推拿治疗小儿急性上呼吸道感染的系统评价

Meta-analysis on Tuina Treatment for Children with Acute Upper Respiratory Infection

目的：系统评价推拿治疗小儿急性上呼吸道感染的临床疗效。方法：通过计算机检索CNKI、VIP、CBM、万方数据库、Cochrane Library、Medline、Embase、Pub Med数据库自建库以来至2016年11月30日的文献,全面收集有关推拿治疗小儿急性上呼吸道感染的临床研究。由2名系统评价员独立筛选、交叉核对、偏倚风险评估、提取数据,采用RevMan5.3软件进行Meta分析。结果：最终纳入7个临床研究,共收录1135例患儿。Meta分析结果显示：推拿治疗组有效率高于对照组,其差异具有统计学意义[RR=1.27,95%CI（1.20,1.33）,P〈0.00001]。敏感性分析显示排除掉权重大的研究,对有效率的评价结果没有改变,研究结果稳定。漏斗图表明存在发表偏倚。结论：推拿能够有效治疗小儿急性上呼吸道感染。由于纳入研究数量有限、文献质量不高、存在发表偏倚,所以有待进行大样本、多中心、高质量的随机对照试验来进一步研究。

Objective： To assess the clinical effect of Tuina treatment of children with acute upper respiratory infections. Methods： A comprehensive collection on clinical researches about Tuina treatment of children with acute upper respiratory infection was carried on by computer,including China National Knowledge Infrastructure,Chongqing VIP database,China Biology Medicine disc,Wan Fang Data,Cochrane Library,Medline,Embase and Pub Med since the self-built database to November 30,2016. The analysis was carried out by two system evaluators,independently sifting,crossing-checking,bias risk assessment,extracting data,and we used Rev Man5. 3 software for a Meta-analysis. Results： Seven studies were included in total,and 1135 children were included in the study. Meta-analysis showed that Tuina treatment group was more effective than the control group and the difference was statistically significant[RR = 1. 27,95% CI（1. 20,1. 33）,P〈0. 00001]. Sensitivity analysis showed that if ruled out the significant studies,the results of the study did not change and the results were stable. The funnel diagram indicates that there was a publication bias. Conclusion： Tuina can effectively treat the acute upper respiratory infections in children. Due to the limited number included in the study,the quality of the literature is not high,and there is publication bias,and so the randomized controlled trials of large numbers of samples,multicenter,high quality are needed for the further research.