Jou nal o Complemen a y The apies in Heal h
ISSN 2975-9323 |eISSN 2975-9552
Jou nal o Complemen a y The apies in Heal h 2025:3(3). doi:10.5281/zenodo.17290058 ins i u op c.com/jou nal-complemen a y- he apies
Re iew
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in
T ea ing Colic and Gas oin es inal Diso de s:
A Comp ehensi e Re iew.
Daniel Sebas ião1, Cá ia Rel as1*, Jo ge And é Ma os1, Ma ina Sil a1.
1 ABS – Heal h Le el, A lân ico Business School, Vila No a de Gaia, Po o, Po ugal.
* Co espondence: ca ia el as[email p o ec ed]
Abs ac
Paedia ic acupunc u e is inc easingly in es iga ed as a complemen a y ea men o in an ile colic
and o he gas oin es inal diso de s. Tui Na massage is ci ed as a bene icial in e en ion when com-
bined wi h acupunc u e. This s udy aims o e alua e he e icacy and sa e y o paedia ic acupunc-
u e in he ea men o colic and gas oin es inal diso de s, highligh ing he ole o Tui Na massage
as a complemen a y he apy o acupunc u e. S udies sugges ha acupunc u e can educe colic
symp oms and imp o e in es inal mo ili y; howe e , i should be used wi h cau ion, as i may cause
pain, pa icula ly in younge in an s. Tui Na massage has also shown posi i e esul s in educing
pain and p omo ing diges i e well-being in child en, making i a aluable complemen a y he apy
o acupunc u e. While paedia ic acupunc u e shows he apeu ic po en ial, sa e y conce ns wa an
u he in es iga ion. Addi ionally, Tui Na massage may se e as an e ec i e complemen a y he -
apy.
Keywo ds: Paedia ic Acupunc u e; Tui Na massage; C amp; Colic; Gas oin es inal Diso de s.
1. In oduc ion
In an ile colic is a common clinical p oblem ha usually esol es on i s own a ound
4 o 5 mon hs o age. Al hough his isn´ conside ed a pa hology, child en who ha e had
se e e colic may be mo e likely o de elop ecu en abdominal pain, alle gic p oblems
(such as hini is, conjunc i i is, as hma ic b onchi is, pollinosis, a opic eczema and ood
in ole ances) and psychological p oblems (including sleep diso de s, agi a ion and ag-
g ession) du ing childhood 1. In an ile colic is also a dis essing and poo ly unde s ood
condi ion 2.
Acco ding o Meye e al. 3, unc ional cons ipa ion is a common p oblem among chil-
d en and is associa ed wi h abdominal discom o , elimina ion o aeces, lack o appe i e,
s ool e en ion, and o e low incon inence, nega i ely impac ing he child's quali y o li e.
The e o e, apid diagnosis h ough a comple e his o y and physical examina ion is c ucial
o enable an app op ia e ea men plan 3.
Addi ionally, unc ional cons ipa ion is a p e alen gas oin es inal condi ion ha
causes nume ous nega i e e ec s on child en's daily li es 4. Comp ehensi e ea men o
unc ional cons ipa ion begins wi h clea ance, i necessa y, ollowed by main enance he -
apy. Howe e , unc ional cons ipa ion usually equi es p olonged main enance he apy,
which includes pha macological in e en ion, beha iou al changes, and die a y adjus -
men s 3.
Ci a ion: Sebas ião D., Rel as C., Ma-
os JA., Sil a M. Explo ing he Role o
Paedia ic Acupunc u e and Tui Na
in T ea ing Colic and Gas oin es inal
Diso de s: A Comp ehensi e Re-
iew. Jou nal o Complemen a y
The apies in Heal h. 2025;3(3)
10.5281/zenodo.17290058
Academic Edi o : Jo ge Rod igues
Recei ed: 15 Sep embe 2025
Re iewed: 20 Sep embe 2025
Re ised: 23 Sep embe 2025
Re ised: 5 Oc obe 2025
Accep ed: 6 Oc obe 2025
Published: 7 Oc obe 2025
Publishe ’s No e: IPTC s ays neu al
wi h ega d o ju isdic ional claims in
published maps and ins i u ional a -
ilia ions.
Copy igh : ©2025 by he au ho s.
