The effect of traditional Chinese medicine washing combined with massage for neonatal jaundice: a meta-analysis

Objective: To systematically assess the effect of traditional Chinese medicine washing (TCM washing) combined with massage for the treatment of neonatal jaundice. Methods and analysis: Databases, including PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Biomedical Literature Database (CBM), CNKI, and Wanfang Data were electronically searched for randomized controlled trials (from inception to July 2017). The methodological qualities of included trials were evaluated by the Cochrane risk of bias assessment tool. The meta-analysis was performed by using RevMan 5.3 software. Results: Overall, thirteen trials with a total of 1998 participants were included. The results of meta-analysis indicated that TCM washing combined with massage group was significantly superior to the control group in the first meconium time (MD, -16.67; 95% CI, -24.59 to -8.74; P < 0.001), time for transformation of meconium (MD, -15.44; 95% CI, -23.59 to -7.28; P < 0.001), transcutaneous bilirubin index changes [after treating three days (MD, -1.99; 95% CI, -2.57 to -1.40; P < 0.001), after treating four days (MD, -1.86; 95% CI, -2.77 to -0.95; P < 0.001), after treating five days (MD, -2.44; 95% CI, -3.47 to -1.42; P < 0.001), after treating six days (MD, -2.23; 95% CI, -3.30 to -1.16; P < 0.001), and the changes of serum bilirubin levels [after treating five days (MD, -3.17; 95% CI, -5.83 to -0.50; P = 0.02), after treating six days (MD, -1.63; 95% CI, -3.10 to -0.16; P = 0.03), after treating fifteen days (MD,-1.20; 95% CI, -1.99 to -0.41; P = 0.003). Conclusions: TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice. It can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decrease transcutaneous bilirubin index and the level of serum bilirubin. But it should be careful to interpreting these findings. Well-designed RCTs are needed to further clarify the conclusion