The effect of traditional Chinesemedicine washing combined withmassage for neonataljaundice： a meta-analysis

目的：系统评价中药外洗联合抚触对新生儿黄疸的治疗效果.方法：计算机检索 PubMed、the Cochrane Library、Embase、Web of Science、CBM、CNKI 和万方数据库,收集中药外洗联合抚触治疗新生儿黄疸的随机对照试验,检索时间均为建库至 2017年 7 月.采用 Cochrane偏倚风险评估工具对纳入的文献进行质量评价,Meta 分析采用 RevMan5.3 软件.结果：共纳入 13 个研究,共 1998 人.Meta 分析结果显示：①中药外洗联合抚触可以加快首次胎便的排出[MD=-16.67, 95%CI （-24.59, -8.74） , P〈0.001]; ②缩短胎便变黄的时间[MD=-15.44, 95%CI （-23.59,-7.28） ,P〈0.001];③降低经皮测黄疸指数：治疗3天[MD=-1.99, 95%CI（-2.57, -1.40） , P〈0.001],治疗 4天[MD=-1.86, 95%CI（-2.77, -0.95） , P〈0.001],治疗 5 天[MD=-2.44, 95%CI（-3.47, -1.42） , P〈0.001],治疗 6天[MD=-2.23, 95%CI （-3.30, -1.16） , P〈0.001];④降低血清胆红素值：治疗 5天[MD=-3.17, 95%CI（-5.83, -0.50） , P=0.02],治疗 6 天[MD=-1.63, 95%CI（-3.10, -0.16） , P=0.03],治疗 15 天[MD=-1.20,95%CI（-1.99, -0.41） , P=0.003].结论：中药外洗联合抚触治疗新生儿黄疸的临床疗效显著,但该结论需谨慎对待,以后应该进行设计良好的、高质量的试验来进-步证实该结论.

Objective： To systematically assess the effect of traditional Chinese medicine washing （TCM washing） combined withmassage for the treatment of neonatal jaundice.Methods and analysis： Databases, including PubMed, the Cochrane Library, Embase, Web of Science, the ChineseBiomedical Literature Database （CBM）, CNKI, and Wanfang Data were electronically searched for randomizedcontrolled trials （from inception to July 2017）. The methodological qualities of included trials were evaluated by theCochrane risk of bias assessment tool. The meta-analysis was performed by using RevMan 5.3 software.Results： Overall, thirteen trials with a total of 1998 participants were included. The results of meta-analysis indicatedthat TCM washing combined with massage group was significantly superior to the control group in the first meconiumtime （MD, -16.67; 95% CI, -24.59 to -8.74; P〈0.001）, time for transformation of meconium （MD, -15.44; 95% CI,-23.59 to -7.28; P〈0.001）, transcutaneous bilirubin index changes [after treating three days （MD, -1.99; 95% CI, -2.57 to-1.40; P〈0.001）, after treating four days （MD, -1.86; 95% CI, -2.77 to -0.95; P〈0.001）, after treating five days （MD,-2.44; 95% CI, -3.47 to -1.42; P〈0.001）, after treating six days （MD, -2.23; 95% CI, -3.30 to -1.16; P〈0.001）, and thechanges of serum bilirubin levels [after treating five days （MD, -3.17; 95% CI, -5.83 to -0.50; P=0.02）, after treating sixdays （MD, -1.63; 95% CI, -3.10 to -0.16; P=0.03）, after treating fifteen days （MD,-1.20; 95% CI, -1.99 to -0.41; P=0.003）.Conclusions： TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice.It can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decreasetranscutaneous bilirubin index and the level of serum bilirubin. But it should be careful to interpreting these findings.Well-designed RCTs are needed to further clarify the conclusion.