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Meta-Analysis
. 2022 Apr 12:10:821781.
doi: 10.3389/fpubh.2022.821781. eCollection 2022.

Tuina for Enuresis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chiin Tong  1   2 , Qida He  1   2 , Manin Ho  1 , Zhenghong Zhong  1   2 , Qibiao Wu  1   2   3   4 , Min Chen  1   2
Affiliations
Meta-Analysis

Tuina for Enuresis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chiin Tong et al. Front Public Health. .

Abstract

Objective: To evaluate the effects of Tuina (massage) vs. non-Tuina traditional Chinese medicine (TCM) treatments on nocturnal enuresis in children.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following the Preferred Reported Items for Systematic Review and Meta-analysis (PRISMA) guidelines. RevMan 5.3 software was used for meta-analysis.

Results: Twelve RCTs recruiting a total of 1,007 children were included. Meta-analysis results showed that, compared with non-Tuina TCM treatments, Tuina could significantly improve the total effective rate of children's enuresis [RR = 1.29, 95%CI (1.22-1.36), P < 0.00001]. The results of subgroup analyses indicated that the total effective rate of Tuina combined with acupuncture in the treatment of nocturnal enuresis was higher than acupuncture alone [RR = 1.24, 95%CI (1.12-1.37), P < 0.0001]. The total effective rate of Tuina in the treatment of enuresis in children was better than that of herbal medicine alone [RR = 1.45, 95%CI (1.31-1.61), P < 0.00001]. The total effective rate of Tuina combined with herbal medicine in the treatment of enuresis in children was better than that of herbal medicine alone [RR = 1.16, 95%CI (1.06-1.26), P = 0.0007]. No adverse reactions of Tuina were reported in all included studies.

Conclusion: From the available evidence, Tuina, or Tuina combined with non-Tuina TCM treatments (acupuncture, or herbal medicine) can improve the clinical outcome of children with enuresis, indicating Tuina is a promising treatment choice for children's enuresis. However, because of the intrinsic limitations of the included studies, more high-quality randomized controlled trials with longer follow-up are still needed to further confirm the efficacy and safety of Tuina in the treatment of nocturnal enuresis in children.

Keywords: Tuina; enuresis in children; massage; meta-analysis; randomized controlled trial.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta-analysis (PRISMA) search diagram.
Figure 2
Figure 2
Risk of bias graph.
Figure 3
Figure 3
Risk of bias summary.
Figure 4
Figure 4
Compared with the control group, the total effective rate of the experimental group was significantly improved.
Figure 5
Figure 5
Subgroup analysis showed that compared with the control group, the total effective rate of the experimental group was significantly improved.
Figure 6
Figure 6
Funnel plots showed publication bias.
See this image and copyright information in PMC

References

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