推拿干预慢性疲劳综合征研究的系统评价

Systematic Review of Chronic Fatigue Syndrome Treated by Tuina

摘目的：对国内外公开发表的推拿干预慢性疲劳综合征研究的疗效相关文献进行Meta分析，探讨推拿疗法对慢性疲劳综合征的临床疗效。方法：对推拿治疗慢性疲劳综合征的随机对照试验、半随机对照试验或临床对照试验，按Cochrane协作网推荐的方法进行系统评价。结果：纳入文献10篇，共800例患者，经Meta分析，以推拿为主要干预方法的治疗组临床总有效率优于对照组。进一步进行单一推拿治疗与推拿联合其他疗法的亚组分析，显示推拿联合其他疗法与单一推拿疗法临床疗效差异有统计学意义，推拿联合其他疗法的总有效率高于单一推拿疗法。进行敏感性分析排除异质性来源研究后，进行推拿疗法与中药疗法、西药疗法对比的亚组分析，结果显示推拿疗法总有效率均高于西药组与中药组。疲劳量表的分析说明推拿疗法对疲劳的改善程度优于中药内服疗法。结论：推拿对慢性疲劳综合征的治疗疗效优于针刺、中药内服、西药疗法等，推拿联合其他疗法的临床疗效优于单一推拿疗法，在对疲劳的改善方面，推拿疗法优于中药内服疗法。

Objective： To investigate the clinical efficacy of Tuina therapy on chronic fatigue syndrome by analyzing the literature about the efficacy of chronic fatigue syndrome with Review Manage software. Methods ： A systematic evaluation on randomized controlled trial, quasi - randomized control trial or controlled clinical trial of treatment of chronic fatigue syndrome with Tuina was carried out according to the assessment methods recommended by the Cochrane Collaboration. Results： There were totally 10 articles and 800 subjects were included in this study, and the total effective rate of the treatment group was better than that the control group by the Meta - analysis. Further subgroup analysis for single Tuina therapy and Tuina combined with other therapies, showed a statistically significant clinical curative effect. The efficiency of Tuina combined with other therapies was higher than that of single Tuina therapy. The sensitivity analysis was carried out to exclude the heterogeneity of the origin of the study, the results showed that the total effective rate of Tuina therapy was higher than that of Western medicine group and Chinese medicine group. The analysis of fatigue scale showed that the improvement of Tuina therapy on fatigue was better than that of traditional Chinese medicine. Conclusion： Tuina on treating chronic fatigue syndrome is better than traditional Chinese medicine, acupuncture or Western medicine therapy, and the clinical curative effect of Tuina combined with other therapies is better than single Tuina in terms of the improvement syndrome of fatigue. Tuina theraov is suoerior to traditional Chinese medicine treatment.