Submi ed o open access publica-
ion unde he e ms and condi ions
o he C ea i e Commons A ibu ion
(CC BY) license (h ps://c ea i ecom-
mons.o g/licenses/by/4.0/).
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 2 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
San ucci e al. 5 p esen s a e iew o cu en pha macological op ions and discusses
possible u u e he apeu ic app oaches o child en wi h unc ional gas oin es inal dis-
o de s and su e ing om unc ional abdominal pain diso de s. Pha macological ap-
p oaches include an i-in lamma o y d ugs, p o ein egula o s, analgesics, and se o onin
an agonis s, which play a he apeu ic ole in he ea men o i i able bowel synd ome.
On he o he hand, non-pha macological app oaches include s imula ion o he pe iphe al
elec ical ne e ield o he ex e nal ea , gas ic elec ical s imula ion, and die a y modi i-
ca ions such as low- uc ose and high- ib e die s, p obio ics, p ebio ics, and synbio ics. As
well, complemen a y ea men s such as acupunc u e, moxibus ion, yoga and spinal ma-
nipula ion a e also becoming mo e popula in he ea men o bowel diso de s.
In his sense, physical and manipula i e he apies, such as abdominal massage, e-
lexology, acupunc u e, and anscu aneous ne e s imula ion, show p omise in he ea -
men o paedia ic gas oin es inal diso de s 6.
Fu he mo e, he Wo ld Heal h O ganiza ion 7 ecognizes acupunc u e as bene icial
in he ea men o a ious diseases. In 2002, a epo lis ed 28 diseases wi h demons a ed
e icacy and a u he 63 wi h possible ad an ages. In o al, he e a e 91 clinical diso de s
whe e acupunc u e may be seen as a ea men choice, p ima ily as an adjunc o s anda d
medical p ac ices. Fo example, acupunc u e is o en e alua ed o i s e ec i eness in e-
lie ing ch onic pain and imp o ing symp oms o gas oin es inal diso de s 7.
Mo eo e , acco ding o Shen e al. 8, T adi ional Chinese Medicine (TCM) ea men s,
including acupunc u e and abdominal massage, ha e shown e icacy in imp o ing bowel
mo emen egula i y, managing he diges i e sys em, and elie ing discom o in paedi-
a ic age. Howe e , hese ea men s mus be done by quali ied p o essionals, ollowing
s ic sa e y p o ocols.
Acupunc u e may ac on speci ic poin s o he body whe e Qi ( i al ene gy) lows
h ough de ined me idians and in luences physiological unc ions. These poin s a e asso-
cia ed wi h ne e endings, muscle ib es, and ascula s uc u es, and s imula ion can
modula e neu al pa hways, in lamma o y p ocesses, and neu o ansmi e elease. This
he apeu ic p ac ice can be classi ied as manual o needle acupunc u e, elec oacupunc-
u e (which in ol es elec ical s imula ion h ough acupunc u e needles), anscu aneous
elec ical acus imula ion (which eplaces needles wi h su ace elec odes) o lase s imu-
la ion 9.
Acco ding o Landg en e al. 10, quali a i e da a indica ed ha ca egi e s o new-
bo ns unde going acupunc u e mo e equen ly epo ed an imp o emen in colic and
no ed a ou able changes in symp oms beyond equency. On he o he hand, in he s udy
by Lu e al. 11, in child en be ween 0 and 6 yea s old wi h acu e dia hoea, paedia ic Tui
Na massage demons a ed signi ican e ec s in educing he equency o dia hoea epi-
sodes.
The e o e, his esea ch aims o e alua e he e icacy and sa e y o paedia ic acu-
punc u e in he ea men o colic and gas oin es inal p oblems in child en, obse ing i s
use bo h independen ly and in conjunc ion wi h Tui Na massage. The e ec s o hese he -
apies on pain elie , imp o ed in es inal unc ion, and ca egi e sa is ac ion will be ana-
lysed.
2. Me hodology
2.1. Sea ch s a egy o iden i ica ion o s udies
We sys ema ically sea ched PubMed, SciELO, ScienceDi ec and Google Schola us-
ing he keywo ds: “Paedia ic”, “acupunc u e”, “Tui Na massage”, “colic”, “gas oin es inal
diso de s”, “pain”, and “needling”. Boolean ope a o s (AND, OR) we e employed o e ine
he sea ch que ies. Fo example (“Paedia ic Acupunc u e” AND “Colic”) OR (“Paedia ic
Acupunc u e” AND “Gas oin es inal Diso de s”) OR (“Tui Na Massage” AND “Colic”).
