Mao Hui, Wei Yue-Hui, Su Hui-Ming, Jiang Zi-Yun, Li Xun
School of Humanities, Beijing University of Chinese Medicine, Beijing 100029, China.
Beijing Universality of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China.
Complement Ther Med. 2022 Dec;71:102882. doi: 10.1016/j.ctim.2022.102882. Epub 2022 Aug 27.
To evaluate the effectiveness and safety of pediatric Tui Na for the treatment of cough in children under seven years of age.
Systematic review and meta-analysis of randomized controlled trials.
We searched seven major databases and two ongoing trial registers before November 2021 for randomized controlled trials (RCTs) on pediatric Tui Na for cough in children. Main outcome measures were cough related status (such as cough frequency, severity, and duration), use of western medicines, quality of life, medical costs, recurrence rate, adverse events and acceptance. Two reviewers independently selected studies and extracted data. Results were presented by RevMan 5.4 as risk ratios (RRs) and mean differences (MDs), both with 95 % confidence intervals (CIs). Risk of bias were assessed using ROB tools and quality of evidence by GRADE.
Sixteen RCTs involving 1502 participants were included in this review. Most trials were poor in quality for not reporting allocation concealment, blinding of outcomeassessment or outcome data completeness. The pooled results demonstrated that pediatric Tui Na alone (2 RCTs, 205 participants; MD -2.22, 95 %CI -3.71 to -0.73; P = 0.004; I = 90 %; low certainty) or combined with conventional treatment (7 RCTs, 668 participants; MD -1.66, 95 %CI -2.89 to -0.44; P = 0.008; I = 98 %; low certainty) shortened cough duration. The combined treatment also decreased the recurrence rate of cough (3 RCTs, 135 participants; RR 0.35, 95 %CI 0.21-0.58; P < 0.0001; I = 0 %; moderate certainty). There were insufficient data on adverse events.
This review indicates that pediatric Tui Na may shorten the course and decrease the recurrence rate of cough in children, and appears to be relatively safe. However, large-sample, multi-center and high-quality RCTs are warranted to confirm these findings.
评估小儿推拿治疗7岁以下儿童咳嗽的有效性和安全性。
随机对照试验的系统评价和荟萃分析。
我们在2021年11月之前检索了七个主要数据库和两个正在进行的试验注册库，以查找关于小儿推拿治疗儿童咳嗽的随机对照试验（RCT）。主要结局指标包括咳嗽相关状况（如咳嗽频率、严重程度和持续时间）、西药使用情况、生活质量、医疗费用、复发率、不良事件和接受度。两名评价员独立选择研究并提取数据。结果由RevMan 5.4以风险比（RR）和均值差（MD）表示，并均带有95%置信区间（CI）。使用ROB工具评估偏倚风险，并用GRADE评估证据质量。
本评价纳入了16项RCT，涉及1502名参与者。大多数试验质量较差，未报告分配隐藏、结局评估盲法或结局数据完整性。汇总结果表明，单独使用小儿推拿（2项RCT，205名参与者；MD -2.22，95%CI -3.71至-0.73；P = 0.004；I² = 90%；低确定性）或与传统治疗联合使用（7项RCT，668名参与者；MD -1.66，95%CI -2.89至-0.44；P = 0.008；I² = 98%；低确定性）可缩短咳嗽持续时间。联合治疗还降低了咳嗽复发率（3项RCT，135名参与者；RR 0.35，95%CI 0.21 - 0.58；P < 0.0001；I² = 0%；中等确定性）。关于不良事件的数据不足。
本评价表明，小儿推拿可能缩短儿童咳嗽病程并降低复发率，且似乎相对安全。然而，需要大样本、多中心和高质量的RCT来证实这些发现。
