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针刺治疗儿童 Tic 障碍的临床疗效和安全性:22 项随机对照试验的系统评价和荟萃分析。

Clinical efficacy and safety of acupuncture treatment of TIC disorder in children: A systematic review and meta-analysis of 22 randomized controlled trials.

机构信息

Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang District, Beijing, 100029, China.

Dongfang Hospital,Beijing University of Chinese Medicine, No. 6, Fangxingyuan District 1, Fengtai District, Beijing, 100078, China.

出版信息

Complement Ther Med. 2021 Jun;59:102734. doi: 10.1016/j.ctim.2021.102734. Epub 2021 May 11.

Abstract

OBJECTIVE

To systematically evaluate the clinical efficacy and safety of acupuncture in the treatment of Tic Disorders (TD) in children, and to clarify the current evidence regarding the clinical application of acupuncture in the treatment of TD.

METHODS

Randomized controlled trials (RCTs) comparing acupuncture treatment with pharmaceutical treatment for TD were included in this review. A comprehensive search of 6 electronic literature databases was conducted, and the retrieval date was from the establishment of the database to April 2020. The Cochrane Collaboration's bias risk assessment tool was used to evaluate the bias risk of the included literature, and adopted the Review Manager 5.3 was used for statistical analysis of the data in the included literature.

RESULTS

A total of 22 RCTs (1668 participants) were included in this review. Meta-analysis indicated that acupuncture showed superior effects in the following aspects, including higher overall effective rate [RR = 1.20,95 % CI(1.09,1.20),P<0.00001], significant reduction in Yale Global Tic Severity Scale (YGTSS) scores [MD=-2.79,95 %CI(-4.75,-0.82),P = 0.005], lower incidence of adverse effects [RR = 0.26,95 %CI(0.17,0.41),P<0.00001], and reduced recurrence rate [RR = 0.28,95 %CI(0.17,0.46),P<0.00001].

CONCLUSION

Acupuncture treatment alone is more effective in the treatment of TD than pharmaceutical treatment, as seen in the reduction of YGTSS scores, fewer adverse effects and lower recurrence rates.

摘要

目的

系统评价针刺治疗儿童抽动障碍(TD)的临床疗效和安全性,明确针刺治疗 TD 的临床应用证据。

方法

纳入针刺治疗 TD 与药物治疗比较的随机对照试验(RCT)。全面检索 6 个电子文献数据库,检索日期自建库至 2020 年 4 月。采用 Cochrane 协作偏倚风险评估工具评价纳入文献的偏倚风险,采用 Review Manager 5.3 软件进行纳入文献数据的统计学分析。

结果

共纳入 22 项 RCT(1668 名参与者)。Meta 分析结果显示,针刺在以下方面具有更好的疗效,包括更高的总有效率[RR=1.20,95 %CI(1.09,1.20),P<0.00001]、显著降低耶鲁总体抽动严重程度量表(YGTSS)评分[MD=-2.79,95 %CI(-4.75,-0.82),P=0.005]、不良反应发生率更低[RR=0.26,95 %CI(0.17,0.41),P<0.00001]和复发率更低[RR=0.28,95 %CI(0.17,0.46),P<0.00001]。

结论

与药物治疗相比,针刺治疗 TD 可降低 YGTSS 评分,减少不良反应和降低复发率,疗效更优。

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