目的 系统评价儿童生长痛(GP)相关风险因素,为预防和诊断生长痛提供参考依据。方法 计算机检索PubMed、Embase、Cochrane Library,中国知网(CNKI)、万方数据库、维普数据库(VIP)和中国生物医学文献数据库(CBM),搜集儿童生长痛相关风险因素的临床研究,检索时限均从建库至2024年6月。由2名研究者独立筛选文献、提取数据资料以及评价文献质量,采用RevMan5.3软件对资料进行Meta分析,对无法定量合并的数据采用定性描述性分析。结果 共纳入23项研究,覆盖了9个国家,涉及12个潜在危险因素。系统评价结果显示:血清25-(OH)D水平(MD=-30.41, 95%CI: -40.51~-20.32, P＜0.001)、家族史(OR=2.12, 95%CI:1.74~2.57, P<0.001)、挑食(OR=2.75, 95%CI:1.62~4.67, P<0.001)、体育运动/关节活动(OR=1.30, 95%CI:1.14~1.48, P<0.001)、骨密度(MD=-0.07, 95%CI:-0.12~-0.02, P=0.008)、痛阈值与儿童生长痛的发生具有相关性,可能是生长痛的危险因素。血钙、足部或下肢姿势在个别研究中结果不同,其与生长痛的相关性尚需更多原始研究予以佐证。结论 儿童生长痛受多种因素影响,受研究数量和质量的限制,建议开展高质量的前瞻性研究进一步明确儿童生长痛的风险因素。
Abstract
Objective To systematically evaluate the risk factors related to growing pains in children, in order to provide a reference for the prevention and diagnosis of growing pains. Methods Databases including PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP and CBM were electronically searched to collect clinical studies related to risk factors for growing pains in children from database inception to June 2024. Two researchers independently screened the literature, extracted data, and assessed the quality of the studies. RevMan 5.3 software was used for Meta-analysis, and qualitative descriptive analysis was applied to data that could not be quantitatively combined. Results A total of 23 studies from 9 countries were included, covering 12 potential risk factors. The results of systematic review suggested that serum 25(OH)D concentration (MD=-30.41, 95%CI:-40.51 to -20.32,P＜0.001), family history (OR=2.12, 95%CI:1.74 - 2.57, P<0.001), picky eating (OR=2.75, 95%CI:1.62 - 4.67, P<0.001), physical exercise/joint activity (OR=1.30, 95%CI:1.14 - 1.48, P<0.001), bone mineral density (MD=-0.07, 95%CI:-0.12 to -0.02, P=0.008), and pain threshold might correlate with the occurrence of growing pain in children, and might be risk factors. Blood calcium concentration, foot or lower limb posture had different results in individual studies, and their correlation with growing pains requires further original research for confirmation. Conclusions Growing pains in children is affected by many factors. Due to limitations in the quantity and quality of existing studies, high-quality prospective research is recommended to further clarify the risk factors for growing pains in children.
关键词
生长痛 /
风险因素 /
系统评价 /
儿童
Key words
growing pains /
influencing factors /
systematic review /
children
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基金
成都药学会药学科研项目(2023—2025年度)(cdyxky5040)
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