupuncture can effectively reduce the number of nocturnal enuresis as compared with sham laser acupuncture. However, the quality of evidence was very low by Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Conclusion: Laser acupuncture may be effective in improving the full response rate, partial response rate, and numbers of nocturnal enuresis in children. In future, more double-blind randomized controlled trials for providing high-quality evidence are warranted.

並列關鍵字

laser acupuncture ； children ； nocturnal enuresis

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