소아 주의력결핍 및 과잉행동장애의 추나 요법: 체계적 문헌 고찰 및 메타분석

Chuna Manual Therapy on Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Objectives This study aimed to quantitatively evaluate the clinical efficacy and safe-ty of Chuna manual therapy for children with Attention-Deficit/Hyperactivity Disorder (ADHD) by conducting a systematic review and meta-analysis. Methods A comprehensive search was performed in 12 major international and do-mestic databases (including PubMed, EMBASE, and CNKI) up to October 2025. Only Randomized Controlled Trials (RCTs) were included. The methodological quality of the included studies was assessed using the Cochrane’s Risk of Bias 2.0 (RoB 2.0) tool. Statistical synthesis was performed using Review Manager (RevMan 5.4), presenting results as Standardized Mean Difference (SMD) with 95% Confidence Intervals (CI). Results A total of 6 RCTs, involving 424 children with ADHD, were included. All stud-ies originated from China and Hong Kong. The meta-analysis revealed that Chuna therapy demonstrated a significant beneficial effect on improving ADHD symptoms compared to control interventions(medication) (SMD = -0.98; 95% CI -1.45, -0.51, p < 0.0001). Sensitivity analysis excluding CRS data, focusing on SNAP-IV and ADHD-RS, maintained a significant effect with reduced heterogeneity (SMD = -0.91; 95% CI -1.31, -0.52, p < 0.00001). No serious adverse events (SAE) were reported, and the incidence of adverse events in the Chuna group was statistically lower than in the medication control group (p < 0.05). Conclusions This study provides the quantitative evidence that Chuna therapy is significantly effective and relatively safe for improving core symptoms in children with ADHD. Given the low methodological quality and geographical restriction of the in-cluded studies, future research must prioritize strict blinding of outcome assessors and large-scale, multi-center RCTs to strengthen the evidence base.