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Abstract：
OBJECTIVE: To determine the effectiveness of pediatric Tuina (PT) in preventing recurrent acute respiratory tract infections (ARTIs) in children.
METHODS: This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes.
RESULTS: A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio (IRR): 0.59, 95% confidence interval (CI) (0.42-0.84)] and 2018 [IRR: 0.58, 95% CI (0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI (0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups.
CONCLUSIONS: Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.
METHODS: This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes.
RESULTS: A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio (IRR): 0.59, 95% confidence interval (CI) (0.42-0.84)] and 2018 [IRR: 0.58, 95% CI (0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI (0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups.
CONCLUSIONS: Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.
摘要：
目的：确定小儿推拿（PT）预防小儿反复急性呼吸道感染（ARTI）的有效性。
方法：这是一项回顾性队列研究，基于2016年复发性ARTI患儿的电子病历。患儿分为PT组和非PT组，根据他们在2016年是否收到PT。主要结果是2017年和2018年的ARTI发作次数。次要结局是在同一时间段内导致门诊就诊的ARTI数量和因ARTI导致的门诊抗生素处方。负二项回归用于检测PT和结果之间的关联。
结果：共2303名儿童被纳入分析，其中PT组94例，非PT组2209例。2016年接受PT6次或以上的儿童在2017年[发病率比（IRR）：0.59，95％置信区间（CI）（0.42-0.84）]和2018年[IRR：0.58，95％CI（0.36-0.94）]的ARTI发作次数少于2016年未接受PT的儿童[IRR：0.56，95％CI（0.38-0.83）]。两组患者的门诊抗生素处方数量差异无统计学意义。
结论：在一年内接受6次或更多次PT与随后两年儿童复发性ARTI的减少有关。在建立PT作为预防儿童复发性ARTI的方法之前，需要随机对照试验进行效果评估。
方法：这是一项回顾性队列研究，基于2016年复发性ARTI患儿的电子病历。患儿分为PT组和非PT组，根据他们在2016年是否收到PT。主要结果是2017年和2018年的ARTI发作次数。次要结局是在同一时间段内导致门诊就诊的ARTI数量和因ARTI导致的门诊抗生素处方。负二项回归用于检测PT和结果之间的关联。
结果：共2303名儿童被纳入分析，其中PT组94例，非PT组2209例。2016年接受PT6次或以上的儿童在2017年[发病率比（IRR）：0.59，95％置信区间（CI）（0.42-0.84）]和2018年[IRR：0.58，95％CI（0.36-0.94）]的ARTI发作次数少于2016年未接受PT的儿童[IRR：0.56，95％CI（0.38-0.83）]。两组患者的门诊抗生素处方数量差异无统计学意义。
结论：在一年内接受6次或更多次PT与随后两年儿童复发性ARTI的减少有关。在建立PT作为预防儿童复发性ARTI的方法之前，需要随机对照试验进行效果评估。
