Combined effect of external treatment of herbal medicine and tuina in congenital muscular torticollis: Systematic review and meta-analysis

Scientific knowledge graph and trend analysis of Tuina: A bibliometric analysis

OBJECTIVES

Tuina is an effective complementary and alternative therapy. However, no bibliometric analysis has explored the global research status and emerging trends of tuina. Therefore, our study aimed to provide a perspective on the current state and frontier trends in the field.

DESIGN

Bibliometric analysis SETTING: Tuina-related publications between January 1, 2003, and December 31, 2022, were obtained from the Web of Science Core Collection database.

MAIN OUTCOME MEASURES

The knowledge graph software CiteSpace and VOSViewer were used to quantitatively analyse annual trends in annual publication volume, journals, countries, institutions, authors, cited references, and keywords.

RESULTS

Overall, 1877 articles were obtained. Consequently, the number of annual publications in tuina gradually increased. China published the most articles (1402 articles, 58.01%), followed by the Chinese Academy of Sciences (110 articles, 2.57%). Original and review articles were the two main types of publications. Photonics Research ranked first (101 articles, 5.38%) as the most influential affiliate and productive journal. These articles come from 8423 authors, among whom Min Fang published the most publications, and Ernst E was co-cited most often. According to the keyword co-occurrence analysis, the new research frontiers were meta-analyses.

CONCLUSION

This comprehensive bibliometric study analysed the publications on tuina and presented them visually, revealing new research trends, pivotal points, research hotspots, and frontiers. Prospective strategies and potential directions for further studies were also provided.

External Treatment of Pyritum for Musculoskeletal Trauma: a protocol for systematic review

Objectives

Musculoskeletal trauma is a common type of injury that can result from damage to the muscular or skeletal system and has been recognized as a leading cause of death and disability worldwide. This study aims to analyze the efficacy of Pyritum external treatment for musculoskeletal trauma.

Methods

Randomized controlled trials evaluating the external treatment effect of Pyritum on various types of musculoskeletal traumatic injuries will be considered and identified in the searches of eight databases from their inception to Feb 2023. There will be no restrictions with respect to the publication status, language, or country. The experimental intervention group will be treated with external application of Pyritum alone or in combination with other therapies, and the comparator intervention group will include all types of control interventions. The primary outcome will be measured as treatment efficacy rate, and secondary outcomes will include pain reduction, pain disappearance time, swelling, joint function, and recovery period. Assessment of the methodological quality of this study will be concluded using the risk of bias assessment recommended by the Cochrane Collaboration. If there are sufficient numbers of studies per group in terms of specific rating scales to compare the treatment effects of Pyrium alone and combined external treatment groups, we will consider subgroup analysis.

Results

This systematic review will be conducted in compliance with the PRISMA-P statement.

Conclusion

We will conduct an extensive search on the proposed topic within the available literature and provide systematic evidence for the efficacy and safety of external application of Pyritum for all types of musculoskeletal trauma. The evidence generated will help design interventions for the external use of Pyritum for this patient group.

Combined effect of external treatment of herbal medicine and tuina in congenital muscular torticollis: Systematic review and meta-analysis

BACKGROUND

Congenital muscular torticollis (CMT) is the third most common musculoskeletal disease in children. With no standardized treatment method hence, so it is necessary to find an effective treatment method that can be received comfortably by children. This review assessed the efficacy of an external treatment of herbal medicine (ETHM) with tuina for CMT in children.

METHODS

This study searched the English, Chinese, and Korean databases (total of 10) until June 7 2022, without any language restrictions. All included studies were randomized clinical trials (RCTs) of ETHM with tuina as an intervention comparted to the same tuina alone according to the inclusion and exclusion criteria. The mean differences (MD), standardized mean differences (SMD), risk ratio (RR) with the 95% confidence interval (CI), and risk of bias (ROBs) were calculated using Review Manager Version 5.4 software. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) rating system was used to assess the quality of evidence. The publication bias was evaluated using a funnel plot, the Egger test, the fail-safe N test, and the Duval and Tweedle's trim and fill method using Review Manager Version 5.4 software, the software R Version 4.1.1 and R studio Version 1.4.1106 program.

RESULTS

Nineteen RCTs with 1710 patients were included in the meta-analysis. ETHM plus tuina improved the outcomes of the total effective rate (TER) [RR 1.21, 95% CI:1.15 to 1.26, P < .001], sternocleidomastoid (SCM) muscle thickness [MD: -1.82, 95% CI: -2.23 to -1.41, P < .001], cervical rotation range [MD: 13.43, 95% CI: 10.41-16.45, P < .001] and lateral flexion range [MD: 8.50, 95% CI: 6.15-10.85, P < .001], tissue elasticity grade [SMD: -0.46; 95% CI: -0.71 to -0.22, P = .0002], muscle elasticity scores [RR: 1.56; 95% CI: 1.04 to 2.34, P = .03], and clinical symptom and sign scores [SMD: -0.78; 95% CI: -1.09 to -0.47, P < .001].

CONCLUSIONS

ETHM plus tuina have a combined effect on CMT children. However, further studies with high-quality clinical trials are needed to obtain more robust clinical evidence.