Background: This study aimed to assess the efficacy of acupuncture for treating attention deficit hyperactivity disorder (ADHD) in children and adolescents. Patients and Methods: Systematic review and meta-analysis including randomized controlled trials that compared the effects of acupuncture treatment (AT) with pharmacotherapy (methylphenidate hydrochloride, MPH) among patients with ADHD. A total of 12 electronic databases were searched from inception until February 3, 2020. The main outcomes were the effective rate and post-treatment hyperactivity scores. We also assessed the incidence of adverse events and follow-up course. Results: A total of 10 studies involving 876 patients were included in this study. The meta-analysis revealed that AT yielded a significantly higher effective rate than MPH (odds ratio 2.239, 95% CI 1.438–3.487, p #x3c; 0.001, 8 studies), and that AT can reduce the hyperactivity scores to a lesser degree than MPH (standardized mean difference = –0.882, 95% CI –1.295 to –0.469, p #x3c; 0.001, 3 studies). Two studies reported no adverse events in the AT group, while one study suggested that AT can reduce adverse drug reactions. Furthermore, 3 studies concluded that the effects of AT were maintained, even after completion of treatment. Conclusion: This study suggests that AT may be more beneficial than MPH therapy for ADHD patients. However, the evidence may be highly limited, especially considering the outcome of hyperactivity scores with the high risk of bias, very low GRADE, and small number of studies. Thus, further studies of rigorous design and high quality are needed to confirm and strengthen the results, especially in the Western part of the world. Additionally, well-designed randomized controlled trials that evaluate adverse events and include a long-term follow-up should be conducted to determine the efficacy, safety, and side effects of AT for ADHD in children and adolescents.
Complement Med Res

中文翻译：

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针灸治疗注意缺陷多动障碍的疗效：系统评价和荟萃分析

背景：本研究旨在评估针灸治疗儿童和青少年注意力缺陷多动障碍（ADHD）的疗效。患者和方法：系统评价和荟萃分析，包括比较针灸治疗 (AT) 与药物治疗（盐酸哌甲酯，MPH）在 ADHD 患者中的效果的随机对照试验。从开始到2020年2月3日共检索了12个电子数据库。主要结果是有效率和治疗后多动评分。我们还评估了不良事件的发生率和随访过程。结果：本研究共纳入 10 项研究，涉及 876 名患者。荟萃分析显示，AT 的有效率显着高于 MPH（优势比 2.239，95% CI 1.438–3.487，p #x3c；0.001，8 项研究），并且 AT 可以将多动评分降低到低于 MPH 的程度MPH（标准化平均差 = –0.882，95% CI –1.295 至 –0.469，p #x3c；0.001，3 项研究）。两项研究报告 AT 组没有不良事件，而一项研究表明 AT 可以减少药物不良反应。此外，3 项研究得出结论，即使在完成治疗后，AT 的效果仍能保持。结论：这项研究表明，对于 ADHD 患者，AT 可能比 MPH 治疗更有益。然而，证据可能非常有限，特别是考虑到多动评分的结果具有高偏倚风险、非常低的 GRADE 和少量研究。因此，需要对严谨的设计和高质量的进一步研究来确认和加强结果，特别是在世界西部地区。此外，应进行设计良好的随机对照试验，评估不良事件并包括长期随访，以确定 AT 治疗儿童和青少年 ADHD 的疗效、安全性和副作用。
补充医学资源