대한한방소아과학회지 (The Journal of Pediatrics of Korean Medicine)

  • 제37권1호
  • /
  • Pages.1-14
  • /
  • 2023
  • /
  • 1226-8038(pISSN)
  • /
  • 2287-9463(eISSN)
대한한방소아과학회 (The Association of Korean Oriental Pediatrics)
권호 표지
DOI QR코드

DOI QR Code

소아 식욕부진에 대한 삼령백출산(蔘苓白朮散)의 효과: 체계적 문헌고찰 및 메타분석

Effects of Samryungbaekchul-san on Childhood Anorexia: A Systematic Review and Meta-Analysis

  • 이해솔 (한국한의학연구원 임상연구협력팀) ;
  • 이선행 (경희대학교 한의과대학 소아과학교실) ;
  • 장규태 (경희대학교 한의과대학 소아과학교실) ;
  • 이보람 (한국한의학연구원 한의과학연구부)
  • Hesol, Lee (Clinical Research Coordinating Team, Korea Institute of Oriental Medicine) ;
  • Sun Haeng, Lee (Department of Korean Pediatrics, College of Korean Medicine, Kyung Hee University) ;
  • Gyu Tae, Chang (Department of Korean Pediatrics, College of Korean Medicine, Kyung Hee University) ;
  • Boram, Lee (KM Science Research Division, Korea Institute of Oriental Medicine)
  • 투고 : 2022.10.05
  • 심사 : 2023.02.22
  • 발행 : 2023.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives This study aimed to evaluate the effect of Samryungbaekchul-san on childhood anorexia. Methods We searched 11 English, Korean, Chinese, and Japanese databases for studies published up to May 30, 2022. Randomized controlled trials (RCTs) assessing the effect of Samryungbaekchul-san on childhood anorexia were included. In the meta-analysis, relative risk (RR) and 95% confidence intervals (CI) were indicated as dichotomous variables, and mean difference (MD) or standardized mean difference (SMD) and 95% CIs were indicated as continuous variables. Results We included 12 RCTs with 1345 participants. The Samryungbaekchul-san treatment group had a significantly higher total effective rate (TER) than that of the western medicine control group (RR 1.42, 95% CI 1.23-1.64, I2 = 0%). The combined Samryungbaekchul-san and western medicine treatment group had significantly higher TER (RR 1.31, 95% CI 1.23 to 1.40, I2 = 0%) and levels of neuropeptide Y (SMD 0.93, 95% CI 0.47-1.39, I2 = 70%) and ghrelin (SMD 1.45, 95% CI 1.14-1.76, I2 = 0%) than those of the western medicine alone group. Additionally, leptin levels were significantly lower in the combined treatment group (SMD -1.19, 95% CI -1.88 to -0.51, I2 = 86%) compared with the western medicine alone group, although statistical heterogeneity was substantial. Conclusions Samryungbaekchul-san may be effective for childhood anorexia. However, owing to limitations such as high clinical heterogeneity between the studies, unclear risks of biases, and insufficient reports of adverse events and follow-ups, well-designed RCTs with a low risk of bias are needed in the future.

키워드

과제정보

본 연구는 보건복지부의 재원으로 한국보건산업진흥원의 보건의료기술연구개발사업 지원에 의하여 이루어진 것임 (과제고유번호: HF21C0096).

