Top

Published in:

Open Access 01-12-2021 | Diarrhea | Research

Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial

Authors: Taoying Lu, Lingjia Yin, Ruoqing Chen, Huiyan Zhang, Jianxiong Cai, Meiling Li, Lin Dai, Conghao Zhu, Yongping Zhang, Feng Xiang, Li Wang, Lu Li, Lixin Wang, Darong Wu

Published in: Health and Quality of Life Outcomes | Issue 1/2021

Abstract

Background

Pediatric Tuina has been widely used in children with acute diarrhea in China. However, due to the lack of high-quality clinical evidence, the benefit of Tuina as a therapy is not clear. We aimed to assess the effect of pediatric Tuina compared with sham Tuina as an add-on therapy in addition to usual care for 0–6-year-old children with acute diarrhea.

Methods

Eighty-six participants aged 0–6 years with acute diarrhea were randomized to receive pediatric Tuina plus usual care (n = 43) or sham Tuina plus usual care (n = 43). The primary outcomes were days of diarrhea from baseline and times of diarrhea on day 3. Secondary outcomes included a global change rating (GCR) and the number of days when the stool characteristics returned to normal. Adverse events were assessed.

Results

Pediatric Tuina was associated with a reduction in times of diarrhea on day 3 compared with sham Tuina in both ITT (crude RR, 0.73 [95% CI, 0.59–0.91]) and PP analyses (crude RR, 0.66 [95% CI, 0.53–0.83]). However, the results were not significant when we adjusted for social demographic and clinical characteristics. No significant difference was found between groups in days of diarrhea, global change rating, or number of days when the stool characteristics returned to normal.

Conclusions

In children aged 0–6 years with acute diarrhea, pediatric Tuina showed significant effects in terms of reducing times of diarrhea compared with sham Tuina. Studies with larger sample sizes and adjusted trial designs are warranted to further evaluate the effect of pediatric Tuina therapy.

Trial registration

Clinicaltrials.gov, Identifier: NCT03005821, Data of registration: 2016-12-29.

Available only for authorised users

Das JK, Bhutta ZA. Global challenges in acute diarrhea. Curr Opin Gastroenterol. 2016;32:18–23. https://doi.org/10.1097/MOG.0000000000000236.CrossRefPubMed

Walker CL, Rudan I, Liu L, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381:1405–16. https://doi.org/10.1016/S0140-6736(13)60222-6.CrossRefPubMedPubMedCentral

GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388:1459–544. https://doi.org/10.1016/S0140-6736(16)31012-1.CrossRef

GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the global burden of disease study 2015. Lancet Infect Dis. 2017;17:909–48. https://doi.org/10.1016/S1473-3099(17)30276-1.CrossRef

Simpson E, Zwisler G, Moodley M. Survey of caregivers in Kenya to assess perceptions of zinc as a treatment for diarrhea in young children and adherence to recommended treatment behaviors. J Glob Health. 2013;3:010405. https://doi.org/10.7189/jogh.03.010405.CrossRefPubMedPubMedCentral

Ahmed S, Nasrin D, Ferdous F, et al. Acceptability and compliance to a 10-day regimen of zinc treatment in diarrhea in rural Bangladesh. Food Nutr Sci. 2013;4:357–64. https://doi.org/10.4236/fns.2013.44046.CrossRef

Donowitz M, Alpers DH, Binder HJ, Brewer T, Carrington J, Grey MJ. Translational approaches for pharmacotherapy development for acute diarrhea. Gastroenterology. 2012;142:e1–9. https://doi.org/10.1053/j.gastro.2012.01.014.CrossRefPubMedPubMedCentral

Zwisler G, Simpson E, Moodley M. Treatment of diarrhea in young children: results from surveys on the perception and use of oral rehydration solutions, antibiotics, and other therapies in India and Kenya. J Glob Health. 2013;3(1):010403. https://doi.org/10.7189/jogh.03.010403.CrossRefPubMedPubMedCentral

Zhang XH, Guo TP, Zhu BW, et al. Pediatric Tuina for promoting growth and development of preterm infants: a protocol for the systematic review of randomized controlled trail. Medicine (Baltimore). 2018;97(18):e0574. https://doi.org/10.1097/MD.0000000000010574.CrossRef

10.

World Health Organization. Benchmarks for training in traditional/ complementary and alternative medicine:benchmarks for training in tuina. Geneva: World Health Organization; 2010. http://www.who.int/iris/handle/10665/44358. Accessed 12 July 2020

11.

