| ObjectiveChronic cough is a common disease in pediatrics,and upper airway cough syndrome is one of the common causes of chronic cough in children.There are few clinical reports on the treatment of children's upper airway cough syndrome with pediatric massage.This study aims to verify the efficacy and safety of pediatric massage for children's upper airway cough syndrome.MethodsStudy 1:A meta-analysis of randomized controlled trials of massage for chronic cough in childrenChose randomized controlled trials and quasi-randomized controlled trials of massage therapy for chronic cough in children.We searched CNKI,VIP,Wan Fang,PubMed database,the Cochrane library and Web of Science.The deadline for searching was from their inception to January 1,2020.Literature screening and data extraction were carried out by two researchers independently,and the methodological quality of included literature was evaluated by referring to the Cochrane Handbook for Systematic Reviews of Interventions.RevMan5.3 software was used for data analysis.The data results of dichotomous variables were expressed by relative risk(RR),and that of continuous variables were expressed by mean difference(MD),all of which were 95%confidence intervals.Study 2:Observation of the clinical effect of massage on children with upper airway cough syndromeWe set two groups which were observation group and control group in this experiment.The observation group used the infantile massage therapy,and the control group used oral Chinese medicine.We collected cases from infantile massage outpatient and otolaryngology outpatient in our hospital respectively.For children meeting inclusion and exclusion criteria,the symptom and sign scores were record respectively before the treatment and they were divided according to the TCM syndrome features into three types which were qi deficiency of both lung and spleen type,excessive heat in lung and stomach type,stagnation of phlegm and dampness type.According to these different TCM syndrome types.they were treated by different pediatric massage manipulations or prescriptions,and the acupoints and manipulations in the massage group were different depending on the children's upper airway cough syndrome caused by nose or throat.Children in the massage group received treatment once a day for a total of 5 times a week and about 30 minutes each time,and the oral Chinese medicine group received a dose of Chinese medicine once a day.Children all received treatment for a course of two weeks for a total of 3 courses.After the course of treatment,the scores of symptoms and signs of children in the two groups were recorded.According to the scores of symptoms and signs before and after treatment,the efficacy index was calculated and according to the efficacy index,it was divided into three results:obvious effect,effect and no effect,and the total effective rate of the two groups was calculated.In this study,the primary outcome was the total effective rate and the secondary outcome was the symptom and sign scores.SPSS22.0 was used for statistical calculation.ResultsStudy 1:a meta-analysis of randomized controlled trials of massage for chronic cough in childrenA total of 10 studies were included,involving 691 children,with the ratio of male to female being 1.08 to 1,and the overall quality of the literature included was low.Compared with one therapy only such as montelukast sodium,antibiotic,acupoint application,the total effective rate of combining massage with them in treating chronic cough in children was higher(RR 1.18,95%CI 1.09,1.27,P<0.0001,n=5,I2=0%).The total effective rate of massage in treating chronic cough in children was higher than that of traditional Chinese medicine,Chinese patent medicine and montelukast sodium(RR 1.14.95%CI 1.03,1.26,P=0.008,n=5,I2=22%).Study 2:Observation of the clinical effect of massage on children with upper airway cough syndromeA total of 55 cases were included in this study including 27 cases in the massage group and 28 cases in the oral Chinese medicine group.In the massage group,there were 20 males and 7 females,and 17 males and 11 females in the traditional Chinese medicine group.The age of children in the massage group was 4.19±1.33,and that of the oral Chinese medicine group was 5.07±1.76.The disease duration of children in the massage group was 1.93±1.17.and that of the oral Chinese medicine group was 1.68±1.39.In the massage group,there were 4 cases of qi deficiency of both lung and spleen type.15 cases of excessive heat in lung and stomach type,8 cases of stagnation of phlegm and dampness type,and in the oral Chinese medicine group,there were3 cases of qi deficiency of both lung and spleen type,14 cases of excessive heat in lung and stomach type,and 11 cases of stagnation of phlegm and dampness type.The total score of symptoms and signs before treatment was 11.11±2.82 in the massage group,and 11.36±2.73 in the traditional Chinese medicine group.By comparing the gender,age,disease course,TCM syndrome type,and total score of symptoms and signs before treatment of the two groups,there was no statistical difference between the baseline information of the two groups,which were comparable.The total score of symptoms and signs in the massage group after treatment was 2.41±2.02,and that in the traditional Chinese medicine group was 2.75±2.08,and the differences between total score of symptoms and signs before treatment and that after treatment in two groups were both statistically significant(P<0.05).After treatment there were 17 cases of obvious efficacy,9 cases of effective efficacy and 1 case of ineffective efficacy in the massage group,and 14 cases of obvious efficacy,12 cases of effective efficacy and 2 cases of ineffective efficacy in the traditional Chinese medicine group.The total effective rate of the massage group was 96.3%,and that of the traditional Chinese medicine group was 92.9%.There was no statistically significant difference in the total effective rate between the two groups(P>0.05).The difference of total symptoms and signs scores before and after treatment in the massage group was 8.70±0.39,and that in the traditional Chinese medicine group was 8.61±0.46.There was no statistically significant difference between the two groups(P>0.05).No adverse reactions were found in the treatment of the two groups.ConclusionThe clinical effectiveness of massage therapy for chronic cough in children is exact,and compared with the conventional oral drug treatment,the total effective rate of massage is higher.For children with higher airway cough syndrome,infantile tuina can obviously decrease the total scores of signs and symptoms,and is the same as oral Chinese medicine in the aspects of decreasing symptoms and signs scores and the total effective rate.Pediatric massage therapy on children's airway cough syndrome is safe and effective. |
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