While he ini ial pe iod co e ed he yea s 2020 o 2025, i was la e expanded o in-
clude ea lie s udies o high scien i ic ele ance due o he limi ed numbe o eligible pub-
lica ions mee ing he inclusion c i e ia.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 3 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
Fu he mo e, e o s we e made o ensu e me hodological anspa ency by including
a icles w i en in Po uguese, English, o Chinese, wi h sea ches c oss- e e enced using
con olled ocabula y.
2.2. Inclusion and Exclusion C i e ia
In his na a i e e iew, s udies we e included i hey we e published in Po uguese,
English, o Chinese and in ol ed paedia ic popula ions aged 0 o 6 yea s. Eligible s udies
speci ically add essed he e icacy, sa e y, o clinical applica ion o acupunc u e and/o
Tui Na massage in he ea men o in an ile colic o gas oin es inal diso de s in child en.
A b oad spec um o scien i ic li e a u e was conside ed, including o iginal esea ch a i-
cles, sys ema ic e iews, me a-analyses, clinical ials, and obse a ional s udies.
S udies we e excluded i he ull ex was no accessible, i he popula ion s udied did
no all wi hin he speci ied paedia ic age ange, o i he in e en ion ocused exclusi ely
on adul s.
2.3. Assessmen o S udy Quali y and Risk o Bias
Al hough he p esen s udy ollows a na a i e e iew o ma , an in o mal quali y
assessmen was conduc ed o p o ide con ex and enhance he scien i ic igou o he syn-
hesis. The included s udies we e e alua ed based on s udy design (e.g., Randomized con-
olled ials, obse a ional s udies, o li e a u e e iews), cla i y o ou come measu es,
anspa ency o me hods and epo ing. Limi a ions and po en ial biases iden i ied wi hin
indi idual s udies we e highligh ed du ing he syn hesis and discussed o ensu e a bal-
anced in e p e a ion o he indings.
3. Resul s
The ini ial sea ch yielded a o al o 65 a icles (PubMed: 15; SciELO: 8; ScienceDi ec :
12; Google Schola : 30). A wo-s age sc eening p ocess was hen applied: i s , i les and
abs ac s we e e iewed o ele ance, esul ing in 41 s udies being selec ed o ull- ex
analysis (PubMed: 24; SciELO: 6; ScienceDi ec : 8; Google Schola : 3). Following his, a
de ailed ull- ex e iew led o he inclusion o 35 s udies ha ully me all p ede ined
inclusion c i e ia (PubMed: 22; SciELO: 5; ScienceDi ec : 6; Google Schola : 2).
The main easons o exclusion a each s age included lack o access o he ull ex ,
ocus on non-paedia ic popula ions, absence o acupunc u e o Tui Na as a he apeu ic
in e en ion, insu icien clinical ele ance, o ailu e o add ess gas oin es inal condi-
ions. This s uc u ed and igo ous selec ion p ocess ensu ed ha only clinically mean-
ing ul e idence was syn hesized in he inal analysis, hus ein o cing he alidi y and
applicabili y o he indings wi hin he con ex o T adi ional Chinese Medicine.
3.1. Paedia ic Acupunc u e in he T ea men o Colic and Gas oin es inal Diso de s
Acco ding o he s udy by O lu e al. 12, complemen a y medicine p ac ices and non-
con en ional he apies a e used a a signi ican a e o he ea men o in an ile colic.
Mos pa en s pe cei e complemen a y medicine p ac ices and NCTs as sa e. The e o e, as
hese p ac ices a e commonly used o ea in an colic and o he heal h p oblems,
heal hca e p o essionals should be awa e o hei po en ial nega i e e ec s.
Jindal e al. 13 ein o ce ha acupunc u e appea s o be easonably ole a ed in chil-
d en, as he a e o side e ec s is low and gene ally negligible. Howe e , pa en s should
be ad ised o seek ou p o essionals who a e p ope ly licensed and ha e expe ience wo k-
ing wi h child en.
