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

Abstract

Background. Nocturnal enuresis (NE) is recognized as a widespread health problem in young children and adolescents. Clinical researches about acupuncture therapy 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.

A Systematic Review and a Meta-Analysis of Using Acupuncture for the Treatment of Nocturnal Enuresis

“…In this study, randomized controlled trials which compared acupuncture therapy and pharmacological therapy or placebo treatment were identified, and a meta-analysis was performed. The results of meta-analysis of this study showed that acupuncture therapy is more effective for clinical efficacy when compared with placebo or pharmacological treatment, but this study suggested additional RCTs with rigorous experimental design, large-scale high quality methodological control, long follow-ups, and strict reporting specification [6]. Another systematic review was done about acupuncture for nocturnal enuresis in children.…”

“…Three mechanisms were imaged for NE including: bladder over-activity, failure to awaken in response to bladder sensations, and excessive nocturnal urine production [5]. The current acceptable treatments for NE are oral pharmacological therapies, including desmopressin, tricyclics, and oxybutynin, and behavioral therapies [6]. Desmopressin has been proven to have reliable effects on one third of the unselected enuretic children.…”

“…However, when the medication is not taken anymore, the clinical drug effects cannot be continued, and the side effects of drugs may cause the patients to oppose taking them for a long time [7]. Complementary and alternative medicine (CAM) widely helped to encounter the increasing demand for nonpharmacological approaches [6].…”

“…Compared to formal treatment, safety and cost effectiveness of acupuncture cause the maintenance of patients' compliance [6]. The purpose of this study is to evaluate the effect of acupuncture therapy in the treatment of nocturnal enuresis on randomized controlled trials (RCTs).…”

Nocturnal enuresis in children - Treatment with acupuncture

“…[1] Nocturnal enuresis affects 5% to 10% of the younger school-age children. [2] The frequency and severity of wetting episodes progressively increases with age, and children over 10 years of age have significantly more day time urinary symptoms and incontinence. [3] The enuresis appears as monosymptomatic, with no daytime urinary symptoms and nonmonosymptomatic which is accompanied by day time urinary symptoms.…”