Liao PD. Pediatric Tuina [in Chinese]. Beijing: People’s Medical Publishing House; 2016.

12.

Liu JE. Comparative analysis on clinical curative effects of acupuncture combined with Chinese massage and montmorillonite powder in treatment of children with acute non-bacterial diarrhea [in Chinese]. J Basic Chin Med. 2018;24:387–9.

13.

Liu L, Yang WT, Zheng YL, et al. Comparative analysis on clinical curative effects of traditional Chinese medicine decoction combined with Tuina and montmorillonite powder in treatment of children with acute non-bacterial diarrhea [in Chinese]. Mater Child Health Care China. 2015;30:5905–6.

14.

Wang KT, Li QR. Therapeutic effect of Tuina combined with Nuanqitieon children with acute non-bacterial diarrhea [in Chinese]. Mater Child Health Care China. 2017;32:4730–1.

15.

Chang ZH, Chen CL, Cheng K. Study on the therapeutic effect of three-character-scripture school Tuina combined with acupuncture in the treatment of acute diarrhea in children [in Chinese]. Lab Med Clin. 2019;16:3539–41.

16.

Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 2005;115:1397–413. https://doi.org/10.1080/00207450590956459.CrossRefPubMed

17.

Field T, Diego M, Hemandez-Reif M, et al. Insulin and insulin-like growth factor-1 increased in preterm neonates following massage therapy. J Dev Behav Pediatr. 2008;29:463–6. https://doi.org/10.1097/DBP.0b013e3181856d3b.CrossRefPubMedPubMedCentral

18.

Lindgren L, Rundgren S, Winsö O, et al. Physiological responses to touch massage in healthy volunteers. Auton Neurosci. 2010;158:105–10. https://doi.org/10.1016/j.autneu.2010.06.011.CrossRefPubMed

19.

Powell L, Cheshire A, Swaby L. Children’s experiences of their participation in a training and support programme involving massage. Complement Ther Clin Pract. 2010;16:47–51. https://doi.org/10.1016/j.ctcp.2009.06.013.CrossRefPubMed

20.

Zhou HY, Xu XM. Effect of TCM Tuina on immune function and inflammatory factors in children with diarrhea [in Chinese]. J Pract Tradit Chin Intern Med. 2020;34(4):69–72.

21.

Gao L, Jia C, Huang H. Paediatric massage for treatment of acute diarrhoea in children: a meta-analysis. BMC Complement Altern Med. 2018;18:257. https://doi.org/10.1186/s12906-018-2324-4.CrossRefPubMedPubMedCentral

22.

Lai BY, Liang N, Cao HJ, et al. Pediatric Tui Na for acute diarrhea in children under 5 years old: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med. 2018;41:10–22. https://doi.org/10.1016/j.ctim.2018.08.011.CrossRefPubMed

23.

Lai BY, Wang LQ, Jia LY, et al. Evaluation on methodological and reporting quality of randomized controlled trials of Tuina therapy for childhood diarrhea using CONSORT and STRICTA standards [in Chinese]. J Tradit Chin Med. 2018;59:941–6.

24.

Lu TY, Zhang HY, Yin LJ, et al. Chinese pediatric Tuina on children with acute diarrhea: study protocol for a randomized sham-controlled trial. Trials. 2019;20:689. https://doi.org/10.1016/j.aimed.2019.03.264.CrossRefPubMedPubMedCentral

25.

Shen XM, Wang WP. Pediatrics [in Chinese]. 7th ed. Beijing: People’s Medical Publishing House; 2011.

26.

World Health Organization. Diarrhoeal disease fact sheet N 330. 2015. http://www.who.int/mediacentre/factsheets/fs330/en/. Accessed 16 Sept 2015.

27.

Huang YL, Lv FW. Treating 35 cases of infantile autumn diarrhea by Smecta and Tuina [in Chinese]. Shandong J Tradit Chin Med. 1999;17:25–6.

28.

Li Y, Di W. Observation of therapeutic effect of massage on rotavirus enteritis [in Chinese]. Modern J Integr Tradit Chin Western Med. 2006;15:3357–8.

29.

Chen LL, Su YC, Su CH, Lin HC, Kuo HW. Acupressure and meridian massage: combined effects on increasing body weight in premature infants. J Clin Nurs. 2008;17:1174–81. https://doi.org/10.1111/j.1365-2702.2007.02147.x.CrossRefPubMed

30.

