指南推荐的中医外治法治疗儿童厌食症临床疗效的网状Meta分析

doi:10.20274/j.cnki.issn.1674-3865.2026.01.005

Abstract

Abstract:

Objective To evaluate the efficacy and safety of guideline-recommended non-pharmacological TCM therapies for pediatric anorexia via a network Meta-analysis. Methods RCTs from CNKI, Wanfang, PubMed, Web of Science, Embase, and Cochrane Library up to March 2025 were searched. Quality assessment used ROB 2.0,and data were analyzed with Stata 18.0. Results Thirty-eight RCTs (3 546 patients) covering pricking at Sifeng points, acupoint application, pediatric Tuina, and their combinations were included. Pricking at Sifeng points+pediatric Tuina was most likely the best intervention for overall clinical effectiveness(SUCRA=78.9%) and serum zinc improvement(SUCRA=95.1%).Pediatric Tuina+oral medication ranked highest for improving serum iron(SUCRA=85.7%) and serum calcium(SUCRA=83.4%). Conclusion Pricking at Sifeng points plus pediatric Tuina is recommended for overall efficacy and serum zinc, while pediatric Tuina with oral medication performs better for serum iron and calcium. Therapy selection should be individualized based on serological indicators. Further high-quality RCTs are warranted.

Key words: Anorexia, External treatment of TCM, Network Meta-analysis, Child

CLC Number:

R725.7

Zhonghe ZENG, Longming LEI, Jun ZHAO, Qiongxiao WANG, Lin FU, Mengyun WU, Danlu SU, Guanghui CHEN. A network Meta-analysis of the clinical efficacy of guideline-recommended external treatment of traditional Chinese medicine for anorexia in children[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(1): 23-30.

Figures/Tables 6

Fig.1

Table 1

Characteristics of included literature（x ± s）"

