ObjectiveTo systematically review the efficacy and safety of pediatric tuina in the treatment of children with acute diarrhea.MethodsCNKI, VIP, WanFang Data, CBM, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on the treatment of children acute diarrhea with tuina from inception to November 20th, 2020. Two researchers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 15 RCTs involving 1 464 children were included. The results of meta-analysis showed that compared with Western medicine, tuina for children with acute diarrhea could increase the cure rate (RR=1.43, 95%CI 1.26 to 1.63, P<0.001), shorten the time for the frequency of diarrhea to return to normal (MD=?0.86, 95%CI ?1.05 to ?0.66, P<0.001) and the time for stool traits to return to normal (MD=?1.07, 95%CI ?1.15 to ?0.99, P<0.001). There was no statistically significant difference in the incidence of adverse reactions between tuina and Western medicine (RR=0.25, 95%CI 0.03 to 2.23, P=0.22).ConclusionsCurrent evidence shows that tuina has a superior effect on treating children with acute diarrhea, the incidence of adverse reactions is not increased. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.
ObjectivesTo overview the systematic reviews/meta-analyses (SRs/MAs) of effectiveness and safety of spinal manipulation for low back pain or neck pain. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015), CBM, CNKI, WanFang Data and VIP to collect SRs/MAs of spinal manipulation for low back pain or neck pain from inception to January 30th, 2015. Two reviewers independently screened literature, extracted data, and then AMSTAR tool was used to assess the methodological quality of included SRs/MAs. ResultsA total of 21 SRs/MAs were included. Twenty of them assessed the methodological quality of included original randomized controlled trials (RCTs) with different tools:2 used Jadad scale, 5 used PEDro scale, 6 used Cochrane bias risk assessment tool and 7 used other tools. The assessment results of AMSTAR tool suggested that:among 11 items, the item 1 of "Was an ‘a priori’ design provided" (18 SRs/MAs did not provide) and item 4 of "Was a list of studies (included and excluded) provided" (18 SRs/MAs did not provide) appeared to be the most problematic, followed by item 10 of "Was the likelihood of publication bias assessed" (14 SRs/MAs did not assess the publication bias) and item 11 of "Was the conflict of interest stated" (14 SRs/MAs did not provide the conflict of interest and 4 were incomplete). ConclusionThe methodological quality of included SRs/MAs is poor. The limited evidence showed that spinal manipulation is more effective for acute low back pain than chronic low back pain, and the short term effect is better than the long term one. Different spinal manipulation techniques have various effects but are all safe. Chiropractic manipulation may have the best effect. Due to the limitation of quality and quantity of included SRs/MAs, there may be potential bias in the above conclusion that needs more high quality studies to verify.
ObjectivesTo conduct an overview of systematic reviews (SRs) on Tuina from 2013 to 2017, and to explore recent research improvements on Tuina.MethodsPubMed, Web of Science, The Cochrane Library, SpringerLink e-book database, CNKI, VIP, WanFang Data and CBM databases were searched to collect SRs including randomized controlled clinical trials on Tuina from January 1st, 2013 to December 31st, 2017. Two reviewers independently screened literature, extracted data, and used AMSTAR 2 tool and PRISMA statement to assess methodology quality and reporting quality of included studies, respectively. The R 3.4.3 software was used to analyze data.ResultsA total of 8 SRs studies were included in the overview. The studied diseases involved radiculopathy cervical spondylotic, myelopathy cervical spondylotic, constipation, child anorexia, child diarrhea and external humeral epicondylitis. The results of above SRs showed that massage might be superior to other interventions in clinical efficacy, curative effects or total effective rate. However, due to the low quality of included studies of SRs, further evidence from high-quality clinical studies is required to verify above conclusions. For the results of AMSTAR 2 assessment, all 8 SRs were rated as very low quality. The quantity of items accomplished for each SR ranged from 7 to 13, 2 SRs had low methodological quality (percentage of accomplishment or partial accomplishment <50.0%) and 6 SRs with high methodological quality (percentage of accomplishment or partial accomplishment ≥50.0%). All 8 SRs did not report item 2 "Whether to declare research methods", item 10 "Whether reports have included funding sources for each study" and item 11 "Whether reports used the correct statistical method". The results of PRISMA assessment showed that all SR had good quality of reporting. The accomplished items number of each SR ranged from 22 to 26. However, there were defects in item 5(0), item 16(25.0%) and item 23(25.0%). All SRs did not report item 5 "Whether to declare research program".ConclusionsThis study finds that Tuina has supportive evidence-based medical evidence for treating anorexia, cervical spondylosis and other diseases, however, the SRs of Tuina are yet needed to be improved in terms of standardized degree. Therefore, establishing a reporting consolidated standard for evidence-based medicine on Tuina in order to improve the quality of clinical studies so as to provide clinicians with high-quality evidence is the focus of our further research.
