为CP/CPPS优化体外冲击波疗法的使用:以模式为基础的系统审查和对焦和辐射设备进行比较的元分析
Min-Jui Wu1, Chien-Chang Kao1, Ming-Hsin Yang1
1Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
Journal of clinical medicine
|February 13, 2026
概括
低强度体外冲击波疗法 (Li-ESWT) 提供慢性前列腺炎/慢性骨盆疼痛综合征 (CP/CPPS) 的显著缓解症状,主要是通过减少疼痛. 聚焦器件表现出一致的好处,而辐射和多焦器件的结果由于异质性而需要谨慎解释.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 疼痛管理 疼痛管理
- 医疗器械 医疗器械
背景情况:
- 慢性前列腺炎/慢性盆腔疼痛综合征 (CP/CPPS) 是一种具有挑战性的疾病,通常对传统治疗有抗性.
- 低强度体外冲击波疗法 (Li-ESWT) 是一种基于机制的治疗选择.
- 之前的审查发现Li-ESWT研究中存在显著的异质性,可能是由于波发生器方式的变化.
研究的目的:
- 综合随机对照试验 (RCT) 关于Li-ESWT对CP/CPPS的疗效的证据.
- 为了研究不同波生成器模式 (聚焦,辐射,多焦) 作为预规定的效果修饰器的影响.
- 分析治疗策略,比较单一疗法与标准医疗治疗 (SMT) 的附加疗法.
主要方法:
- 在主要数据库 (PubMed,Embase,Web of Science,Cochrane Library) 中系统搜索2015年1月至2025年10月期间发表的RCT.
- 包括比较Li-ESWT (焦点,辐射或多焦点) 与假或SMT的研究.
- 使用大约12周的全国卫生研究院慢性前列腺炎症状指数 (NIH-CPSI) 总数进行初级结果评估,并根据模式和策略对子组进行分析.
主要成果:
- 包括8个涉及455名参与者的RCT.
- 与对照组相比,Li-ESWT显示了NIH-CPSI总体的显著改善 (WMD -8.46;95% CI -12.12至 -4.79).
- 聚焦器件显示出一致的积极效果 (WMD -6.59; I2 = 0.0%),而辐射和多焦器件则产生了显著的好处,但具有实质性的异质性,因此需要谨慎解释.
结论:
- -ESWT为CP/CPPS提供了临床上有意义的症状缓解,主要是通过减轻疼痛.
- 效率可能因波生成器模式而异,聚焦设备显示最一致的结果.
- 需要进一步的研究,包括对比,以澄清在CP/CPPS管理中不同Li-ESWT模式的最佳使用.
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