Meng Xiang-Ran, Cao Xue, Sun Ming-Lin, Deng Hui, He Li-Yun, Liu Jia
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
College of Acupuncture-Moxibustion and Tuina, Shaanxi University of CM.
Zhongguo Zhen Jiu. 2023 Feb 12;43(2):223-31. doi: 10.13703/j.0255-2930.20220526-k0002.
To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.
The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.
A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.
Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.
重新评估针灸治疗儿童孤独症（CA）的系统评价/Meta分析，旨在为临床诊断和治疗提供决策依据。
在PubMed、EMbase、Cochrane图书馆、中国生物医学文献数据库、中国知网和万方数据库中检索针灸治疗CA的系统评价和/或Meta分析。检索时间为各数据库建库至2022年5月5日。采用PRISMA（系统评价和Meta分析优先报告条目）评估报告质量，采用AMSTAR 2（系统评价质量评估工具2）评估方法学质量，采用气泡图构建证据图，采用GRADE评估证据质量。
共纳入9篇系统评价。PRISMA评分在13至26分之间。报告质量较低，在方案与注册、检索、其他分析和资助等方面严重欠缺。方法学方面的主要问题包括未制定预先指定的方案、检索策略不完整、未提供排除文献清单、对异质性分析和偏倚风险解释不完整。证据图显示，6个结论有效，2个结论可能有效，1个结论有效性不确定。证据总体质量较低，导致证据降级的主要因素是局限性，其次是不一致性、不精确性和发表偏倚。
针灸治疗CA有一定疗效，但纳入文献的报告质量、方法学质量和证据质量有待提高。建议未来开展高质量、规范化研究，以提供循证依据。
