中医药治疗小儿抽动秽语综合征有效性及安全性的系统评价与Meta分析

Efficacy and safety of treatment of children with Tourette’s syndrome by traditional Chinese medicine:a systematic review and Meta-analysis

关键词:  小儿抽动秽语综合征  系统评价  Meta分析

Key words:  children with Tourette's syndrome  systematic review  Meta-analysis

摘要:

[目的]系统评价中医药治疗小儿抽动秽语综合征的临床有效性及安全性。[方法]计算机检索中国知网(CNKI)、万方(Wanfang Data)、中国生物医学文献服务系统(SinoMed)、PubMed、the Cochrane Library、Embase,搜集中医药治疗小儿抽动秽语综合征的随机对照试验(RCT),检索时间均为从建库至2022年4月30日。按照预先制定的纳入、排除标准独立进行文献筛选、资料提取、偏倚风险评估后,采用RevMan 5.4.1软件进行数据分析。[结果]最终纳入16篇RCT,1 371例患者。Meta分析显示,中医药治疗小儿抽动秽语综合征可以提高临床疗效[OR=2.22,95%CI(1.58,3.13),P＜0.01],改善耶鲁综合抽动严重程度量表(YGTSS)总分[MD=-3.70,95%CI(-4.99,-2.42),P＜0.01],YGTSS运动性抽动评分[MD=-2.50,95%CI(-3.19,-1.81),P＜0.01],YGTSS发声性抽动评分[MD=-1.56,95%CI(-2.38,-0.75),P＜0.01],降低抽动症状评分量表(TSSS)评分[MD=0.08,95%CI(0.03,0.13),P＜0.01],提高儿童少年主观生活质量问卷(ISLQ)评分[MD=5.30,95%CI(0.33,10.27),P＜0.01],降低中医证候积分,同时具有良好的安全性[OR=0.17,95%CI(0.09,0.31),P＜0.01]。[结论]中医药治疗小儿抽动秽语综合征可以提高临床疗效、改善运动性抽动和发声性抽动症状,提高小儿生活质量,降低中医证候积分,且具有较好的安全性。由于受纳入原始研究质量的限制,尚需高质量的临床研究予以验证。

Abstract:

[Objective] To systematically evaluate the efficacy and safety of treatment of children with Tourette's syndrome by traditional Chinese medicine. [Methods] 6 databases of China National Knowledge Infrastructure(CNKI),Wanfang Data,SinoMed,PubMed,the Cochrane Library and Embase were comprehensively searched by computer to collect randomized controlled trials of treatment of children with Tourette's syndrome by traditional Chinese medicine. The retrieval time was from these databases inception to April 30,2022.RevMan 5.4.1 software was used for data analysis after independent literature screening,data extraction,and bias risk assessment according to pre-established inclusion and exclusion criterias. [Results] Finally,16 RCTs with 1 371 patients were included. Metaanalysis showed that traditional Chinese medicine in the treatment of pediatric tics can improve clinical efficacy, [OR =2.22,95% CI(1.58,3.13),P＜0.01],improved the YGTSS total score[MD=-3.70,95%CI(-4.99,-2.42),P＜0.01],YGTSS motor tic activity score[MD=-2.50,95%CI(-3.19,-1.81),P＜0.01],YGTSS vocal tic score[MD=-1.56,95%CI(-2.38,-0.75),P＜0.01],reduce the TSSS score[MD=0.08,95%CI(0.03,0.13),P＜0.01],improve the ISLQ score[MD=5.30,95%CI(0.33,10.27),P＜0.01],reduce the score of traditional Chinese medicine syndrome,and have good safety[OR=0.17,95%CI(0.09,0.31),P＜0.01]. [Conclusion] Traditional Chinese medicine in the treatment of Tourette's syndrome in children can improve clinical efficacy,improve motor tic and vocal tic symptoms,improve children's quality of life,reduce traditional Chinese medicine syndrome score. And it has good clinical safety. Due to the limitation of the quality of the included ariticles,high-quality clinical studies are needed for validation the conclusion.