The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, China.
Guangzhou University of Chinese Medicine, China.
Complement Ther Clin Pract. 2021 May;43:101293. doi: 10.1016/j.ctcp.2020.101293. Epub 2021 Jan 19.
Tension-type headache (TTH) is one of the most common primary headache diseases in the world and has a serious negative impact on the physical and mental health of patients. Tuina is now widely used to treat tension-type headaches. This article aims to systematically review the evidence about the effectiveness of Tuina on the effectiveness rate, pain intensity, and impact of headache in individuals with TTH.
Eight databases for randomized controlled trials (RCTs) of Tuina were included in treatments for TTH. Cochrane Collaboration's tool was applied to evaluate the quality of the studies. Confidence in the effect estimates was determined with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. We use the software STATA 12.0 for meta-analysis and TSA software for test sequence analysis.
Seven studies were included with a total sample of 1228 individuals. Meta-analysis results showed that Tuina was superior to drugs for improving the effectiveness rate (RR = 1.49, 95%CI: 1.25 to 1.77, p < 0.01, low evidence). A visual analog scale (VAS) score of Tuina was significantly lower than that of drugs (WMD = -0.738, 95% CI: -1.128 to -0.349, p < 0.01, moderate evidence). The trial sequential analysis showed that the effectiveness of Tuina for TTH was accurate. Adverse events were tolerable.
Tuina has a certain effect in treating tension headache. However, due to the low level of methodological quality included in the article, this conclusion should be considered cautiously. More studies are necessary to strengthen the evidence regarding the effectiveness and safety of Tuina for subjects with TTH.
紧张型头痛（TTH）是世界上最常见的原发性头痛疾病之一，对患者的身心健康有严重的负面影响。推拿现广泛用于治疗紧张型头痛。本文旨在系统评价推拿治疗 TTH 的疗效、疼痛强度和头痛影响的证据。
纳入推拿治疗 TTH 的随机对照试验（RCT）的 8 个数据库。应用 Cochrane 协作工具评价研究质量。使用 Grading of Recommendations, Assessment, Development and Evaluation（GRADE）工具确定效果估计的置信度。我们使用 STATA 12.0 软件进行荟萃分析和 TSA 软件进行测试序列分析。
纳入 7 项研究，共 1228 例患者。荟萃分析结果表明，推拿在提高有效率方面优于药物（RR=1.49，95%CI：1.25 至 1.77，p<0.01，低证据）。推拿的视觉模拟量表（VAS）评分明显低于药物（WMD=-0.738，95%CI：-1.128 至-0.349，p<0.01，中证据）。试验序贯分析表明，推拿治疗 TTH 的效果是准确的。不良反应可耐受。
推拿治疗紧张性头痛有一定疗效。然而，由于文章中纳入的方法学质量水平较低，此结论应谨慎考虑。需要更多的研究来加强推拿治疗 TTH 受试者有效性和安全性的证据。
