中国循证医学杂志

中国循证医学杂志

从循证视角观小儿推拿的机遇与挑战

查看全文

本文全面阐述全球现有小儿推拿种类及其在新生儿生长、情绪问题、疼痛、呼吸系统、消化系统、黄疸、大脑神经系统等领域的应用。对于小儿推拿临床研究,我们发现目前面临着认知差异大、临床研究质量偏低、缺乏基础性数据等挑战。我们建议通过系统评价已有临床试验结果,凝练出有临床价值的干预方案,开展高质量的临床研究,有计划地逐步积累基础数据,促进小儿推拿研究的发展。

With the existing clinical research of pediatric Tuina, this paper introduces the existing types of pediatric Tuina and their application areas in the aspect of growth of newborn babies, emotion problem, pain, respiratory system diseases, digestive system diseases, jaundice, brain and nerve system diseases. As for the clinical researches of pediatric Tuina, the authors found the challenges including different understanding of knowledge of pediatric Tuina, poor quality of clinical researches, and lack of basic data in regards of pediatric Tuina. Meanwhile, the authors suggested three corresponding strategies to improve the clinical researches, i.e. to concise valuable intervention method on the basis of clinical practice; to conduct high quality clinical studies; to collect and accumulate basic data according to a certain plan gradually.

关键词: 循证; 小儿推拿; 机遇; 挑战

Key words: Evidence-based; Pediatric Tuina; Opportunity; Challenge

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. Evidence-Based Medicine Working Group. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA, 1992, 268(17): 2420-2425.
2. WHO. Kangaroo mother care: A practical guide. Geneva: WHO (Department of Reproductive Health and Research), 2003.
3. Lin CH, Yang HC, Cheng CS, et al. Effects of infant massage on jaundiced neonates undergoing phototherapy. Ital J Pediatr, 2015, 25(41): 94.
4. Field TM, Schanberg SM, Scafidi F, et al. Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics, 1986, 77(5): 654-658.
5. Im H, Kim E, Cain KC. Acute effects of Yakson and Gentle Human Touch on the behavioral state of preterm infants. J Child Health Care, 2009, 13(3): 212-226.
6. Arora J, Kumar A, Ramji S. Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian Pediatr, 2005, 42(11): 1092-1100.
7. Piravej K, Tangtrongchitr P, Chandarasiri P, et al. Effects of Thai traditional massage on autistic children’s behavior. J Altern Complement Med, 2009, 15(12): 1355-1361.
8. 廖品东. 小儿推拿学 (第 2 版). 北京: 人民卫生出版社, 2016.
9. 孙思邈. 备急千金要方 (第 1 版). 北京: 中国医药科技出版社, 2011.
10. Yao Y, Zhao Y. Diseases spectrum study on pediatric tuina in recent 10 years. J Acupunct Tuina Sci, 2012, 10(3): 181-184.
11. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report, 2008, 10(12): 1-23.
12. Huillet A, Erdie-Lalena C, Norvell D, et al. Complementary and alternative medicine used by children in military pediatric clinics. J Altern Complement Med, 2011, 17(6): 531-537.
13. Groenewald CB, Beals-Erickson SE, Ralston-Wilson J, et al. Complementary and alternative medicine use by children with pain in the United States. Acad Pediatr, 2017, 17(7): 785-793.
14. Zuzak TJ, Boňková J, Careddu D, et al. Use of complementary and alternative medicine by children in Europe: published data and expert perspectives. Complement Ther Med, 2013, 21 (Suppl 1): S34-S47.
15. Smith C, Eckert K. Prevalence of complementary and alternative medicine and use among children in South Australia. J Paediatr Child Health, 2006, 42(9): 538-543.