참고문헌

  1. Hu YM, Jiang ZF. Zhu futang textbook of pediatrics. 7th ed. Beijing: People's Medical Publishing House. 2012:1038.
  2. Department of Pediatrics, Nationwide Korean Medicine College. Pediatrics of Korean medicine. 3rd ed. Seoul: Ui Sung Dang Publishing Co. 2020:397-401.
  3. Zhang J. Study and treatment of pediatric anorexia by traditional Chinese medicine and western medicine. Med Recapitul. 2010;16(8):1198-201.
  4. McDonald CM, Manji KP, Kupka R, Bellinger DC, Spiegelman D, Kisenge R, Msamanga G, Fawsi WW, Duggan CP. Stunting and wasting are associated with poorer psychomotor and mental development in HIV-exposed Tanzanian infants. J Nutr. 2013;143(2):204-14. https://doi.org/10.3945/jn.112.168682
  5. Duncan A, Yacoubian C, Watson N, Morrison I. The risk of copper deficiency in patients prescribed zinc supplements. J Clin Pathol. 2015;68(9):723-5. https://doi.org/10.1136/jclinpath-2014-202837
  6. Briefel R, Hanson C, Fox MK, Novak T, Ziegler P. Feeding infants and toddlers study: do vitamin and mineral supplements contribute to nutrient adequacy or excess among US infants and toddlers? J Am Diet Assoc. 2006;106(1):52.
  7. Guo Y. Clinical observation on treatment of infantile anorexia by acupuncture at Sifung point combined with replenishing spleen Chinese medicine. Guangming J Chin Med. 2019;34(2):271-3.
  8. Health Insurance Review & Assessment Service. Disease subdivision statistics [Internet]. Healthcare Bigdata Hub; 2022 [Updated 2022 Oct; cited 2022 Oct 28]. Available from: http://opendata.hira.or.kr/op/opc/olap4thDsInfo.do
  9. Lee EJ, Lee BR, Lee JH, Chang GT. A study on the recent trend of chief complaint of Korean pediatric and adolescent outpatients. J Pediatr Korean Med. 2016;30(1):45-58. https://doi.org/10.7778/JPKM.2016.30.1.045
  10. Seo HS, Kim HY, Park SG, Lee SH, Lee JY. A review of etiology, pattern identification, treatment of traditional Chinese medicine for childhood anorexia. J Pediatr Korean Med. 2022;36(1):1-37.
  11. Shin HJ, Park YS, Lee J, Chang GT. Recent trends in clinical research of herbal medicine treatment for anorexia in children-Focused on Chinese randomized controlled trials. J Pediatr Korean Med. 2019;33(4):1-25.
  12. Lee J, Lee SH, Kim JH, Park YS, Park S, Chang GT. Survey of clinical practice patterns of Korean medicine doctors for anorexia in children: a preliminary study for clinical practice guidelines. Children (Basel). 2022;9(9):1409.
  13. Lee JY, Lee SY, Yu S. Recent clinical research on the effect of external therapy for infantile anorexia-based on the recent traditional Chinese medical journal. J Pediatr Korean Med. 2016;30(3):97-107. https://doi.org/10.7778/jpkm.2016.30.3.097
  14. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA; Cochrane Bias Methods Group; Cochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
  15. Feng D, Qiu H. Efficacy evaluation of Shenling Baizhu powder combined with multi-enzyme tablets in the treatment of children with anorexia. Chin J ExpTradit Med Formulae. 2012;18(20):315-7.
  16. Kang C. To explore the curative effect of Shenling Baizhu powder combined with probiotics on children with anorexia and the effect of appetite regulating factors. Mod Diagn Treat. 2018;29(17):2709-11.
  17. Lai C. Observation on the curative effect of Shenling Baizhu powder in treating infantile anorexia. Med J Chin People Health. 2008;20(16):1863.
  18. Liu H, He H. Efficacy of Shenling Baizhu powder combined with Saccharomyces boulardii in the treatment of anorexia in children and its effect on appetite regulators. Mod J Integr Tradit Chin Western Med. 2017;26(14):1549-52.
  19. She J. Clinical observation of Shenling Baizhu powder in the treatment of infantile anorexia. Professor Liu Bichen's 65th Anniversary Academic Thought Seminar and the National Academic Exchange Conference of the Pediatric Branch of the Chinese Association of Traditional Chinese Medicine and the Pediatric Branch of the National Association of Chinese Medicine Higher Education. 2004:4.
  20. Su LG. Observation on the curative effect of integrated traditional Chinese and western medicine in the treatment of infantile anorexia. Cardiovasc Dis J Integr Tradit Chin West Med. 2015;(26):108-9.
  21. Wang T. Clinical study on combined use of traditional Chinese and western medicine in the treatment of infantile anorexia. J Pract Tradit Chin Med. 2017;33(7):803-4.
  22. Wang X. Observation on the curative effect of Shenling Baizhu powder combined with multi-enzyme tablets and probiotics in the treatment of children with anorexia. Cap Food Med. 2020;27(4):200.
  23. Yang L, Zhang W, Quan Y, Zhu L. Clinical observation on infantile anorexia treated by integrated traditional Chinese and western medicine. Shanxi J Tradit Chin Med. 2013;29(4):25.
  24. Zhang J. Clinical efficacy of Shenling Baizhu powder and Xiaoyao powder in adjuvant treatment of left-behind children with anorexia. Chin J Clin Ration Drug Use. 2021;14(28):126-7.
  25. Zhong L. Observation on the therapeutic effect of Shenling Baizhu powder combined with Saccharomyces boulardii in the treatment of children with anorexia. Our Health. 2020;(7):164.
  26. Zhou T, Dong W. Clinical study on Shenling Baizhu powder in adjuvant treatment of children with anorexia. Guangming J Chin Med. 2020;35(18):2875-7.
  27. Chatoor I, Kerzner B, Zorc L, Persinger M, Simenson R, Mrazek D. Two year old twins refuse to eat: A multidisciplinary approach to diagnosis and treatment. Infant Ment Health J. 1992;13(3):252-68. https://doi.org/10.1002/1097-0355(199223)13:3<252::AID-IMHJ2280130311>3.0.CO;2-9
  28. Liang SB, Lai BY, Cao HJ, Cai QH, Bai X, Li J, Zhang YP, Chi Y, Robinson N, Liu JP. Pediatric tuina for the treatment of anorexia in children under 14 years: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2020;51:102411.
  29. Chatoor I, Hirsch R, Ganiban J, Persinger M, Hamburger E. Diagnosing infantile anorexia: the observation of mother-infant interactions. J Am Acad Child Adolesc Psychiatry. 1998;37(9):959-67. https://doi.org/10.1097/00004583-199809000-00016
  30. Zero to Three. Diagnostic classification of mental health and developmental disorders of infancy and early childhood (DC: 0-3R). Revised ed. Washington: Zero to Three Press. 2005:600-6.
  31. Jin W, Zhong J, Song Y, Li MF, Song SY, Li CR, Hou WW, Li QJ. Chinese herbal formula shen-lingbai-zhu-san to treat chronic gastritis: Clinical evidence and potential mechanisms. World J Gastroenterol. 2022;28(33):4890-908. https://doi.org/10.3748/wjg.v28.i33.4890
  32. Zhang S, Lin L, Liu W, Zou B, Cai Y, Liu D, Xiao D, Chen J, Li P, Zhong Y, Liao Q, Xie Z. Shen-Ling-Bai-Zhu-San alleviates functional dyspepsia in rats and modulates the composition of the gut microbiota. Nutr Res. 2019;71:89-99. https://doi.org/10.1016/j.nutres.2019.10.001