Efficacy and safety of acupuncture in the treatment of Tourette syndrome in children: a network meta-analysis

Objective: this study was based on a reticulated meta-analysis to investigate the differences in efficacy and advantages and disadvantages of different acupuncture methods for the treatment of TS and to find the optimal acupuncture method for clinical reference. Methods: Randomized controlled trials of acupuncture for childhood tic-obstruction syndrome included in PubMed, Web of Science, Embase, Web of Science, CNKI, Wanfang, Vipers (VIP), and Chinese Biomedical Literature Database (SinoMed) databases were searched until 09/2022. The retrieved literature was screened and information extracted, and the risk of bias of the literature was evaluated using ROB2, and a Network Meta-analysis was performed using STATA 16. Results: A total of 22 studies including 1433 patients were included. 4 acupuncture methods were included: acupuncture, scalp acupuncture , electroacupuncture, and Auricular-Plaster. Network meta-analysis results showed that: efficacy: compared with western medicine acupuncture combined with scalp acupuncture (RR=1.26, 95% CI (1.18,1.35), P<0.05) was better. Reduction of YGTSS scores: compared with western , electroacupuncture (MD=-3.89, 95% CI(-7.10,-0.69), P<0.05) and acupuncture (MD=-4.35, 95% CI(-5.76,-2.95), P<0.05) were more effective. Overall, acupuncture combined with scalp acupuncture was the most effective. In terms of safety, acupuncture was superior to western medicine. Conclusion: Acupuncture has better efficacy and safety in the treatment of TS. Overall, acupuncture combined with scalp acupuncture was the most effective. Due to the low methodological quality of the included studies, the results of this study need to be confirmed by a large sample, more rigorous, randomized double-blind controlled tri