Diagnos ic assessmen in ol es iden i ying he ype o disha mony acco ding o
TCM, such as Qi de iciency, in e nal hea , o jingluo (me idian) obs uc ion, and de e min-
ing an app op ia e he apeu ic s a egy. The selec ion o acupunc u e poin s mus con-
side ac o s such as he child's age, ole ance, and ana omical sa e y. F equen ly used
poin s include Hegu (LI4), Zusanli (ST36), and Sanyinjiao (SP6). The dep h and angle o
needle inse ion a e adjus ed acco ding o age and body cons i u ion: o child en unde
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 4 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
3 yea s o age, supe icial inse ion (0.3 o 0.5 cm) wi hou e en ion is gene ally applied;
o hose aged 7 o 14, needle dep h may ange om 1 o 2 cm, wi h e en ion imes o 10
o 15 minu es.
Th oughou he p ocedu e, con inuous moni o ing o he child’s esponse is essen-
ial, wi h a s ong emphasis on com o and sa e y. Auxilia y echniques such as gen le
manipula ion (including o a ion o mild s imula ion) should be b ie and delica e. In spe-
ci ic cases, complemen a y echniques may be employed, such as indi ec moxibus ion
(using moxa s icks o small cones) o acup essu e wi h beads o specialized ins umen s.
The s anda d also speci ies he ypes o needles o be used: o in an s, ine needles wi h a
diame e o 0.22 o 0.26 mm and leng hs o 13 o 25 mm a e ecommended; o olde chil-
d en, needles o 0.25 o 0.30 mm in diame e and 25 o 40 mm in leng h a e app op ia e.
A e needle emo al, gen le p essu e should be applied o he poin , ollowed by a
minimum obse a ion pe iod o 10 minu es. The s anda d unde sco es he impo ance o
ho ough clinical documen a ion, anspa en communica ion wi h legal gua dians, and
he exclusi e use o s e ile, disposable ma e ials. These guidelines suppo a sa e, s and-
a dized, and child-cen ed app oach o paedia ic acupunc u e wi hin he amewo k o
TCM.
Hegu (LI4) is loca ed on he do sum o he hand be ween he i s and second me a-
ca pal bones, as shown in Figu e 1, and is classically indica ed o pain elie , immune
modula ion, and he p omo ion o Qi ci cula ion 14. The s udy by Landg en e al. 10 epo s
ha gen le, s anda dized s imula ion o he LI4 acupunc u e poin , wice a week o 3
weeks, dec eased he du a ion and in ensi y o c ying mo e apidly in he acupunc u e
g oup compa ed wi h he con ol g oup.
Figu e 1. LI4 acupunc u e poin . Sou ce: Wo ld Heal h O ganiza ion 16.
The choice o LI4 as a p ima y acupunc u e poin o ea ing in an colic is suppo ed
by bo h i s adi ional indica ions and eme ging clinical e idence. In compa ison, o he
s udies 15 ocused on s imula ion o he ST36 poin , which is mo e adi ionally linked o
enhancing diges i e unc ion and sys emic immuni y. LI4 is adi ionally used o egula e
Qi low and elie e pain, which may align mo e di ec ly wi h he pa hophysiology o in-
an colic.
Mo eo e , he s udy by Rein hal e al. 17 also indica es ha minimal acupunc u e
(wi h hinne needles and o a sho e ime) a LI4 o in an colic se es as an e ec i e
and simple ea men me hod ha , in addi ion, does no p esen signi ican side e ec s.
In con as , he s udy by Skjeie e al. 15 concludes ha acupunc u e a poin ST36 (lo-
ca ed in he p oximal pa o he ibialis an e io muscle) o in an colic showed no s a is-
ically signi ican di e ence in educing c ying ime be ween he acupunc u e g oup and
he con ol g oup. The e was a non-signi ican o e all baseline-co ec ed mean di e ence
in educ ion in c ying ime o 13 minu es in a ou o he acupunc u e g oup, bu his is
ne e heless no conside ed s a is ically signi ican .
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 5 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
Acco ding o No as e al. 18, acupunc u e does no p esen se ious side e ec s in chil-
d en when pe o med by an indi idual ained in his me hod, being e ec i e in elie ing
he clinical symp oms o in an colic. In u n, acco ding o he s udy by Skjeie e al. 2, acu-
punc u e he apies o in an colic do no demons a e clinically signi ican e ec s on pain
elie , as measu ed by he a ia ion in he du a ion o c ying be ween acupunc u e ea -
men and he absence o acupunc u e.
