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Cerebral Palsy in Children
Zhang 2010
Objective| The objective of this study was to systematically evaluate the effects of Traditional Chinese Medicine (TCM) therapy including acupuncture, tu’ina, oral herbal medicine, herbal bathing, and collateral-channels conduct therapy for treating children with cerebral palsy (CP)¶ Methods| We included randomized controlled trials (RCTs) on TCM for children with CP. We searched the China National Knowledge Infrastructure, Database for Chinese Technical Periodicals, Chinese Biomedical Literature Database, databases of Chinese biomedical journals=Chinese Medical Current Contents, Wan Fang Data, PubMed, MEDLINE,Ò Embase, and the Cochrane Library until the end of July 2009, and searched the reference list of retrieved papers. Data were extracted by 1 author and checked for validation by another author, and data were analyzed using RevMan 4.3.2. Only one meta-analysis was performed due to the heterogeneity among the trials. Results: Thirty-five (35) RCTs involving 3286 children with CP using TCM therapy and conventional therapy (CT) including physical, occupational, and speech therapy, hyperbaric oxygen, cranial nerves nutrition agents, or any combination of above were included. The methodological quality was generally low in terms of allocation concealment, blinding, and intention-to-treat analysis.¶ Meta-analysis| showed acupuncture combine with CT improved activities of daily living (mean difference: 6.38, 95% confidence interval 5.15–7.61; p < 0.00001, n 1⁄4 160) compared with CT alone. Acupuncture plus tu’ina, or plus herbal medicine and CT showed significant beneficial effects on comprehensive function in terms of both physical and mental aspects, independence, and verbal function compared with CT alone. The combination of radix Astragali injection with CT showed significant benefit on gross motor function and social behavior adaptation comparing with CT. There are six trials reported adverse events that were not associated with acupuncture, tu’ina, and=or herbal medicine.¶
Conclusions|: Acupuncture with or without CT or other conventional therapy, tu’ina, herbal medicine, and collateral channels conduct treatment combined with CT may have benefit in children with CP. However, due to insufficient evidence, further rigorous trials are warranted
encéphalopathie hypoxique-ischémique du nouveau-né : évaluation de l'acupuncture
1. Wong 2013
Wong V, Cheuk Dk, Chu V. Acupuncture for hypoxic ischemic encephalopathy in neonates. Cochrane Database Syst Rev. 2013. [160660].
| Background | Hypoxic ischemic encephalopathy (HIE) in the neonate is associated with high mortality and morbidity. Effective treatment options are limited and therefore alternative therapies such as acupuncture are increasingly used. |
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| Objectives | We sought to determine the efficacy and safety of acupuncture on mortality and morbidity in neonates with HIE. |
| Methods | Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Cochrane Neonatal Specialized Register, MEDLINE, AMED, EMBASE, PubMed, CINAHL, PsycINFO, WHO International Clinical Trials Registry Platform, and various Chinese medical databases in November 2012. Selection criteria: We planned to include randomized or quasi-randomized controlled trials comparing needle acupuncture to a control group that used no treatment, placebo or sham treatment in neonates (less than 28 days old) with HIE. Co-interventions were allowed as long as both the intervention and the control group received the same co-interventions. We excluded trials that evaluated therapy that did not involve penetration of the skin with a needle or trials that compared different forms of acupuncture only. Data collection and analysis: Two review authors independently reviewed trials for inclusion. If trials were identified, the review authors planned to assess trial quality and extract data independently. We planned to use the risk ratio (RR), risk difference (RD), and number needed to benefit (NNTB) or harm (NNTH) with 95% confidence intervals (CI) for dichotomous outcomes, and mean difference (MD) with 95% CI for continuous outcomes. |
| Main results | No trial satisfied our predefined inclusion criteria. Existing trials only evaluated acupuncture in older infants who survived HIE. There are currently no randomized controlled trials evaluating the efficacy of acupuncture for treatment of HIE in neonates. The safety of acupuncture for HIE in neonates is unknown. |
| Authors' conclusions | The rationale for acupuncture in neonates with HIE is unclear and the evidence from randomized controlled trial is lacking. Therefore, we do not recommend acupuncture for the treatment of HIE in neonates. High quality randomized controlled trials on acupuncture for HIE in neonates are needed. |
