推拿治疗儿童急性腹泻循证临床指南

Tuina for children with acute diarrhea:an evidence-based clinical guideline

儿童急性腹泻是儿童的急性高发病。推拿治疗已广泛应用于儿童急性腹泻的临床实践中,但暂无推拿治疗儿童急性腹泻的临床指南。本指南严格按照循证医学原则,根据《世界卫生组织指南制订手册》要求制订。其中系统评价制作方法参照Cochrane协作网要求,证据评价和推荐意见分级使用GRADE方法,并参照RIGHT报告规范进行撰写。本指南通过文献调研和专家共识进行临床问题遴选,最终确定了7个临床问题(2个前景性问题和5个背景性问题)。基于系统评价结果,综合考虑证据利弊、证据质量、患者偏好和其他资源,通过德尔菲法专家共识形成推荐意见:在西医常规治疗基础上,建议使用推拿治疗儿童急性腹泻(弱推荐,低质量证据)。本指南可供中医儿科、小儿推拿科的医生和护士、中医推拿相关从业人员使用,西医相关人员也可作参考,亦适用于全部开展推拿治疗的机构。

Acute diarrhea has a high incidence in children.Pediatric tuina has been widely used in children with acute diarrhea in China.However,there is no guideline on the treatment of tuina for children with acute diarrhea.This guideline was developed following evidence-based principles and the World Health Organization handbook for guideline development.The linked systematic review was conducted following the Cochrane handbook.The quality of evidence and the strength of recommendations were evaluated using the GRADE approach.The reporting followed the RIGHT statement.Seven clinical questions(2 foreground questions and 5 background questions)were identified by literature review and expert consensus.Based on the linked systematic review and through comprehensive consideration of the balance of benefit and harm,quality of evidence,patient preferences,and other resources,we formulated the recommendations using Delphi expert consensus.We suggested combination of a weak recommendation for tuina with Western medicine usual care to treat children with acute diarrhea.This guideline can be used by clinicians and nurses in the department of traditional Chinese medicine pediatrics,and department of pediatric tuina,and can also be used as a reference for relevant clinicians of Western medicine and is also applicable to all institutions that practice tuina treatment.