Based on the existing clinical research of pediatric Tuina, this paper introduced the current types of pediatric Tuina and their applications in the aspect of growth of newborn babies, emotion problems, pain, respiratory system diseases, digestive system diseases, jaundice, brain and nerve system diseases. As for the clinical researches of pediatric Tuina, the authors found the challenges including different understandings of pediatric Tuina, poor quality of clinical researches, and lack of basic data regarding pediatric Tuina. Meanwhile, the authors suggested three corresponding strategies to improve the clinical researches, i.e. to extract valuable intervention methods based on clinical practice; to conduct high quality clinical studies; to gradually collect and accumulate basic data according to a certain plan.
目的 探討陽性激發點推拿聯合依托芬那酯凝膠治療對頸肩背肌筋膜炎的臨床療效。 方法 收集2011年2月－10月確診為頸肩背肌炎的患者52例，采用隨機對照試驗,其中26例采用依托芬那酯凝膠加陽性激發點推拿（治療組），另外26例采用傳統推拿進行常規推拿手法治療（對照組）。對兩組患者5次治療后的療效率、每次治療后的疼痛面譜量化評分、7個月后隨訪疼痛復發率等療效進行對照分析。 結果 治療組和對照組經連續治療5次后，總有效率分別為96.15%和80.77%，差異均有統計學意義（P＜0.05）；疼痛面譜量化評分治療組在第一次治療后就較對照組改善明顯，差異有統計學意義（P＜0.05）；7個月后隨訪疼痛復發人數治療組較對照組少，差異有統計學意義（P＜0.05）。 結論 陽性激發點推拿聯合依托芬那酯凝膠治療方案對改善頸肩背肌筋膜炎引發的頸肩背部疼痛不適等癥狀優于傳統推拿組，值得臨床推廣運用。
目的 探討陽性激發點推拿治療對足底筋膜炎的臨床療效。 方法 對2011年3月－8月門診確診為足底筋膜炎的52例患者，采用隨機方式分為治療組和對照組各26例，治療組采用陽性激發點推拿，對照組采用電針治療。并對兩組患者治療5次后的即時療效率、日本骨科學會（JOA）足底治療療效評分、每次治療后的疼痛面譜量化評分、3個月隨訪疼痛復發率等療效進行對照分析。 結果 治療組和對照組經連續治療5次后，其JOA足底治療療效評分分別為（91.32 ± 10.61）、（82.92 ± 13.61）分，總有效率分別為96.15%、80.77%，差異均有統計學意義（P＜0.05）。疼痛面譜量化評分，治療組在第一次治療后較對照組改善明顯，差異有統計學意義（P＜0.05）。3個月后隨訪疼痛復發情況，治療組復發人數較對照組少，差異有統計學意義（P＜0.05）。結論 陽性激發點推拿治療法對改善足底筋膜炎引發的足底疼痛、步行不適等癥狀優于電針治療法，值得臨床推廣運用。
Acute diarrhea has a high incidence in children. Pediatric tuina has been widely used in children with acute diarrhea in China. However, there is no guideline on the treatment of tuina for children with acute diarrhea. This guideline was developed following evidence-based principles and the World Health Organization handbook for guideline development. The linked systematic review was conducted following the Cochrane handbook. The quality of evidence and the strength of recommendations were evaluated using the GRADE approach. The reporting followed the RIGHT statement. Seven clinical questions (2 foreground questions and 5 background questions) were identified by literature review and expert consensus. Based on the linked systematic review and through comprehensive consideration of the balance of benefit and harm, quality of evidence, patient preferences, and other resources, we formulated the recommendations using Delphi expert consensus. We suggested combination of a weak recommendation for tuina with Western medicine usual care to treat children with acute diarrhea. This guideline can be used by clinicians and nurses in the department of traditional Chinese medicine pediatrics, and department of pediatric tuina, and can also be used as a reference for relevant clinicians of Western medicine and is also applicable to all institutions that practice tuina treatment.