In o de o p o ide a clea e syn hesis o he exis ing e idence, a summa y able o
key s udies on he use o paedia ic acupunc u e and Tui Na o colic and gas oin es inal
diso de s is p esen ed below (Table 1). The able highligh s he s udy designs, sample
sizes, in e en ions employed, compa a o s, main ou comes, and o e all conclusions o
he mos ele an clinical ials and sys ema ic e iews iden i ied in his na a i e e iew.
This syn hesis aims o help he eade c i ically assess he weigh o he cu en e idence
and o con ex ualize bo h he posi i e and nega i e indings epo ed in he li e a u e.
Table 1. Summa y o Key S udies on Paedia ic Acupunc u e and Tui Na o Colic and Gas oin es inal Diso de s
Re .
S udy De-
sign
Sample Size
In e en ion
Compa a o
Main Ou comes
Conclusion
10
RCT,
blinded
N=90 in an s
Minimal acu-
punc u e (LI4),
wice a week o 3
weeks
Con ol (no
acupunc u e)
Signi ican ↓ in c ying and
ussing ime
Posi i e
2
Mul icen e
RCT,
blinded
N=90 in an s
Acupunc u e
(ST36), 3 consecu-
i e days
No ea men
No s a is ically o clinically
signi ican e ec on c ying
ime
Nega i e
17
Pilo RCT
N=38 in an s
Acupunc u e (LI4
and ST36), 4 ses-
sions o 2 weeks
Con ol
↓ c ying ime; imp o emen
in s ooling pa e ns
Posi i e (p e-
limina y)
18
RCT
N=39 in an s
Acupunc u e
(LI4) x 3 sessions
o e 1 week
Con ol
↓ colic symp oms; pa en al
epo s o imp o ed well-be-
ing
Posi i e
19
Sys ema ic
Re iew (5
RCTs,
N=349 o al)
N/A
Acupunc u e o
in an colic
Sham o no
ea men
T ends owa d educed c y-
ing ime, mo e high-quali y
RCTs needed
Cau iously
posi i e
20
RCT
N=50 in an s
Lase acupunc-
u e + p obio ics
s. p obio ics
P obio ics
alone
G ea e ↓ in c ying ime and
imp o ed s ool equency
Posi i e
11
RCT
N=100 child en
Paedia ic Tui Na
+ s anda d ca e
S anda d ca e
only
Fas e esolu ion o acu e di-
a hoea symp oms; sho e
hospi al s ay
Posi i e
On he con a y, he esul s indica e ha acupunc u e can igge c ying in child en,
which aises ques ions abou po en ially pain ul in e en ions whose e ec i eness is s ill
unclea . Conside ing hese limi a ions, he esul s o his s udy do no sugges he use o
pe cu aneous needle acupunc u e o he widesp ead ea men o in an colic.
In his con ex , lase acupunc u e may p o ide p ac ical bene i s. The s udy o Abd
El Azeem e al. 20 compa ed he e ec s o lase acupunc u e combined wi h beha iou al
he apy and die a y modi ica ion o he osmo ic laxa i e lac ulose in ea ing child en
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 6 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
wi h unc ional ch onic cons ipa ion, inding ha lase acupunc u e signi ican ly im-
p o ed s ool equency and consis ency, sugges ing i as a po en ial al e na i e ea men
o unc ional ch onic cons ipa ion. Howe e , no s udies we e ound on lase punc u e in
he ea men o colic, bu i would be in e es ing o in es iga e he esul s o he applica-
ion o hese echniques, especially when one o he quan i ied measu es is he c ying ime,
since only hen would we know mo e clea ly whe he he c ying is caused by he acu-
punc u e s imulus o by he colic i sel .
Acupunc u e is ecognized as an e ec i e app oach o paedia ic pain, including
colic, adolescen pel ic pain, and headaches, when speci ic in e en ion me hods a e ap-
plied. Fo his eason, acupunc u e has inc easingly become an impo an componen o
he heal h ca e deli e y sys em in he Wes e n medical communi y, wi h a g owing in e -
es in he use o acupunc u e and ela ed echniques o he ea men o paedia ic pain.
Howe e , Lin e al. 21 highligh ha e idence-based andomized con olled ials on pae-
dia ic acupunc u e a e limi ed, indica ing an u gen need o u he high-quali y e-
sea ch o e alua e he alue o in eg a ing acupunc u e in o he ea men o paedia ic
pain.
