小儿推拿退热有效性及安全性系统评价及meta分析
首发时间:2018-03-22
摘要:目的系统评价小儿推拿退热的有效性及安全性。方法以"小儿发热"、"推拿"、"tuina"、"infantile fever"等为主题词,检索PubMed、Cochrane、CNKI、VIP及万方数据库。检索时间从建库开始截止至2018年2月15日。根据Cochrane Handbook中的方法对文献进行质量评价。采用RevMan 5.3软件进行meta分析。结果最终纳入文献9篇,涉及病例1278例。①推拿结合药物或刮痧治疗可以提高总有效率(RR=0.84[0.77,0.91](95%CI)P<0.0001)(RR=0.56[0.46,0.69](95%CI) P<0.00001);②推拿结合药物治疗可以提升即刻退热效果(WMD=-0.37[-0.69,-0.04](95%CI) P=0.03);③推拿治疗小儿发热的不良反应发生率较低(WMD=0.05[0.01,0.40](95%CI) P=0.004)。结论推拿结合药物或刮痧治疗小儿发热可以提高有效率及即刻退热效果,降低不良反应的发生。但是仍需要多中心、大样本的更规范的RCT加以验证,并需要实验研究明确机制,指导临床。
关键词: 推拿 小儿发热 meta分析 随机对照试验 系统评价
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Systematic review and meta-analysis of randomized controlled trials of tuina in the treatment of infantile fever
Abstract:Objective: To assess the effectiveness and safety of tuina in the treatment of infantile anorexia. Methods: we used the following keywords: infantile fever,tuina,etc. Literature was searched from PubMed, Cochrane Library, CNKI, VIP and Wanfang Database. The time limitation ran from the commencement of each database to February 15, 2018. Two authors collected data independently. The assessment of methodological quality was based on the Cochrane Handbook. The data were analyzed by using RevMan 5.3 software for meta-analysis. Results: there were 9 RCTs and 1278Systematic review and meta-analysis of randomized controlled trials of tuina in the treatment of infantile fever cases that were included in this meta-analysis. ①tuina in combination with medicine or scraping therapy was superior in improving clinical effective percentage (RR=0.84[0.77,0.91](95%CI)P<0.0001)(RR=0.56[0.46,0.69] (95%CI) P<0.00001); ②tuina in combination with medicine was superior in enhancing the immediate antipyretic effectiveness (WMD=-0.37[-0.69,-0.04](95%CI) P=0.03).③tuina was superior in reducing adverse reactions. Conclusion: Tuina in combination with medicine or scraping therapy appears to improve the clinical effective percentage, enhancing the antipyretic effectiveness and reduce adverse reactions. However, due to the low quality of included studies, further well designed multicenter and large -scale RCTs are still needed to evaluate the beneficial effects of tuina. Moreover, further related experiments should be carried out to analyse the mechanism of tuina.
Keywords: tuina infantile fever meta-analysis randomized controlled trials systematic review
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