推拿治疗小儿反复呼吸道感染的Meta分析

Effects of massage in treatment of recurrent respiratory tract infection: A Meta-analysis

目的：探讨推拿治疗小儿反复呼吸道感染的临床疗效,为临床实践提供循证医学证据。方法：检索中国知网（1990年-2015年）、维普（1990年-2015年）、万方（1990年-2015年）等数据库,收集推拿治疗小儿反复呼吸道感染的临床随机对照试验。经筛选,最终纳入符合标准的11篇文献作为Meta分析对象。用Cochrane协作网免费提供的Review Manage 5.0专用软件进行统计分析。结果：11项研究经Meta分析合并,结果显示,11项研究同质性检验结果,χ~2=17.32,自由度为10（P=0.07）（P〉0.05）,表明11项研究具有同质性,故采用固定效应模式进行分析计算、汇总统计量。OR合并后经Z检验：Z=6.76（P〈0.00001）,说明推拿和其他疗法相比,临床疗效的差异有统计学意义。结论：现有的临床证据表明,推拿治疗小儿反复呼吸道感染疗效明显优于中药、穴位敷贴、西药等疗法,但鉴于本研究纳入的方法学质量偏低、样本量有限,尚需要更多设计合理、执行严格的大样本、科学规范的高质量临床随机对照试验来进一步验证其临床疗效。

Objective： To explore the clinical curative of massage in treatment of recurrent respiratory tract infection, and to provide evidence for clinical practice. Methods： Published articles were searched in CNKI, VIP and Wanfang database between 1990-2015, the clinical randomized controlled trials of massage treatment on recurrent respiratory infection were collected for this reviewing. After screening, 11 peer-reviewed papers in line with the standard were enrolled finally. Review Manage 5.0 software that was free provided by Cochrane collaboration network was used for analyzing. Results： Eleven studies were combined by meta-analysis, the homogeneity test results of the 11 studies were showed as follows, χ2=17.32, the degree of freedom was 10（P=0.07）（P〉0.05）, which indicated that the 11 studies had homogeneity, so the fixed effect model was adopted for analysis, calculation and summary statistics. OR merged with the Z test： Z=6.76（P〈0.00001）, which demonstrated that the clinical curative effect of massage treatment had statistically significant compared with other treatments. Conclusion： The existing evidence shows that the curative effect of massage treatment on infantile repeated respiratory infection is better than Chinese materia medica, acupoint sticking, and the Western medicine, ect. Since the methodology quality of paper is comparatively low, the sample size is limited, so more clinical randomized controlled trials of strict implementation, large sample, reasonable design, scientific, standardized and high quality are still need to further verify the clinical curative effect.