16. Huang TP, Liu PH, Lien AS. A nationwide population-based study of traditional Chinese medicine usage in children in Taiwan. Complement Ther Med, 2014, 22(3): 500-510.
17. WHO. The world health report 2013: research for universal health coverage. Geneva: WHO, 2013.
18. Kelmanson IA, Adulas EI. Massage therapy and sleep behaviour in infants born with low birth weight. Complement Ther Clin Pract, 2006, 12(3): 200-205.
19. Chwo MJ, Anderson GC, Good M, et al. A randomized controlled trial of early kangaroo care for preterm infants: effects on temperature, weight, behavior, and acuity. J Nurs Res, 2002, 10(2): 129-142.
20. Bier JA, Ferguson AE, Morales Y, et al. Comparison of skin-to-skin contact with standard contact in low-birth-weight infants who are breast-fed. Arch Pediatr Adolesc Med, 1996, 150(12): 1265-1269.
21. Li X, Zhong Q, Tang L. A meta-analysis of the efficacy and safety of using oil massage to promote infant growth. J Pediatr Nurs, 2016, 31(5): e313-e322.
22. Badr LK, Abdallah B, Kahale L. A meta-analysis of preterm infant massage: an ancient practice with contemporary applications. MCN Am J Matern Child Nurs, 2015, 40(6): 344-358.
23. Massaro AN, Hammad TA, Jazzo B, et al. Massage with kinesthetic stimulation improves weight gain in preterm infants. J Perinatol, 2009, 29(5): 352-357.
24. Diego MA, Field T, Hernandez-Reif M. Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms. Early Hum Dev, 2014, 90(3): 137-140.
25. Lyngstad LT, Tandberg BS, Storm H, et al. Does skin-to-skin contact reduce stress during diaper change in preterm infants? Early Hum Dev, 2014, 90(4): 169-172.
26. Cullen LA, Barlow JH, Cushway D. Positive touch, the implications for parents and their children with autism: an exploratory study. Complement Ther Clin Pract, 2005, 11(3): 182-189.
27. Hernandez-Reif M, Diego M, Field T. Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behav Dev, 2007, 30(4): 557-561.
28. Parashar P, Samuel AJ, Bansal A, et al. Yakson touch as a part of early intervention in the Neonatal Intensive Care Unit: A systematic narrative review. Indian J Crit Care Med, 2016, 20(6): 349-352.
29. Phipps S, Barrera M, Vannatta K, et al. Complementary therapies for children undergoing stem cell transplantation: report of a multisite trial. Cancer, 2010, 116(16): 3924-3933.
30. Phipps S, Peasant C, Barrera M, et al. Resilience in children undergoing stem cell transplantation: results of a complementary intervention trial. Pediatrics, 2012, 129(3): e762-e770.
31. Lee MS, Kim JI, Ernst E. Massage therapy for children with autism spectrum disorders: a systematic review. J Clin Psychiatry, 2011, 72(3): 406-411.
32. Neu M, Pan Z, Workman R, et al. Benefits of massage therapy for infants with symptoms of gastroesophageal reflux disease. Biol Res Nurs, 2014, 16(4): 387-397.
33. Rodríguez-Mansilla J, González-Sánchez B, Torres-Piles S, et al. Effects of the application of therapeutic massage in children with cancer: a systematic review. Rev Lat Am Enfermagem, 2017, 8(25): e2903.
34. Batalha LM, Mota AA. Massage in children with cancer: effectiveness of a protocol. J Pediatr (Rio J), 2013, 89(6): 595-600.
35. Huhtala V, Lehtonen L, Heinonen R, et al. Infant massage compared with crib vibrator in the treatment of colicky infants. Pediatrics, 2000, 105(6): E84.