文献来源	观察组	对照组	样本量（n）		平均年龄（年）		平均病程			结局指标
文献来源	观察组	对照组	观察组	对照组	观察组	对照组	观察组	对照组		结局指标
张华等2024^[10]	SF+PO	PO	55	55	4.45±0.41	4.62±0.49	34.20±1.32	34.32±1.69	（d）	①②③
刘乾等2024^[11]	PMT+PO	PO	45	45	3.05±0.98	3.02±1.05	4.05±1.49	4.06±1.56	（月）	①②④
冯硕等2024^[12]	PMT+PO	PO	42	42	5.69±1.52	5.73±1.58	3.25±1.06	3.31±1.12	（月）	①②④
杜正强等2024^[13]	PMT	PO	37	36	3.1±1.8	3.3±1.5	0.6±0.3	0.5±0.2	（年）	①②③
王景润等2023^[14]	PMT	PO	35	35	4.07±0.26	4.02±0.25	13.38±0.27	13.22±0.25	（月）	①②
徐雪梅等2022^[15]	PMT+PO	PO	45	45	9.75±1.62	9.23±1.35	4.52±0.73	4.23±0.97	（月）	①②③④
李博等2022^[16]	PMT+PO	PO	41	41	4.52±1.48	4.11±1.89	-	-		①②
解涛等2022^[17]	PMT	PO	47	47	5.1±1.2	4.7±1.4	1.9±0.2	1.2±0.2	（年）	①②④
陈亚云2022^[18]	SF+PMT	PO	30	30	4.36±0.45	4.25±0.38	5.48±3.31	5.45±3.28	（月）	①②
周博文等2021^[19]	SF+PMT	PO	31	31	3.7±1.8	3.7±1.9	1.22±0.59	1.20±0.63	（年）	①②③
张文静2021^[20]	PMT+PO	PO	50	50	5.26±1.04	5.67±1.12	5.01±1.04	5.07±0.91	（月）	①②③④
李绮玲2021^[21]	PMT	PO	30	30	3.11±0.15	3.24±0.18	-	-		①②
黄国定等2021^[22]	SF+PMT	PO	50	50	5.14±1.86	5.22±1.83	2.91±0.49	2.84±0.51	（月）	①②
范亚丽等2021^[23]	PMT+PO	PO	61	45	5.69±0.72	5.47±0.66	3.15±0.57	2.88±0.53	（月）	①②④
张昊地2020^[24]	APA	PO	39	38	5.59±1.71	5.13±1.64	3.03±1.01	3.04±1.13	（月）	①②
张方方2020^[25]	PMT+PO	PO	50	50	3.79±1.64	3.92±1.43	7.09±2.28	7.15±2.71	（月）	①②③④
牟超2020^[26]	PMT	PO	35	35	3.1±0.5	3.2±0.7	5.2±1.4	5.3±1.6	（月）	①②
崔平2020^[27]	PMT+PO	PO	35	35	3.29±1.25	3.51±1.43	4.26±1.24	4.58±1.33	（月）	①②
张琳琳2019^[28]	APA	PO	36	34	5.5±1.46	5.56±1.4	3.97±1.36	4.2±1.58	（月）	①②
王俪淇2019^[29]	PMT+PO	PO	52	52	3.67±1.14	3.64±1.12	6.25±1.81	6.27±1.83	（月）	①②③④
骆志昭等2019^[30]	PMT	PO	30	30	5.06±0.28	5.08±0.26	7.61±0.66	7.55±0.75	（月）	①②
刘彬媛2019^[31]	APA	PO	40	40	5.21±1.12	5.21±1.11	5.21±0.13	5.25±0.17	（月）	①②
高阿宁等2019^[32]	PMT	PO	43	43	3.52±1.32	3.48±1.08	9.08±3.41	8.86±2.37	（月）	①②③④
樊淑娟等2019^[33]	PMT	PO	45	45	4.43±1.37	4.58±1.44	5.56±2.35	5.66±2.42	（月）	①②④
张新平等2018^[34]	SF+PO	PO	40	40	8.5±1.6	8.4±1.3	3.3±1.6	3.4±1.4	（月）	①②
孙波2018^[35]	PMT	PO	54	51	3.06±0.84	2.85±0.7	-	-		①②
马建强等2018^[36]	PMT	PO	45	45	3.2±2.1	3.7±2.4	6.6±3.5	6.9±3.8	（月）	①②③④
李玉霞等2018^[37]	PMT+PO	PO	45	45	3.6±0.4	3.5±0.7	7.3±1.3	7.0±1.4	（月）	①②③④
李向云2018^[38]	SF+PO	PO	120	120	4.15±2.13	4.13±2.21	5.51±0.21	5.53±0.32	（月）	①②④
卓慕春2017^[39]	PMT	PO	40	40	3.34±1.21	3.31±1.24	-	-		①②④
钟慈英等2017^[40]	PMT	PO	40	40	4.12±1.12	4.14±1.24	4.11±1.01	4.21±1.34	（月）	①②④
汤丽珠2017^[41]	PMT	PO	30	30	40.47±16.22	40.87±17.29	10.57±6.68	9.67±5.31	（月）	①②
孔令霞等2017^[42]	SF+PO	PO	56	56	4.8	5.1	-	-		①②
喜悦等2016^[43]	SF	PO	41	42	8.13±5.13	7.96±4.88	11.67±6.22	12.62±7.25	（周）	①②③④
吴强等2016^[44]	PMT+PO	PO	122	121	3.7±2.0	3.3±2.2	-	-		①②
张强2013^[45]	PMT	PO	30	30	5.52±1.34	5.43±1.42	-	-		①②
张霞等2006^[46]	SF+PMT	PO	31	31	-	-	-	-		①②
熊建平等1998^[47]	APA	PO	103	70	4.3		8.3		（月）	①②③

Table 1

Fig.2

Fig.3

Fig.5

Table 3

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纳入研究	治疗措施（观察组/对照组）	不良反应
纳入研究	治疗措施（观察组/对照组）	观察组	对照组
刘乾等2024^[11]	小儿推拿/口服药物	恶心呕吐1例，腹泻1例	头晕1例，皮疹1例
王景润等2023^[14]	小儿推拿/口服药物	情绪低落1例，嗜睡1例，皮疹1例	情绪低落5例，嗜睡5例，皮疹4例
李绮玲2021^[21]	小儿推拿/口服药物	食欲不振1例，情绪低落1例，呕吐1例	食欲不振4例，情绪低落3例，呕吐3例
范亚丽等2021^[23]	小儿推拿/口服药物	便秘1例	便秘2例
张昊地2020^[24]	穴位贴敷/口服药物	轻微皮肤瘙痒1例	一过性恶心2例
张琳琳2019^[28]	穴位贴敷/口服药物	轻微皮肤瘙痒1例	一过性恶心2例
刘彬媛2019^[31]	穴位贴敷/口服药物	恶心1例，泄泻1例，皮疹1例	恶心1例，泄泻2例

A network Meta-analysis of the clinical efficacy of guideline-recommended external treatment of traditional Chinese medicine for anorexia in children

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