Pediatric Tuina for the treatment of functional dyspepsia: A systematic review and meta-analysis of randomized controlled trials

IF 3.3 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine Pub Date : 2024-12-09 DOI:10.1016/j.ctim.2024.103117

Na-Yeon Ha , Chang-Yul Keum , Jinsung Kim

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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.

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小儿推拿治疗功能性消化不良：随机对照试验的系统回顾和荟萃分析。

背景：功能性消化不良（FD）是最常见的儿科胃肠道疾病，给医疗保健服务带来了巨大的负担，并经常持续到成年。推拿是一种传统的手工疗法，常用于FD的治疗。本研究旨在系统评价推拿治疗小儿FD的疗效和安全性。方法：对11个数据库进行全面检索，检索截至2022年6月发表的随机对照试验（rct）。两名独立审稿人筛选文献，提取数据，使用Cochrane风险偏倚工具评估随机对照试验的方法学质量，并使用Review Manager软件进行meta分析以量化Tuina的疗效。结果：本综述涵盖了10项随机对照试验，共1336名儿童。单独推拿或联合常规治疗（CT）较单独推拿有效率显著提高(相对危险度（RR) = 1.16, 95%可信区间（CI） [1.11, 1.21], p < 0.00001）。综合推拿组总体消化不良症状评分明显降低（标准平均差值(SMD) = -1.18, 95% CI [-1.46, -0.91], p < 0.00001），主要症状缓解时间较短，包括腹胀（平均差值(MD) = -2.08, 95% CI [-2.35, -1.81], p < 0.00001），腹痛（MD = -1.54, 95% CI [-1.92, -1.17], p < 0.00001），打嗝（MD = -1.11, 95% CI [-1.44, -0.77], p < 0.00001），厌食（MD = -1.37, 95% CI[-1.67, -1.07]）。P < 0.00001)。治疗后复发率明显降低（RR = 0.32, 95% CI [0.14, 0.72], p = 0.006）。血清胃动素水平（MD = 22.93, 95% CI [13.56, 32.30], p < 0.00001）和尿d -木糖排泄量（MD = 3.11, 95% CI [0.31, 5.92], p = 0.03）也升高。联合推拿组与CT组在四种个体消化不良症状或神经肽Y水平上无显著差异。推拿组无不良事件发生。结论：本系统综述提示推拿可有效、安全地改善FD患儿的临床症状。然而，解决已确定的方法学弱点对未来的研究至关重要，以确保有力的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Complementary therapies in medicine 医学-全科医学与补充医学

CiteScore

8.60

自引率

2.80%

发文量

101

审稿时长

112 days

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.