Is integrating acupuncture into the management of attention-deficit/hyperactivity disorder among children and adolescents now opportune and evidence-based? A systematic review with meta-analysis and trial sequential analysis

作者：Zhao FY, Xu Y, Kennedy GA, Conduit R, Zhang WJ, Jiang T, Xu P, Ho YS, Fu QQ, Chow CM · 发表于：Complementary therapies in medicine · 年份：2025 · DOI：10.1016/j.ctim.2025.103163 · 研究领域：Acupuncture Therapy、Attention Deficit Disorder with Hyperactivity、Adolescent、Child、Humans、Methylphenidate、Meta-Analysis as Topic

BACKGROUND AND AIM: The use of acupuncture is becoming increasingly popular in the management of attention-deficit/hyperactivity disorder (ADHD). This systematic review consolidates evidence on acupuncture's efficacy and safety for treating ADHD in children and adolescents. METHODS: Controlled clinical trials assessing acupuncture against waitlist-control, placebo or active controls, or as an adjunct treatment were systematically searched across seven databases from inception to November 2024. Cochrane criteria were adhered to. RESULTS: We reviewed 25 studies with 1758 participants. None compared acupuncture to placebo or behavioral therapy. Subdomain analysis of the Conners' Parent Rating Scale indicated that acupuncture and Methylphenidate had comparable effects on Conduct Problems [SMD = 0.03, 95 %CI (-0.93, 0.99), p = 0.95] and Learning Problems [SMD = 0.29, 95 %CI (-0.38, 0.97), p = 0.39], but acupuncture was more effective in controlling Impulsive/Hyperactive symptoms [SMD = -1.71, 95 %CI (-2.08, -1.35), p < 0.01]. Insufficient sample size prevented confirmation of potential false positives. Acupuncture was safer and reduced Methylphenidate-related side-effects, including appetite loss, sleep disturbances, dry mouth, abdominal pain, and constipation. Acupuncture combined with behavioral therapy outperformed behavioral therapy alone in improving Psychosomatic symptoms [SMD = -0.88, 95 %CI (-1.54, -0.23), p < 0.01]. In the Integrated Visual and Auditory Continuous Perfo...