Pu Tong, Liu Yu, Wang Junxia, Zhang Jieying, Zhang Jinhao, Ran Zhiling, Sheng Qiaoni, Yi Zhiqiang, Ye Jiansong, Li Yanling, Wang Xijun, Chi Hao, Luo Wei
College of Acupuncture and Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China.
Department of Oncology, Chongqing General Hospital, Chongqing, China.
Front Neurosci. 2023 Apr 17;17:1156308. doi: 10.3389/fnins.2023.1156308. eCollection 2023.
Tic disorders (TD) are a kind of neuropsychiatric disease that frequently occur among preschool and school-age children, mainly characterized by motor tics or sometimes accompanied by vocal tics, and its pathogenesis is still unclear. The clinical manifestations are mainly characterized by chronic multiple movements, rapid muscle twitching, involuntary occurrence, and language disorder. Acupuncture, tuina, traditional Chinese medicine, and other methods are commonly used in clinical treatments, which have unique therapeutic advantages but have not been recognized and accepted by the international community. This study conducted a quality evaluation and meta-analysis of the currently published randomized controlled trials (RCTs) of acupuncture for TD in children in order to provide reliable evidence-based medical evidence for acupuncture for TD.
All the randomized controlled trials (RCTs) using the intervention methods acupuncture + traditional Chinese medical herbs, acupuncture + tuina, and acupuncture, and the control group using Western medicine were included in the analysis. The main outcomes were obtained by using the Yale Global Tic Severity Scale (YGTSS), the Traditional Chinese medicine (TCM) syndrome score scale, and clinical treatment efficiency. Secondary outcomes included adverse events. The risk of bias in the included studies was assessed according to the tool recommended by Cochrane 5.3. The risk of bias assessment chart, risk of bias summary chart, and evidence chart in this study will be produced using R and Stata software.
There were 39 studies that met the inclusion criteria, including 3,038 patients. In terms of YGTSS, the TCM syndrome score scale changes and shows a clinically effective rate, and we found that acupuncture combined with Chinese medicine is the best treatment.
Acupuncture + traditional Chinese medical herbs may be the best therapy to improve TD in children. At the same time, compared with Western medicine commonly used in clinical practice, acupuncture and acupuncture combined with tuina therapy have better effects on improving TD in children.
抽动障碍（TD）是一种常见于学龄前和学龄儿童的神经精神疾病，主要表现为运动抽动，有时伴有发声抽动，其发病机制尚不清楚。临床表现主要为慢性多发性运动、快速肌肉抽搐、不由自主发作以及语言障碍。针灸、推拿、中药等方法在临床治疗中常用，具有独特的治疗优势，但尚未得到国际社会的认可和接受。本研究对目前已发表的儿童抽动障碍针灸随机对照试验（RCT）进行质量评估和荟萃分析，以便为抽动障碍的针灸治疗提供可靠的循证医学证据。
纳入所有采用针灸+中药、针灸+推拿、针灸干预方法以及采用西药作为对照组的随机对照试验（RCT）进行分析。主要结局通过耶鲁全球抽动严重程度量表（YGTSS）、中医证候评分量表和临床治疗有效率获得。次要结局包括不良事件。根据Cochrane 5.3推荐的工具评估纳入研究的偏倚风险。本研究的偏倚风险评估图、偏倚风险汇总图和证据图将使用R和Stata软件制作。
有39项研究符合纳入标准，包括3038例患者。在YGTSS、中医证候评分量表变化及临床有效率方面，我们发现针灸结合中药是最佳治疗方法。
针灸+中药可能是改善儿童抽动障碍的最佳疗法。同时，与临床常用的西药相比，针灸及针灸结合推拿疗法在改善儿童抽动障碍方面效果更好。
