Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China.
State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macau SAR, China.
Front Public Health. 2022 Apr 12;10:821781. doi: 10.3389/fpubh.2022.821781. eCollection 2022.
To evaluate the effects of Tuina (massage) vs. non-Tuina traditional Chinese medicine (TCM) treatments on nocturnal enuresis in children.
A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following the Preferred Reported Items for Systematic Review and Meta-analysis (PRISMA) guidelines. RevMan 5.3 software was used for meta-analysis.
Twelve RCTs recruiting a total of 1,007 children were included. Meta-analysis results showed that, compared with non-Tuina TCM treatments, Tuina could significantly improve the total effective rate of children's enuresis [RR = 1.29, 95%CI (1.22-1.36), < 0.00001]. The results of subgroup analyses indicated that the total effective rate of Tuina combined with acupuncture in the treatment of nocturnal enuresis was higher than acupuncture alone [RR = 1.24, 95%CI (1.12-1.37), < 0.0001]. The total effective rate of Tuina in the treatment of enuresis in children was better than that of herbal medicine alone [RR = 1.45, 95%CI (1.31-1.61), < 0.00001]. The total effective rate of Tuina combined with herbal medicine in the treatment of enuresis in children was better than that of herbal medicine alone [RR = 1.16, 95%CI (1.06-1.26), = 0.0007]. No adverse reactions of Tuina were reported in all included studies.
From the available evidence, Tuina, or Tuina combined with non-Tuina TCM treatments (acupuncture, or herbal medicine) can improve the clinical outcome of children with enuresis, indicating Tuina is a promising treatment choice for children's enuresis. However, because of the intrinsic limitations of the included studies, more high-quality randomized controlled trials with longer follow-up are still needed to further confirm the efficacy and safety of Tuina in the treatment of nocturnal enuresis in children.
评价推拿（按摩）与非推拿中医治疗儿童遗尿症的疗效。
按照系统评价和荟萃分析首选报告条目（PRISMA）指南，对随机对照试验（RCT）进行系统评价和荟萃分析。使用 RevMan 5.3 软件进行荟萃分析。
纳入 12 项 RCT 共 1007 名儿童。荟萃分析结果显示，与非推拿中医治疗相比，推拿能显著提高儿童遗尿症的总有效率[RR=1.29，95%CI（1.22-1.36），＜0.00001]。亚组分析结果表明，推拿结合针刺治疗遗尿症的总有效率高于单纯针刺[RR=1.24，95%CI（1.12-1.37），＜0.0001]。推拿治疗儿童遗尿症的总有效率优于单纯中药[RR=1.45，95%CI（1.31-1.61），＜0.00001]。推拿结合中药治疗儿童遗尿症的总有效率优于单纯中药[RR=1.16，95%CI（1.06-1.26），=0.0007]。所有纳入研究均未报告推拿的不良反应。
现有证据表明，推拿或推拿联合非推拿中医治疗（针刺或中药）可改善遗尿症患儿的临床疗效，提示推拿是治疗儿童遗尿症的一种有前途的选择。然而，由于纳入研究的固有局限性，仍需要更多高质量的、随访时间更长的随机对照试验，以进一步证实推拿治疗儿童遗尿症的疗效和安全性。