Yang XX. Observation on therapeutic effect of Tuina on infantile diarrhea [in Chinese]. Liaoning J Tradit Chin Med. 2005;32:1301.

31.

Tian QL. 55 cases of infantile diarrhea treated with the combination of Tuina and auricular point sticking [in Chinese]. Shanghai J Acup Moxib. 2008;27:33.

32.

Xie WJ, Li WC, Tang W, Liu SY. Clinical observation of Liu’s pediatric Tuina in the treatment of acute diarrhea in children [in Chinese]. J Pract Tradit Chin Med. 2019;35:863–4.

33.

Cui XL. Observation on therapeutic effect of moxibustion combined with Tuina on children with acute diarrhea [in Chinese]. J Pract Tradit Chin Med. 2019;35:1017–8.

34.

Shang Y. Clinical observation on 45 cases of acute non-bacterial infections diarrhea in children treated with the combination of modified Weiling decoction and Tuina [in Chinese]. J Pediatr Tradit Chin Med. 2018;14:58–60.

35.

Li XF, Yan YB, Dian YB. Clinical effective observation on treating diarrhea in the acute phase in infants by massage [in Chinese]. Clin J Chin Med. 2015;7:22–3.

36.

Guo XQ, Wang YG, Zeng QY. Systematic review of pediatric tuina for infantile diarrhea [in Chinese]. J Tradit Chin Med. 2012;53:1198–201.

37.

Si MR, Cai JH, Wang WY, Ji Q. Systematic review of comparing pediatric tuina therapy with montmorillonite in treating children diarrhea [in Chinese]. China Med Herald. 2016;13:76–9.

38.

Peng Y, Leng L, Chen Z, et al. Acute infantile diarrhea treated with infantile Tuina: a multicentre randomized controlled trial [in Chinese]. Chin Acup Moxib. 2011;31:1116–20.

39.

Tao HQ, Li ZS, Xu L. Clinical efficacy of massage in treatment of infantile indigestion diarrhea caused by improper diet: a report of 30 cases [in Chinese]. J Anhui Univ Chin Med. 2015;34:33–5.

40.

Chen QY, Li RH, Wang AJ. Clinical study of traditional Chinese medicine massage therapy in the treatment of diarrhea in children [in Chinese]. Res J Integr Tradit Chin West Med. 2019;11:236–8 242.

41.

Tang ST, Zhang LL. Massage therapy for 45 cases of chronic diarrhea in children [in Chinese]. Chin J Trait Med Sci Techno. 2020;27:107–8.

42.

Wang YJ, Guo Y. Study on key problems in the positive control design methods of acupuncture and moxibustion [in Chinese]. Chin Acup Moxib. 2009;29:321–4.

43.

Ho YB, Lee RS, Chow CB, Pang MY. Impact of massage therapy on motor outcomes in very low-birthweight infants: randomized controlled pilot study. Pediatr Int. 2010;52:378–85. https://doi.org/10.1111/j.1442-200X.2009.02964.x.CrossRefPubMed

44.

Diego MA, Field T, Hernandez-Reif M. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J Pediatr. 2005;147:50–5. https://doi.org/10.1016/j.jpeds.2005.02.023.CrossRefPubMed

45.

Vickers A, Ohlsson A, Lacy JB, Horsley A. Massage for promotinggrowth and development of preterm and/or low birth-weight infants. https://www.cochrane.org/CD000390. Accessed 12 July 2020.

Title: Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial
Authors: Taoying Lu
Lingjia Yin
Ruoqing Chen
Huiyan Zhang
Jianxiong Cai
Meiling Li
Lin Dai
Conghao Zhu
Yongping Zhang
Feng Xiang
Li Wang
Lu Li
Lixin Wang
Darong Wu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Diarrhea
Diarrhea
Published in: Health and Quality of Life Outcomes / Issue 1/2021
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-020-01636-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2021

Translation and validation of the Arabic version of the osteoarthritis quality of life questionnaire (OAQoL) in Saudi patients with osteoarthritis

Predictors of poor health-related quality of life among hemodialysis patients with anemia in Jordan

Mothers’ quality of life delivering kangaroo mother care at Malawian hospitals: a qualitative study

Impact of moderate-to-severe psoriasis on quality of life in China: a qualitative study

Same same-but different: using qualitative studies to inform concept elicitation for quality of life assessment in telemedical care: a request for an extended working model

Short Inflammatory Bowel Disease Questionnaire: translation and validation to the Portuguese language