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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24.	高桂奇. 推拿治疗婴幼儿轮状病毒性肠炎临床观察. 中医药临床杂志, 2005, 17(3): 267-268.
25.	李明. 辨证分型推拿治疗对腹泻患儿的临床效果及胃肠激素产生的影响. 中国医学创新, 2020, 17(4): 93-96.
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28.	周可林, 国生, 董硕, 等. 基于数据挖掘技术探讨推拿手法在腹泻治疗中的选穴配伍规律. 北京中医药, 2020, 39(10): 1082-1086.

1. 王卫平, 孙锟, 常立文. 儿科学(第 9 版). 北京: 人民卫生出版社, 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. 公共卫生科学数据中心. 其他感染性腹泻病. Available at: http://www.phsciencedata.cn/Share/index.html?766c8437-9d73-4360-aa40-47c420767105.
5. 廖品东. 小儿推拿学(第 2 版). 北京: 人民卫生出版社, 2016: 2-11.
6. 彭蓉晏, 王瑞婷, 程诺, 等. 小儿推拿治疗 12 岁以下儿童迁延性、慢性腹泻随机对照试验的系统综述及 GRADE 评价. 中医杂志, 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. 司梦冉, 蔡君豪, 王文奕, 等. 推拿与蒙脱石散治疗小儿腹泻效果比较的 Meta 分析. 中国医药导报, 2016, 13(19): 76-79.
9. 白金凤. 推拿治疗小儿腹泻的系统评价. 成都: 成都中医药大学, 2014.
10. 郭秀琴, 王艳国, 曾庆云. 推拿治疗小儿腹泻系统评价. 中医杂志, 2012, 53(14): 1198-1201.
11. 来保勇. 推拿治疗小儿腹泻的循证证据分析与评价. 北京: 北京中医药大学, 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, 严晓慧. 益气补脾手法治疗小儿脾虚腹泻临床研究. 中医学报, 2014, 29(3): 444-445.
14. 孙士丹. 三字经流派推拿治疗小儿泄泻(湿热型)的临床疗效观察. 福州: 福建中医药大学, 2012.
15. 尤晓燕. 推拿治疗婴幼儿腹泻32例疗效观察. 中国中西医结合儿科学, 2013, (5): 423-424, 425.
16. 李正. 推拿治疗伤食型非感染性小儿腹泻的临床研究. 济南: 山东中医药大学, 2009.
17. 梁锦俊. 虚实推拿治疗小儿急性非细菌感染性腹泻的临床研究. 广州: 广州中医药大学, 2010.
18. 周鸿雁, 徐秀敏. 中医推拿疗法对腹泻患儿免疫功能和炎性因子的影响. 实用中医内科杂志, 2020, 34(4): 69-72.
19. 郭安余. 推拿联合妈咪爱治疗小儿腹泻临床观察. 中华养生保健, 2020, 38(9): 175-176.
20. 李江全, 徐珊, 汪受传, 等. 推拿治疗小儿泄泻 271 例临床研究. 中华中医药学会儿科分会: 第三十次学术大会论文汇编, 2013: 4.
21. 杨元平, 张艳梅. 推拿治疗小儿非感染性腹泻临床研究. 中医学报, 2013, 28(11): 1763, 1765.
22. 汤伟, 符明进, 李洲进. 刘氏小儿推拿法治疗小儿伤食泻 45 例. 湖南中医杂志, 2011, 27(5): 73-74.
23. 王华强. 中医推拿按摩治疗小儿消化不良性腹泻的临床疗效观察. 智慧健康, 2020, 6(11): 195-196.
24. 高桂奇. 推拿治疗婴幼儿轮状病毒性肠炎临床观察. 中医药临床杂志, 2005, 17(3): 267-268.
25. 李明. 辨证分型推拿治疗对腹泻患儿的临床效果及胃肠激素产生的影响. 中国医学创新, 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. 王军. 中医推拿按摩治疗小儿消化不良性腹泻的临床效果. 医学食疗与健康, 2020, 18(1): 41-42.
28. 周可林, 国生, 董硕, 等. 基于数据挖掘技术探讨推拿手法在腹泻治疗中的选穴配伍规律. 北京中医药, 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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