Tuina treatment for children and adults with functional dyspepsia: a meta-analysis and systematic review of randomized controlled trials

Objective To evaluate the efficacy and safety of Tuina (Chinese therapeutic massage) in the treatment of functional dyspepsia (FD) in children and adults. Methods Related articles in PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Web of Science, China Biology Medicine Disc (CBM), Wanfang Academic Journal Full-text Database (Wanfang), China National Knowledge Infrastructure (CNKI), and Chongqing VIP Database (CQVIP) were collected. The retrieval time was from each database’s start to March 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. A meta-analysis was then performed using the RevMan 5.4 software. Results A total of 19 clinical trials were included, 9 of which encompassed studies on adults while 10 were on children with FD, comprising a total of 1 961 patients. The findings of the meta-analysis showed that the effective rate of FD in children and adults treated with Tuina was significantly higher than that in the control group [risk ratio (RR)=1.15, 95% confidence interval (CI) (1.09, 1.21), P <0.001], [RR=1.13, 95%CI (1.06, 1.21), P <0.001]. In addition, the effective rate of FD in children and adults treated with Tuina combined with other treatments was significantly higher than that in the control group [RR=1.14, 95%CI (1.07, 1.21), P <0.001], [RR=1.12, 95%CI (1.02, 1.24), P =0.02]. In terms of single symptoms, Tuina improved epigastric burning sensation score in adults [standardized mean difference (SMD)=-0.41; 95%CI (-0.79, -0.02); Z =2.08; P =0.04] compared with that of the Western medicine group. Compared with children treated with oral Chinese medications (CM) or Chinese patent medicine (CPM), children with FD demonstrated lower scores of epigastric pain [SMD=-0.38, 95%CI (-0.56, -0.19); Z =3.96; P <0.001], postprandial fullness [SMD=-0.30, 95%CI (-0.50, -0.10); Z =2.88; P =0.004], and early satiety [SMD=-0.26, 95%CI (-0.47, -0.06); Z =2.54; P =0.01] after receiving Tuina combined with CM or CPM treatment. No adverse events were reported in the Tuina treatment group, and the follow-up indicated that the symptom scores in the Tuina group improved. Conclusion Compared with the control group, both Tuina and Tuina combined with other treatments are shown to have better effective rates, lower incidence of adverse events, and better follow-up outcomes. The study results suggest that Tuina may be a clinically viable complementary therapy. However, due to limitations in the number and quality of the included studies, the above conclusions should be verified by further high-quality studies.