Abstract：
BACKGROUND: Anorexia in children can cause malnutrition, low immunity, growth retardation, and various secondary infections, resulting in a huge burden on society. In East Asia, Chuna manual therapy has been widely used for the treatment of childhood anorexia. We aimed to comprehensively evaluate the effects of Chuna manual therapy for treating childhood anorexia.
METHODS: Twelve databases were comprehensively searched from their inception to September 13, 2022. Only randomized controlled trials assessing Chuna manual therapy for the treatment of childhood anorexia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. The quality of evidence for each main outcome was evaluated using the grading of recommendations assessment, development, and evaluation approach. A meta-analysis was performed, and the pooled data were presented as risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes.
RESULTS: Twenty-five RCTs involving 2230 participants were included. The meta-analysis showed that Chuna manual therapy had a higher total effective rate (TER) based on anorexia symptoms than that of lysine inositol and vitamin B12 (RR: 1.53, 95% CI: 1.28-1.84), multi-enzyme and multi-vitamin (RR: 1.21, 95% CI: 1.11-1.33), and zinc calcium gluconate (RR: 1.22, 95% CI: 1.06-1.39). There was no significant difference in total effective rate between Chuna manual therapy and zinc gluconate plus lysine. No adverse events associated with Chuna manual therapy were reported. Overall, the included studies had an unclear risk of bias, and the quality of evidence was generally moderate to low.
CONCLUSIONS: Current evidence showed that Chuna manual therapy may be effective and safe for improving anorexia symptoms, especially compared with lysine inositol and vitamin B12, multi-enzyme plus multi-vitamin, and zinc calcium gluconate. However, owing to the low methodological quality of the included studies, more rigorous, high-quality RCTs are required on this topic.
METHODS: Twelve databases were comprehensively searched from their inception to September 13, 2022. Only randomized controlled trials assessing Chuna manual therapy for the treatment of childhood anorexia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. The quality of evidence for each main outcome was evaluated using the grading of recommendations assessment, development, and evaluation approach. A meta-analysis was performed, and the pooled data were presented as risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes.
RESULTS: Twenty-five RCTs involving 2230 participants were included. The meta-analysis showed that Chuna manual therapy had a higher total effective rate (TER) based on anorexia symptoms than that of lysine inositol and vitamin B12 (RR: 1.53, 95% CI: 1.28-1.84), multi-enzyme and multi-vitamin (RR: 1.21, 95% CI: 1.11-1.33), and zinc calcium gluconate (RR: 1.22, 95% CI: 1.06-1.39). There was no significant difference in total effective rate between Chuna manual therapy and zinc gluconate plus lysine. No adverse events associated with Chuna manual therapy were reported. Overall, the included studies had an unclear risk of bias, and the quality of evidence was generally moderate to low.
CONCLUSIONS: Current evidence showed that Chuna manual therapy may be effective and safe for improving anorexia symptoms, especially compared with lysine inositol and vitamin B12, multi-enzyme plus multi-vitamin, and zinc calcium gluconate. However, owing to the low methodological quality of the included studies, more rigorous, high-quality RCTs are required on this topic.
摘要：
背景：儿童厌食症可导致营养不良，免疫力低,生长迟缓,和各种继发感染，给社会带来了巨大的负担。在东亚,Chuna手法疗法已广泛用于儿童厌食症的治疗。我们旨在全面评估Chuna手法治疗儿童厌食症的效果。
方法：从成立到2022年9月13日，对12个数据库进行了全面搜索。仅包括评估Chuna手动疗法治疗儿童厌食症的随机对照试验。使用Cochrane偏倚风险工具评估纳入研究的方法学质量。每个主要结果的证据质量都使用建议评估的分级进行评估，发展,和评价方法。进行了荟萃分析，汇总数据以二分结局的风险比(RR)和95%置信区间(CI)表示.
结果：纳入了25个RCT，涉及2230名参与者。meta分析显示，基于厌食症状的Chuna手法治疗总有效率（TER）高于赖氨酸肌醇和维生素B12（RR：1.53，95％CI：1.28-1.84），多酶和多维生素（RR：1.21，95%CI：1.11-1.33），和葡萄糖酸钙锌（RR：1.22，95%CI：1.06-1.39）。Chuna手法治疗与葡萄糖酸锌加赖氨酸治疗的总有效率差异无统计学意义。未报告与Chuna手动治疗相关的不良事件。总的来说,纳入的研究有不清楚的偏倚风险，证据质量一般为中低。
结论：目前的证据表明，春娜手法治疗对改善厌食症症状可能是有效和安全的，特别是与赖氨酸肌醇和维生素B12相比，多酶加多维生素，和葡萄糖酸钙锌.然而,由于纳入研究的方法学质量较低，更严格,在这个主题上需要高质量的RCT。
方法：从成立到2022年9月13日，对12个数据库进行了全面搜索。仅包括评估Chuna手动疗法治疗儿童厌食症的随机对照试验。使用Cochrane偏倚风险工具评估纳入研究的方法学质量。每个主要结果的证据质量都使用建议评估的分级进行评估，发展,和评价方法。进行了荟萃分析，汇总数据以二分结局的风险比(RR)和95%置信区间(CI)表示.
结果：纳入了25个RCT，涉及2230名参与者。meta分析显示，基于厌食症状的Chuna手法治疗总有效率（TER）高于赖氨酸肌醇和维生素B12（RR：1.53，95％CI：1.28-1.84），多酶和多维生素（RR：1.21，95%CI：1.11-1.33），和葡萄糖酸钙锌（RR：1.22，95%CI：1.06-1.39）。Chuna手法治疗与葡萄糖酸锌加赖氨酸治疗的总有效率差异无统计学意义。未报告与Chuna手动治疗相关的不良事件。总的来说,纳入的研究有不清楚的偏倚风险，证据质量一般为中低。
结论：目前的证据表明，春娜手法治疗对改善厌食症症状可能是有效和安全的，特别是与赖氨酸肌醇和维生素B12相比，多酶加多维生素，和葡萄糖酸钙锌.然而,由于纳入研究的方法学质量较低，更严格,在这个主题上需要高质量的RCT。
