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CC BY 4.0 · Chinese medicine and natural products 2023; 03(04): e143-e157
DOI: 10.1055/s-0043-1777296
Review Article

Systematic Review and Meta-analysis of Randomized Controlled Trials on Manual Therapy for the Treatment of Gastroesophageal Reflux Disease

Mengdie Yan
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Yunzhou Shi
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Yanqin Liu
2   Department of Massage, Pidu District Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Yue Shi
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Mengzhu Zhang
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Dongnan Chen
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Senlin Ye
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Shiyin Li
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
,
Yue Feng
1   College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
› Institutsangaben Funding This work was supported by the National Natural Science Foundation of China (82074575), Project of Sichuan Provincial Administration of Traditional Chinese Medicine (2020LC0029), and Chengdu University of Traditional Chinese Medicine Teaching Quality Project Key Programs (ZLGC202140).
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Abstract

Objective The objective of our study was to systematically evaluate the clinical efficacy and safety of manual therapy in the treatment of gastroesophageal reflux disease (GERD), providing a reference value for clinical decision-making.

Method Studies of randomized controlled trials (RCTs) evaluating the efficacy of manual therapy in patients with GERD were searched through Chinese National Knowledge Infrastructure, Wanfang, VIP China Science and Technology Journal Database, China Biology Medicine Database, PubMed, The Cochrane Library, OVID Medline, and Embase. Two researchers independently reviewed the literature, extracted data, and performed a risk of bias analysis using the Cochrane risk of bias assessment tool, and conducted meta-analysis analysis and publication bias evaluation, the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool 26 was used to rate the caliber of the data in this meta-analysis.

Results This study included 11 RCTs. Meta-analysis showed that the manual therapy group had a higher total effective rate (odds ratio [OR] = 4.63, 95% confidence interval [CI; 3.01, 7.14], p < 0.00001) and better Reflux Disease Questionnaire scores {weighted mean difference (WMD) = −1.59, 95% CI [−2.85, −0.33], p = 0.01} than the control group. The subgroup analysis showed significant differences in improving the total effective rate in manual therapy versus Western medicine, manual therapy versus Chinese medicine decoction, manual therapy + Western medicine versus Western medicine, and manual therapy + conventional treatment versus conventional treatment groups. Among the 11 trials, 5 reported adverse events, and all RCTs had the possibility of publication bias. Subgroup analysis shows that the differences in age could significantly influence heterogeneity; The GRADE analysis revealed that the overall quality of evidence for all outcome indicators was low and did not support our recommendation for the outcome.

Conclusion Manual therapy is more effective than medication therapy alone in relieving GERD symptoms. Furthermore, conventional therapy combined with manual therapy was found to be even more effective. Hence, it is crucial to consider these findings when applying manual therapy to GERD patients to enhance treatment outcomes. Future studies must address issues such as study quality, treatment duration, and generalizability.

Keywords

gastroesophageal reflux disease - manual therapy - tuina - massage - systematic review - meta-analysis

CRediT Authorship Contribution Statement

M.Y. was responsible for conceptualization, data curation and formal analysis, and writing original draft. Y.S. was responsible for conceptualization, methodology, and writing review and editing. Y.L. was responsible for methodology, methodology. Y.S. and M.Z. were responsible for data curation and formal analysis. S.Y., D.C., and S.L. were responsible for literature searching and funding acquisition. Y.F. was responsible for funding acquisition and writing review and editing.




Publikationsverlauf

Eingereicht: 20. Juli 2023

Angenommen: 11. August 2023

Artikel online veröffentlicht:
28. Dezember 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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