| Objective: Based on literature research,the efficacy of external treatment of traditional Chinese medicine for simple obesity in children and adolescents was systematically evaluated by Meta analysis.Methods: The search was conducted on the commonly used Chinese and English literature database,and the search time was limited from the establishment of the database until now(the publication year of the final included literature was 1998 to 2022).The published clinical research literature on the application of external treatment of traditional Chinese medicine in the treatment of simple obesity in children and adolescents was published at home and abroad.Database selection: CNKI,Wanfang Data,VIP Information,Pub Med.The literature was screened and included,and the literature quality was evaluated to detect the publication bias.Data tables were established to collect information such as literature research objects,research protocols,outcome evaluation(efficacy index),etc.Meta-analysis software Review Manager 5.3was used for data analysis to evaluate the heterogeneity and statistical significance among the data.Forest maps and funnel plots were drawn for display.If necessary,subgroup analysis was conducted to explore the possible sources of heterogeneity differences.Results: A total of 2029 literatures were collected through professional retrieval,including 2019 in Chinese and 10 in English.After eliminating repetition,reading titles and abstracts,and intensive reading,a total of 43 scientific research results and academic papers were included,including 42 in Chinese and 1 in English.The results of literature quality evaluation and bias risk analysis showed that the literature was generally weak in implementing the blind method.The meta-analysis included the effectiveness of TCM external treatment on obesity in children and adolescents and the primary and secondary outcome indexes.The results showed that the grouped data were statistically significant,and the heterogeneity and bias risks were basically controllable.The results of meta-analysis showed that massage therapy and auricular acupoint therapy were the most commonly used external treatment methods of traditional Chinese medicine in pediatric clinic.(1)The effect on the effectiveness: the effectiveness of "massage + auricular point group >auricular point group > massage group",three groups of treatment on the effectiveness of all have improved effect.(2)The influence on weight: improve the weight "massage group >auricular point group",both groups have the effect of weight reduction,which auricular point group on large base weight loss effect is better.(3)Influence on height: massage and auricular point therapy have an increasing effect on height in most single studies of forest figure;However,comprehensive analysis showed that massage and auricular point had no statistical significance on height.It is considered that the age span of each study sample population is large,and the growth and development speed of children and adolescents are quite different.(4)The influence of body mass index(BMI): reduce the body mass index "acupuncture group > massage group >auricular point group",three groups have reduced body mass index effect.(5)The influence of massage on body fat percentage: The analysis only included massage group,the results indicated that massage has a reducing effect on body fat percentage,but the effect is more obvious for the higher base body fat percentage,which may be related to the advantage of massage on fat reduction.(6)the influence of waist circumference: reduce the waist "massage group > auricular point group",two groups have reduced effect on waist circumference.(7)Influence on hip circumference: massage group analysis did not have statistical significance;Auricular point group can reduce hip circumference.(8)Effects on waist-to-hip ratio: Only massage group was included in the analysis,massage had a reduced effect on waist-to-hip ratio.(9)The effect on total cholesterol(TC): there was no statistical significance in auricular point group analysis;The massage group had a lower effect on total cholesterol.(10)Influence on triglyceride(TG):There was no statistical significance in auricular point group analysis;The massage group had a lower effect on triglyceride.(11)Effects on high density lipoprotein(HDL): Only the massage group was included,and massage had an elevated effect on HDL.(12)The effect on low density lipoprotein(LDL): only the massage group was included,and massage had a lowering effect on LDL.(13)Effects on high-density lipoprotein cholesterol(HDL-C): only the auricular point group was included,and there was no statistical significance in the analysis of auricular point group.Conclusion:(1)The effectiveness of external treatment of traditional Chinese medicine for simple childhood and adolescent obesity is clear.(2)TCM external treatment can improve primary and secondary outcome indexes such as body weight,body fat percentage,waist circumference,hip circumference,waist-to-hip ratio and blood lipid in children and adolescents with simple obesity,and has a positive effect.(3)For other physical and chemical indexes such as changes in blood sugar,blood pressure and hormone levels,although there were less than 3similar literature data,which could not meet the needs of meta-analysis,there were still definite effects in literature description and data statistics.(4)In the process of literature research,there are very few cases of sample loss due to intolerance to external treatment of traditional Chinese medicine.The compliance of children is greatly improved,and the adverse reactions are less,which is a good choice for children and adolescents.To sum up,external treatment of traditional Chinese medicine can be considered into routine clinical treatment. |
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