目的 探讨阳性激发点推拿联合依托芬那酯凝胶治疗对颈肩背肌筋膜炎的临床疗效。 方法 收集2011年2月－10月确诊为颈肩背肌炎的患者52例，采用随机对照试验,其中26例采用依托芬那酯凝胶加阳性激发点推拿（治疗组），另外26例采用传统推拿进行常规推拿手法治疗（对照组）。对两组患者5次治疗后的疗效率、每次治疗后的疼痛面谱量化评分、7个月后随访疼痛复发率等疗效进行对照分析。 结果 治疗组和对照组经连续治疗5次后，总有效率分别为96.15%和80.77%，差异均有统计学意义（P＜0.05）；疼痛面谱量化评分治疗组在第一次治疗后就较对照组改善明显，差异有统计学意义（P＜0.05）；7个月后随访疼痛复发人数治疗组较对照组少，差异有统计学意义（P＜0.05）。 结论 阳性激发点推拿联合依托芬那酯凝胶治疗方案对改善颈肩背肌筋膜炎引发的颈肩背部疼痛不适等症状优于传统推拿组，值得临床推广运用。
目的 探讨阳性激发点推拿治疗对足底筋膜炎的临床疗效。 方法 对2011年3月－8月门诊确诊为足底筋膜炎的52例患者，采用随机方式分为治疗组和对照组各26例，治疗组采用阳性激发点推拿，对照组采用电针治疗。并对两组患者治疗5次后的即时疗效率、日本骨科学会（JOA）足底治疗疗效评分、每次治疗后的疼痛面谱量化评分、3个月随访疼痛复发率等疗效进行对照分析。 结果 治疗组和对照组经连续治疗5次后，其JOA足底治疗疗效评分分别为（91.32 ± 10.61）、（82.92 ± 13.61）分，总有效率分别为96.15%、80.77%，差异均有统计学意义（P＜0.05）。疼痛面谱量化评分，治疗组在第一次治疗后较对照组改善明显，差异有统计学意义（P＜0.05）。3个月后随访疼痛复发情况，治疗组复发人数较对照组少，差异有统计学意义（P＜0.05）。结论 阳性激发点推拿治疗法对改善足底筋膜炎引发的足底疼痛、步行不适等症状优于电针治疗法，值得临床推广运用。
【摘要】 目的 观察循膀胱经弹拨法干预亚健康状态方案的疗效及优势，并规范其技术标准，为临床提供安全有效的治疗技术范例。 方法 2009年3月-2010年8月，采用多中心、分层区组随机、平行对照的临床研究方法，选择亚健康状态受试者360例，随机分为传统组、弹拨组、复合组，每组120例。观察受试者干预前后的临床症状积分、血沉、血浆乳酸、全血黏度（切变率分别为1、5、30、200/s）的变化，及有效性和安全性。 结果 共305例完成试验，其中传统组97例，弹拨组102例，复合组106例。弹拨组、复合组的总体疗效与传统组比较差异有统计学意义（Plt;0.05），弹拨组与复合组比较差异无统计学意义（Plt;0.05）。干预后弹拨组、复合组的临床症状积分、血沉、血浆乳酸、全血黏度与传统组比较差异有统计学意义（Plt;0.05）；弹拨组与复合组临床症状积分、血液乳酸全血黏度（切变率分别为1、200/s）差异无统计学意义（Pgt;0.05），血沉、全血黏度（切变率分别为5、30/s）差异有统计学意义（Plt;0.05）。各组各指标干预后前后自身比较差异均有统计学意义（Plt;0.05）。 结论 推拿能有效地改善亚健康状态，复合组疗效最佳，弹拨组其次，传统组较差。循膀胱经弹拨法对亚健康状态的干预有效性较传统推拿更好。【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 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.
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.
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.
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.
ObjectivesTo evaluate the methodology quality and report quality of the published systematic reviews/meta-analyses (SRs/MAs) of pediatric tuina domestically and abroad.MethodsCBM, VIP, CNKI, WanFang Data, PubMed, EMbase, and The Cochrane Library were electronically searched to collect published pediatric tuina SRs/MAs from inception to December 10th, 2018. The SRs/MAs which includes scale evaluation used AMSTAR2 and the PRISMA report quality evaluation tool to systematically review methodology, adopts Excel to carry out data collation and statistical analysis. ResultsA total of 18 studies (14 in Chinese and 4 in English) on the SRs/MAs of pediatric tuina were finally included. In terms of methodological quality, 6 studies were of low quality and 12 studies were of very low quality. All studies did not explain the reasons for adopting a particular research design type, and few of them explained the pre-plan, exclusion list, reasons and funding. In terms of report quality, 7 studies were relatively complete, 10 studies had certain defects and one study had serious defects. The existing problems were program and registration, comprehensive retrieval, information sources, financial support and so on. ConclusionsSRs/MAs of pediatric tuina have different degrees of issues in terms of methodological quality and report quality which still require further improvement and continuous strengthening.
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.