【摘要】 目的 觀察循膀胱經彈撥法干預亞健康狀態方案的療效及優勢，并規范其技術標準，為臨床提供安全有效的治療技術范例。 方法 2009年3月-2010年8月，采用多中心、分層區組隨機、平行對照的臨床研究方法，選擇亞健康狀態受試者360例，隨機分為傳統組、彈撥組、復合組，每組120例。觀察受試者干預前后的臨床癥狀積分、血沉、血漿乳酸、全血黏度（切變率分別為1、5、30、200/s）的變化，及有效性和安全性。 結果 共305例完成試驗，其中傳統組97例，彈撥組102例，復合組106例。彈撥組、復合組的總體療效與傳統組比較差異有統計學意義（Plt;0.05），彈撥組與復合組比較差異無統計學意義（Plt;0.05）。干預后彈撥組、復合組的臨床癥狀積分、血沉、血漿乳酸、全血黏度與傳統組比較差異有統計學意義（Plt;0.05）；彈撥組與復合組臨床癥狀積分、血液乳酸全血黏度（切變率分別為1、200/s）差異無統計學意義（Pgt;0.05），血沉、全血黏度（切變率分別為5、30/s）差異有統計學意義（Plt;0.05）。各組各指標干預后前后自身比較差異均有統計學意義（Plt;0.05）。 結論 推拿能有效地改善亞健康狀態，復合組療效最佳，彈撥組其次，傳統組較差。循膀胱經彈撥法對亞健康狀態的干預有效性較傳統推拿更好。【Abstract】 Objective To observe the efficacy and advantages of flicking and poking along bladder channels in intervening sub-health state and regulate the technical standards for clinical treatment techniques, in order to provide safe and effective treatment criteria. Methods Multi-centered, stratified randomized and parallel controlled clinical research methods were adopted in this study. From March 2009 to August 2010, 360 subjects with sub-health status were randomly divided into traditional group, flicking and poking group, and combining group with 120 cases in each group. The changes of clinical symptoms, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity (shear rates of 1, 5, 30, 200/s) as well as the efficacy and safety were observed. Results A total of 305 patients completed the trial, including 97 in the traditional group, 102 in the flicking and poking group, and 106 in the combining group. The general efficacy for the flicking and poking group and the combining group was significantly different from that for the traditional group (Plt;0.05), while there was no significant difference between the flicking and poking group and the combining group. After the intervention, the clinical symptom score, erythrocyte sedimentation rate, plasma lactate, and whole blood viscosity of the flicking and poking group and the combining group were significantly different from those of the traditional group (Plt;0.05). The clinical symptom score, plasma lactate and whole blood viscosity (shear rates of 1, 200/s) of the flicking and poking group and the combining group were not significantly different (Pgt;0.05), while erythrocyte sedimentation rate, and whole blood viscosity (shear rates of 5, 30/s) between those two groups were significantly different (Plt;0.05). All the above mentioned indexes before and after intervention in each group were statistically different (Plt;0.05). Conclusion Massage can improve the sub-health state, and the combining method has the best efficacy followed by flicking and poking, while traditional method has a poor efficacy. Intervening sub-health state with flicking and poking along bladder channels has a better efficacy than the traditional method of massage.
ObjectivesTo evaluate the clinical efficacy of massage in the treatment of primary dysmenorrhea (PD).MethodsCNKI, VIP, WanFang Data, CBM, The Cochrane Library, PubMed and EMbase databases were searched to collect randomized controlled trials (RCTs) on the treatment of primary dysmenorrhea from inception to January 6th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. RevMan 5.3 software was used for meta-analysis.ResultsA total of 10 RCTs were included, including 758 patients with PD. Meta-analysis results showed that the total effective rate (RR=1.14, 95% CI 1.03 to 1.26, P<0.000 01; RR=1.24, 95% CI 1.15 to 1.34, P<0.000 01) and the dysmenorrhea symptom score (MD=–2.59, 95% CI –3.08 to –2.29, P<0.000 1) in massage group were superior to the control group.ConclusionCurrent evidence suggests that massage for PD has certain advantages. However, due to the limited quality of the included studies, high-quality clinical trials are required to further verify the clinical efficacy of massage in the treatment of primary dysmenorrhea.