36. etinkaya B, Başbakkal Z. The effectiveness of aromatherapy massage using lavender oil as a treatment for infantile colic. Int J Nurs Pract, 2012, 18(2): 164-169.
37. Cong X, Ludington-Hoe SM, Walsh S. Randomized crossover trial of kangaroo care to reduce biobehavioral pain responses in preterm infants: a pilot study. Biol Res Nurs, 2011, 13(2): 204-216.
38. Ludington-Hoe SM, Hosseini R, Torowicz DL. Skin-to-skin contact (Kangaroo Care) analgesia for preterm infant heel stick. AACN Clin Issues, 2005, 16(3): 373-387.
39. Cong X, Ludington-Hoe SM, McCain G, et al. Kangaroo care modifies preterm infant heart rate variability in response to heel stick pain: pilot study. Early Hum Dev, 2009, 85(9): 561-567.
40. Johnston CC, Filion F, Campbell-Yeo M, et al. Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatr, 2008, 24(8): 13.
41. Herrington CJ, Chiodo LM. Human touch effectively and safely reduces pain in the newborn intensive care unit. Pain Manag Nurs, 2014, 15(1): 107-115.
42. Jain S, Kumar P, McMillan DD. Prior leg massage decreases pain responses to heel stick in preterm babies. J Paediatr Child Health, 2006, 42(9): 505-508.
43. Hogan ME, Probst J, Wong K, et al. A randomized-controlled trial of parent-led tactile stimulation to reduce pain during infant immunization injections. Clin J Pain, 2014, 30(3): 259-265.
44. Taddio A, Ho T, Vyas C, et al. A randomized controlled trial of clinician-led tactile stimulation to reduce pain during vaccination in infants. Clin Pediatr (Phila), 2014, 53(7): 639-644.
45. Fattah MA, Hamdy B. Pulmonary functions of children with asthma improve following massage therapy. J Altern Complement Med, 2011, 17(11): 1065-1068.
46. Field T, Henteleff T, Hernandez-Reif M, et al. Children with asthma have improved pulmonary functions after massage therapy. J Pediatr, 1998, 132(5): 854-858.
47. 田福玲, 李旗, 崔建美, 等. 小儿推拿疗法在小儿支气管哮喘慢性持续期的作用机制和治疗效果研究. 中国全科医学, 2015, 18(1): 105-108.
48. Wu J, Yang XW, Zhang M. Massage therapy in children with asthma: a systematic review and meta-analysis. Evid Based Complement Alternat Med, 2017, 2017: 5620568.
49. Bishop E, McKinnon E, Weir E, et al. Reflexology in the management of encopresis and chronic constipation. Paediatr Nurs, 2003, 15(3): 20-21.
50. Jump VK, Fargo JD, Akers JF. Impact of massage therapy on health outcomes among orphaned infants in Ecuador: results of a randomized clinical trial. Fam Community Health, 2006, 29(4): 314-319.
51. 李静, 王振国. 当代中医小儿推拿学术流派的研究现状. 山东中医杂志, 2012, 31(6): 454-455.
52. Field TM. Massage therapy effects. Am Psychol, 1998, 53(12): 1270-1281.
53. Yan S, Xiong X, Wan Q, et al. Preventative effect of massage on gastric volvulus in infants with gastro esophageal reflux-induced pneumonia. J Tradit Chin Med, 2015, 35(5): 520-527.
54. Neu M, Schmiege SJ, Pan Z, et al. Interactions during feeding with mothers and their infants with symptoms of gastroesophageal reflux. J Altern Complement Med, 2014, 20(6): 493-499.
55. 黄美凌, 陈丽萍, 林冰清, 等. 中医按摩对早产儿生长发育及高胆红素血症影响的研究. 中国实用护理杂志, 2005, 21(16): 1-3.
56. 杨庆玲, 邱学兰, 史长宏. 穴位按压和喂养频率对早发型母乳性黄疸患儿干预治疗的临床研究. 中国实用护理杂志, 2007, 23(1): 1-3.
57. 董明翠, 侯莉, 刘俊. 腹部按摩加茵栀黄口服液治疗新生儿黄疸 90 例. 陕西中医, 2013, (10): 1353-1354.
