Sommaire

Tourette Syndrome

Syndrome de Gilles de la Tourette : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

1.1. Li 2024

Li J, Li C, Ma Y, Yuan M, Liu Y. Efficacy and Safety of Acupuncture Combined with Herbal Medicine for Children and Adolescents with Tourette Syndrome: A Systematic Review and Meta-Analysis. Complement Med Res. 2024;31(1):40-55. English. https://doi.org/10.1159/000534115

Backgound With the increasing prevalence of Tourette syndrome (TS), the search for alternative therapy for TS is a growing public concern. In recent years, a growing number of randomized controlled trials (RCTs) have revealed the value of acupuncture combined with herbal medicine for the treatment of TS; however, its holistic efficacy and safety remains unclear. This study aimed to evaluate the efficacy and safety of acupuncture combined with herbal medicine and to provide preliminary evidence for clinical practice.
Methods Eight databases were searched from their establishment to November 27, 2022, to collect RCTs of acupuncture combined with herbal medicine for TS treatment. Two researchers independently completed the study screening, data extraction, and risk of bias assessment by using NoteExpress, Excel, and Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Stata 15.0 software was applied to conduct meta-analysis.
Results A total of 1,400 participants in 18 RCTs were included. Compared with the Western medicine, acupuncture combined with herbal medicine had better curative effect in the field of effective rate (risk ratio [RR] = 1.18, 95% CI: [1.12, 1.23], p < 0.05, I2 = 0%), Yale Global Tic Severity Scale (YGTSS) total score (mean difference [MD] = -3.91, 95% CI: [-5.49, -2.33], p < 0.05, I2 = 96.4%), TCM syndrome total score (MD = -2.42, 95% CI: [-3.71, -1.13], p < 0.05, I2 = 87.1%), and serum IgE negative rate (RR = 3.41, 95% CI: [1.69, 6.87], p < 0.05, I2 = 0%). Furthermore, acupuncture combined with herbal medicine reduced the adverse reaction rate (RR = 0.20, 95% CI: [0.14, 0.30], p < 0.05, I2 = 0%) and the recurrence rate (RR = 0.27, 95% CI: [0.13, 0.52], p < 0.05, I2 = 0%).
Conclusion This study demonstrated the efficacy and safety of acupuncture combined with herbal medicine, which is probably a better alternative therapy for TS. However, the small number, low quality, and potential bias of the included studies caused the limitations of our results. More high-quality RCTs are required to provide supplementary evidence in the future.

1.2. Zhu 2020 ☆

Zhu Bochang. [Efficacy of acupuncture and moxibustion for treating Tourette syndrome: a meta analysis]. Journal of Modern Medicine & Health-. 2020. [212904].

ObjectiveTo systematically evaluate the clinical efficacy of acupuncture and moxibustion in the treatment of Tourette syndrome.
Methods The clinical randomized controlled trials of acupuncture and moxibustion in the treatment of Tourette syndrome with oral Western medicine as the control were retrieved from the databases of CNKI, Weipu Information Chinese periodical service platform (VIP), Wanfang database, Pubmed and Cochrane Library by computer. The retrieval time was from the establishment of the database to October 6, 2018. Acupuncture and moxibustion adopted the Cochrane system evaluation method and the RevMan 5. 3 software was used to systematically evaluate the included data.
Results A total of 19 papers involving 1 544 patients with Tourette syndrome were included. The total effective rate of acupuncture and moxibustion for treating Tourette syndrome was significantly higher than that of oral Western medicine. The improvement of YGTSS score in the acupuncture and moxibustion had significant superiority than oral Western medicine, and the difference between them was statistically significant (P<0. 05).
Conclusion Acupuncture and moxibustion is effective in the treatment of Tourette syndrome. Compared with oral Western medicine, it has certain curative effect advantages. However, the quality of the included literatures is low and there are some biases. A large number of high-quality randomized controlled trials are needed for further support.

1.3. Chung 2016

Chung Sun-Yong, Noh Byoung Jin, Lee Chang-Won, Hwang Man Ki et al. Acupuncture for Tourette syndrome: A systematic review and meta-analysis. European Journal of Integrative Medicine. 2016;8(5): 809-816. [207401].

Introduction Tourette syndrome (TS) is a tic disorder with multiple motor and vocal or phonic tics. The effect of acupuncture for TS has not been well established.
Methods English, Japanese, Korean and Chinese databases, were explored systematically for randomized controlled trials investigating the use of acupuncture for treating TS, up to August 2016, without language restrictions. All studies evaluating the effects of acupuncture were identified. Studies assessing the effect of moxibustion were excluded. All ages were considered. Data were extracted independently using predefined data fields, including study quality indicators. All pooled analyses were based on random-effects models. The authors individually evaluated risk of bias with the Cochrane Collaboration’s tools.
Results Nineteen Studies (N = 1483) were systematically reviewed. A significant benefit was observed for studies comparing acupuncture versus medication (pooled the risk ratio showed improvement by 1.17; 95% confidence interval: 1.10–1.25, p < 0.00001). Reporting of adverse events was poor with only one study which reported that there were no adverse events in their acupuncture treatment group.
Conclusions This analysis provided limited evidence from studies for the practice of acupuncture in treating TS. However, the conclusions were limited by a high risk of bias. Future studies are needed to verify the superior features of acupuncture. Further study into the efficacy and safety of acupuncture is warranted.

1.4. Yu 2016 ☆

Yu J, Ye Y, Liu J, Wang Y, Peng W, Liu Z. Acupuncture for Tourette Syndrome: A Systematic Review. Evid Based Complement Alternat Med. 2016;1834646. [158338].

Objectives Tourette syndrome (TS) is a neuropsychiatric disorder that affects both children and adults.
Methods We searched for randomised controlled trials (RCTs) using acupuncture to treat TS written in English or Chinese without restrictions on publication status. Study selection, data extraction, and assessment of study quality were conducted independently by two reviewers. Meta-analyses were performed using Review Manager (RevMan) 5.3 software from the Cochrane Collaboration. Data were combined with the fixed-effect model based on a heterogeneity test.
Results Results were presented as risk ratios for dichotomous data and mean differences (MDs) for continuous data. This review included 7 RCTs with a total of 564 participants.
Conclusions The combined results showed that acupuncture may have better short-term effect than Western medicine for TS and that acupuncture may be an effective adjuvant therapy in improving the effect of Western medicine on TS, but the evidence is limited because of existing biases. Rigorous high-quality RCTs are needed to verify these findings.