针灸治疗儿童注意缺陷多动障碍的系统评价再评价

Systematic Review of Acupuncture Treatment for Attention Deficit Hyperactivity Disorder in Children

目的:评价针灸疗法治疗儿童注意缺陷多动障碍的方法学质量、报告质量以及证据质量。方法:采用计算机检索中国知网、万方、维普、中国生物医学文献、Pubmed、Embase、Cochrane library、Web of science数据库,搜集针灸疗法治疗儿童注意缺陷多动障碍的系统评价/Meta分析文献,检索时间为建库至2023年6月17日,应用AMSTAR-2量表评价方法学质量,应用PRISMA声明评价纳入文献的报告质量,应用GRADE系统对结局指标进行证据质量评价。结果:共纳入7篇系统评价/Meta分析,AMSTAR-2评价提示纳入研究质量较低,5篇评分为低等级,2篇评分为极低等级;PRISMA得分平均约为21分,在结果综合方法、结局证据质量评定方法、方案和注册资金及公开信息等方面存在不足;GRADE证据质量评级结果显示,11个结局指标为中等质量、21个为低质量、14个为极低质量。结论:现有的证据表明,针灸疗法对儿童注意缺陷多动障碍有一定疗效,但纳入研究的方法学质量、报告质量、证据质量偏低,期望开展更高质量的系统评价/Meta分析研究,为临床决策提供更可靠的循证研究证据。

Objective To evaluate the methodological quality,reporting quality and evidence quality of acupuncture therapy for attention deficit hyperactivity disorder in children.Methods Systematic review/meta-analysis literature on acupuncture and moxibustion in the treatment of attention deficit hyperactivity disorder in children was collected by computer searching databases of CNKI,Wanfang,VIP,Chinese biomedical literature,Pubmed,Embase,Cochrane library and Web of science.The retrieval time was from the establishment of the database to June 17,2023.AMSTAR-2 scale was used to evaluate the methodological quality,PRISMA statement was used to evaluate the report quality of the included literatures,and GRADE system was used to evaluate the evidence quality of the outcome indicators.Results A total of 7 systematic reviews/meta-analyses were included.AMSTAR-2 evaluation indicated that the quality of the included studies was low,5 were rated as low grade,and 2 were rated as very low grade.The average PRISMA score was about 21 points,and there were shortcomings in results synthesis method,outcome evidence quality assessment method,scheme,registered capital and public information.The results of GRADE quality of evidence rating showed that 11 outcome measures were of moderate quality,21 were of low quality,and 14 were of very low quality.Conclusion Existing evidence shows that acupuncture and moxibustion therapy has a certain effect on attention deficit hyperactivity disorder in children,but the methodological quality,reporting quality and evidence quality of the included studies are low.It is expected to carry out higher quality systematic review/meta-analysis studies to provide more reliable evidence-based research evidence for clinical decision-making.