{"title":"Pediatric Tuina for the treatment of functional dyspepsia: A systematic review and meta-analysis of randomized controlled trials.","authors":"Na-Yeon Ha, Chang-Yul Keum, Jinsung Kim","doi":"10.1016/j.ctim.2024.103117","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is the most prevalent pediatric gastrointestinal disorder, imposing a significant burden on healthcare services and often persisting into adulthood. Tuina, a traditional manual therapy, is frequently employed in the treatment of FD. This study aimed to systematically evaluate the efficacy and safety of Tuina in treating FD in children.</p><p><strong>Methods: </strong>A comprehensive search of 11 databases was conducted for randomized controlled trials (RCTs) published up to June 2022. Two independent reviewers screened the literature, extracted data, assessed the methodological quality of the RCTs using the Cochrane risk-of-bias tool, and performed meta-analysis using Review Manager software to quantify Tuina's efficacy.</p><p><strong>Results: </strong>The review covered ten RCTs with 1336 children. Tuina, alone or with conventional therapy (CT), significantly improved efficacy rates over CT alone (relative risk (RR) = 1.16, 95 % confidence interval (CI) [1.11, 1.21], p < 0.00001). The combined Tuina group demonstrated significantly lower overall dyspeptic symptom scores (standard mean difference (SMD) = -1.18, 95 % CI [-1.46, -0.91], p < 0.00001) and shorter times to resolution of primary symptoms, including abdominal distension (mean difference (MD) = -2.08, 95 % CI [-2.35, -1.81], p < 0.00001), abdominal pain (MD = -1.54, 95 % CI [-1.92, -1.17], p < 0.00001), belching (MD = -1.11, 95 % CI [-1.44, -0.77], p < 0.00001), and anorexia (MD = -1.37, 95 % CI [-1.67, -1.07], p < 0.00001). Additionally, the recurrence rate following treatment was significantly lower (RR = 0.32, 95 % CI [0.14, 0.72], p = 0.006). The levels of serum motilin (MD = 22.93, 95 % CI [13.56, 32.30], p < 0.00001) and urinary excretion of D-xylose (MD = 3.11, 95 % CI [0.31, 5.92], p = 0.03) were also elevated. There were no significant differences between the combined Tuina and CT groups regarding the four individual dyspeptic symptoms or neuropeptide Y levels. No adverse events were reported in the Tuina group.</p><p><strong>Conclusion: </strong>This systematic review collectively suggest that Tuina effectively and safely improves clinical symptoms in children with FD. However, addressing identified methodological weaknesses is crucial for future studies to ensure robust evidence.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103117"},"PeriodicalIF":3.3000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Complementary therapies in medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ctim.2024.103117","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Functional dyspepsia (FD) is the most prevalent pediatric gastrointestinal disorder, imposing a significant burden on healthcare services and often persisting into adulthood. Tuina, a traditional manual therapy, is frequently employed in the treatment of FD. This study aimed to systematically evaluate the efficacy and safety of Tuina in treating FD in children.
Methods: A comprehensive search of 11 databases was conducted for randomized controlled trials (RCTs) published up to June 2022. Two independent reviewers screened the literature, extracted data, assessed the methodological quality of the RCTs using the Cochrane risk-of-bias tool, and performed meta-analysis using Review Manager software to quantify Tuina's efficacy.
Results: The review covered ten RCTs with 1336 children. Tuina, alone or with conventional therapy (CT), significantly improved efficacy rates over CT alone (relative risk (RR) = 1.16, 95 % confidence interval (CI) [1.11, 1.21], p < 0.00001). The combined Tuina group demonstrated significantly lower overall dyspeptic symptom scores (standard mean difference (SMD) = -1.18, 95 % CI [-1.46, -0.91], p < 0.00001) and shorter times to resolution of primary symptoms, including abdominal distension (mean difference (MD) = -2.08, 95 % CI [-2.35, -1.81], p < 0.00001), abdominal pain (MD = -1.54, 95 % CI [-1.92, -1.17], p < 0.00001), belching (MD = -1.11, 95 % CI [-1.44, -0.77], p < 0.00001), and anorexia (MD = -1.37, 95 % CI [-1.67, -1.07], p < 0.00001). Additionally, the recurrence rate following treatment was significantly lower (RR = 0.32, 95 % CI [0.14, 0.72], p = 0.006). The levels of serum motilin (MD = 22.93, 95 % CI [13.56, 32.30], p < 0.00001) and urinary excretion of D-xylose (MD = 3.11, 95 % CI [0.31, 5.92], p = 0.03) were also elevated. There were no significant differences between the combined Tuina and CT groups regarding the four individual dyspeptic symptoms or neuropeptide Y levels. No adverse events were reported in the Tuina group.
Conclusion: This systematic review collectively suggest that Tuina effectively and safely improves clinical symptoms in children with FD. However, addressing identified methodological weaknesses is crucial for future studies to ensure robust evidence.
期刊介绍:
Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.