58. Chen J, Sadakata M, Ishida M, et al. Baby massage ameliorates neonatal jaundice in full-term newborn infants. Tohoku J Exp Med, 2011, 223(2): 97-102.
59. Guzzetta A, D’Acunto MG, Carotenuto M, et al. The effects of preterm infant massage on brain electrical activity. Dev Med Child Neurol, 2011, 53(Suppl 4): 46-51.
60. Guzzetta A, Baldini S, Bancale A, et al. Massage accelerates brain development and the maturation of visual function. J Neurosci, 2009, 29(18): 6042-6051.
61. Scher MS, Ludington-Hoe S, Kaffashi F, et al. Neurophysiologic assessment of brain maturation after an 8-week trial of skin-to-skin contact on preterm infants. Clin Neurophysiol, 2009, 120(10): 1812-1818.
62. Silva LM, Schalock M, Garberg J, et al. Qigong massage for motor skills in young children with cerebral palsy and Down syndrome. Am J Occup Ther, 2012, 66(3): 348-355.
63. Nilsson S, Johansson G, Enskr K, et al. Massage therapy in post-operative rehabilitation of children and adolescents with cerebral palsy-a pilot study. Complement Ther Clin Pract, 2011, 17(3): 127-131.
64. Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev, 2013, (4): CD005038.
65. Sajedi F, Kashaninia Z, Hoseinzadeh S, et al. How effective is Swedish massage on blood glucose level in children with diabetes mellitus? Acta Med Iran, 2011, 49(9): 592-597.
66. Ferber SG, Laudon M, Kuint J, et al. Massage therapy by mothers enhances the adjustment of circadian rhythms to the nocturnal period in full-term infants. J Dev Behav Pediatr, 2002, 23(6): 410-415.
67. Whitley JA, Rich BL. A double-blind randomized controlled pilot trial examining the safety and efficacy of therapeutic touch in premature infants. Adv Neonatal Care, 2008, 8(6): 315-333.
68. Nangia S, Paul VK, Deorari AK, et al. Topical oil application and trans-epidermal water loss in preterm very low birth weight infants-a randomized trial. J Trop Pediatr, 2015, 61(6): 414-420.
69. Cooke A, Cork MJ, Victor S, et al. Olive oil, sunflower oil or no oil for baby dry skin or massage: a pilot, assessor-blinded, randomized controlled trial (the Oil in Baby SkincaRE [OBSeRvE] Study). Acta Derm Venereol, 2016, 96(3): 323-330.
70. Ahmed AS, Saha SK, Chowdhury MA, et al. Acceptability of massage with skin barrier-enhancing emollients in young neonates in Bangladesh. J Health Popul Nutr, 2007, 25(2): 236-240.
71. Sankaranarayanan K, Mondkar JA, Chauhan MM, et al. Oil massage in neonates: an open randomized controlled study of coconut versus mineral oil. Indian Pediatr, 2005, 42(9): 877-884.
72. Diego MA, Field T, Hernandez-Reif M. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr, 2005, 147(1): 50-55.
73. Field T, Hernandez-Reif M, Diego M, et al. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci, 2005, 115(10): 1397-1413.
74. 郭兰中, 蔡坚雄, 蒋俊, 等. 推拿防治小儿黄疸临床研究的方法学要素分析. 中国中医基础医学杂志, 2016, 22(6): 847-852.
75. 王海宽, 王继红, 杨良兵. 推拿治疗小儿厌食症的 Meta 分析. 新中医, 2017, (8): 162-165.
76. 刘建平. 循证医学进展述评. 重庆医学, 2017, 46(14): 1873, 1877.
77. 温玉成, 蔡坚雄, 吴大嵘. 中医外治法治疗小儿腹泻的研究现状. 中医药导报, 2016, 22(9): 96-99.
78. WHO. WHO traditional medicine strategy 2002-2005. Geneva: WHO (Programme on Traditional Medicine), 2002.
79. WHO. WHO traditional medicine strategy 2014-2023. Geneva: WHO, 2013.