Efficacy and safety of pediatric tuina for children with acute diarrhea: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Qiuyu ¹ , CAO Xiao ¹ , ZHANG Qian ¹ , HOU Liangying ^2,3 , WANG Qi ^2,3 ,  GE Long ^2,3,4,5 , on behalf of Trustworthy Traditional Chinese Medicine Recommendations (TCM Recs) Working Group

1. Evidence Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou 730000, P.R.China;
2. Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P.R.China;
3. Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, P.R.China;
4. WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou 730000, P.R.China;
5. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, P.R.China;

Corresponding?author：

GE Long, Email: gelong2009@163.com

Keywords：

Pediatric tuina; Children Acute diarrhea; Randomized controlled trial; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202102099

Video：

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Objective To systematically review the efficacy and safety of pediatric tuina in the treatment of children with acute diarrhea.Methods CNKI, 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 20^th, 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.Results A 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).Conclusions Current 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.

Citation： YANG Qiuyu, CAO Xiao, ZHANG Qian, HOU Liangying, WANG Qi, GE Long, on behalf of Trustworthy Traditional Chinese Medicine Recommendations (TCM Recs) Working Group. Efficacy and safety of pediatric tuina for children with acute diarrhea: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(7): 832-838. doi: 10.7507/1672-2531.202102099 Copy

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22.	湯偉, 符明進, 李洲進. 劉氏小兒推拿法治療小兒傷食瀉 45 例. 湖南中醫雜志, 2011, 27(5): 73-74.
23.	王華強. 中醫推拿按摩治療小兒消化不良性腹瀉的臨床療效觀察. 智慧健康, 2020, 6(11): 195-196.
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25.	李明. 辨證分型推拿治療對腹瀉患兒的臨床效果及胃腸激素產生的影響. 中國醫學創新, 2020, 17(4): 93-96.
26.	Lu T, Yin L, Chen R, et al. Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial. Health Qual Life Outcomes, 2021, 19(1): 4.
27.	王軍. 中醫推拿按摩治療小兒消化不良性腹瀉的臨床效果. 醫學食療與健康, 2020, 18(1): 41-42.
28.	周可林, 國生, 董碩, 等. 基于數據挖掘技術探討推拿手法在腹瀉治療中的選穴配伍規律. 北京中醫藥, 2020, 39(10): 1082-1086.

1. 王衛平, 孫錕, 常立文. 兒科學(第 9 版). 北京: 人民衛生出版社, 2018: 226.
2. WHO. Diarrhea disease. Available at: http://www.who.Int/mediacentre/factsheets/fs330/en/.
3. Local Burden of Disease Diarrhoea Collaborators. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017. Lancet, 2020, 395(10239): 1779-1801.
4. 公共衛生科學數據中心. 其他感染性腹瀉病. Available at: http://www.phsciencedata.cn/Share/index.html?766c8437-9d73-4360-aa40-47c420767105.
5. 廖品東. 小兒推拿學(第 2 版). 北京: 人民衛生出版社, 2016: 2-11.
6. 彭蓉晏, 王瑞婷, 程諾, 等. 小兒推拿治療 12 歲以下兒童遷延性、慢性腹瀉隨機對照試驗的系統綜述及 GRADE 評價. 中醫雜志, 2018, 59(20): 1747-1752.
7. Gao L, Jia C, Huang H. Paediatric massage for treatment of acute diarrhoea in children: a meta-analysis. BMC Complement Altern Med, 2018, 18(1): 257.
8. 司夢冉, 蔡君豪, 王文奕, 等. 推拿與蒙脫石散治療小兒腹瀉效果比較的 Meta 分析. 中國醫藥導報, 2016, 13(19): 76-79.
9. 白金鳳. 推拿治療小兒腹瀉的系統評價. 成都: 成都中醫藥大學, 2014.
10. 郭秀琴, 王艷國, 曾慶云. 推拿治療小兒腹瀉系統評價. 中醫雜志, 2012, 53(14): 1198-1201.
11. 來保勇. 推拿治療小兒腹瀉的循證證據分析與評價. 北京: 北京中醫藥大學, 2019.
12. Higgins JPT, Green S. Cochrane Handbook for systematic reviews of interventions (version 5.1. 0). The Cochrane Collaboration, 2011. Available at: http://www.cochrane-handbook.org.
13. 唐英, 尚清, 嚴曉慧. 益氣補脾手法治療小兒脾虛腹瀉臨床研究. 中醫學報, 2014, 29(3): 444-445.
14. 孫士丹. 三字經流派推拿治療小兒泄瀉(濕熱型)的臨床療效觀察. 福州: 福建中醫藥大學, 2012.
15. 尤曉燕. 推拿治療嬰幼兒腹瀉32例療效觀察. 中國中西醫結合兒科學, 2013, (5): 423-424, 425.
16. 李正. 推拿治療傷食型非感染性小兒腹瀉的臨床研究. 濟南: 山東中醫藥大學, 2009.
17. 梁錦俊. 虛實推拿治療小兒急性非細菌感染性腹瀉的臨床研究. 廣州: 廣州中醫藥大學, 2010.
18. 周鴻雁, 徐秀敏. 中醫推拿療法對腹瀉患兒免疫功能和炎性因子的影響. 實用中醫內科雜志, 2020, 34(4): 69-72.
19. 郭安余. 推拿聯合媽咪愛治療小兒腹瀉臨床觀察. 中華養生保健, 2020, 38(9): 175-176.
20. 李江全, 徐珊, 汪受傳, 等. 推拿治療小兒泄瀉 271 例臨床研究. 中華中醫藥學會兒科分會: 第三十次學術大會論文匯編, 2013: 4.
21. 楊元平, 張艷梅. 推拿治療小兒非感染性腹瀉臨床研究. 中醫學報, 2013, 28(11): 1763, 1765.
22. 湯偉, 符明進, 李洲進. 劉氏小兒推拿法治療小兒傷食瀉 45 例. 湖南中醫雜志, 2011, 27(5): 73-74.
23. 王華強. 中醫推拿按摩治療小兒消化不良性腹瀉的臨床療效觀察. 智慧健康, 2020, 6(11): 195-196.
24. 高桂奇. 推拿治療嬰幼兒輪狀病毒性腸炎臨床觀察. 中醫藥臨床雜志, 2005, 17(3): 267-268.
25. 李明. 辨證分型推拿治療對腹瀉患兒的臨床效果及胃腸激素產生的影響. 中國醫學創新, 2020, 17(4): 93-96.
26. Lu T, Yin L, Chen R, et al. Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial. Health Qual Life Outcomes, 2021, 19(1): 4.
27. 王軍. 中醫推拿按摩治療小兒消化不良性腹瀉的臨床效果. 醫學食療與健康, 2020, 18(1): 41-42.
28. 周可林, 國生, 董碩, 等. 基于數據挖掘技術探討推拿手法在腹瀉治療中的選穴配伍規律. 北京中醫藥, 2020, 39(10): 1082-1086.

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Efficacy and safety of pediatric tuina for children with acute diarrhea: a meta-analysis

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