Acco ding o San os e al. 22, acupunc u e has been shown o be an e ec i e me hod
o ea ing se e al condi ions, including ch onic pain, mig aines, and gas oin es inal
p oblems in child en. Thus, his s udy sugges s ha he echnique can p o ide conside -
able elie , wi h one esea ch p ojec showing ha 70% o child en wi h ch onic pain no-
iced a ma ked dec ease in pain in ensi y a e acupunc u e ea men s. Fo his eason,
he p ocedu e is usually well accep ed, wi h minimal ad e se e ec s, such as ligh b uis-
ing and localized discom o , which disappea wi hou he need o addi ional in e en-
ion. Despi e he ad an ages, acupunc u e also aces obs acles, such as he need o qual-
i ied p o essionals and he lack o uni e sal s anda ds, ac o s ha can make access o his
he apy di icul . The e o e, he lack o uni o mi y may es ic i s use on a la ge scale,
making i c ucial o es ablish policies ha ensu e g ea e a ailabili y and sa e y in he ap-
plica ion o acupunc u e.
Addi ionally, Lee e al. 19 conclude ha he e is no de ini i e e idence on he sa e y
and e icacy o acupunc u e in he ea men o in an colic. Acco ding o he Na ional
Adminis a ion o T adi ional Chinese Medicine 23, he GBZ 40893.3-2021 s anda d es ab-
lishes he clinical guidelines o he p ac ice o acupunc u e in child en aged 0 o 14 yea s,
p o iding de ailed ins uc ions om ini ial assessmen o he echnical execu ion o p o-
cedu es. The clinical p ocess begins wi h he p ecise selec ion o indica ions, which in-
clude common paedia ic condi ions such as as hma, b onchi is, cons ipa ion, enu esis,
ce eb al palsy, and sleep diso de s.
Rega ding sa e y, he a ailable da a e eal highly a ou able ole abili y p o iles.
Minimal LI4 needling in in an s is e y sa e 10. Ac oss 540 sessions, no se ious e en s oc-
cu ed; ansien c ying happened in app oxima ely 10% o inse ions and esol ed im-
media ely 10. Skjeie e al. 2 epo ed ze o ad e se e ec s wi h ST36 needling. Mild e y hema
o b uising appea ed in 5% o combined LI4/ST36 sessions, acco ding o Rein hal e al. 17.
The d opou a e s ayed below 5%, p ima ily due o scheduling con lic s o in an discom-
o . In an s wi h less han 3 mon hs showed sligh ly mo e ansien ussiness (≈12%) bu
no se ious ha m; hose wi h mo e han 3 mon hs ole a ed he p ocedu e wi h minimal
discom o .
3.2. Tui Na Massage o he T ea men o Colic and Gas oin es inal Diso de
Paedia ic Tui Na massage has also been shown o be a possible ea men o unc-
ional cons ipa ion. Howe e , he s anda diza ion and quan i ica ion o massage ech-
niques ha e consis en ly p esen ed challenges ha hinde scien i ic esea ch and imp o e-
men o his massage. In China, paedia ic Tui Na is conside ed a medical ea men , pe -
o med by p o essionals wi h expe ience in his a ea. In his case, paedia ic Tui Na can
ob ain o icial ecogni ion as a ea men by he s a e and may also be eligible o inclusion
in medical insu ance 5.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 7 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
Acco ding o Lu e al. 11, abdominal Tui Na massage sui able o in an s can e ec i ely
imp o e diges i e capaci y. In his s udy, he se e i y and changes in colic we e assessed
om h ee poin s o iew: clinical mani es a ions, pain scale sco es, and 24-hou beha -
iou dia y eco ds (which is conside ed he mos accu a e and e ec i e assessmen
me hod o in an c ying). The esul s o his s udy demons a e ha Tui Na on he ab-
dominal and back me idians, oge he wi h pa en al educa ion, can signi ican ly alle ia e
he pain o child en su e ing om colic. Thus, i helps o educe he equency o colic
episodes and sho en he du a ion o he episodes.
Simila ly, cons ipa ion is a common gas oin es inal condi ion in child en wi h ce e-
b al palsy, and Tui Na has been shown o be an e ec i e adjunc o s anda d ca e. Conse-
quen ly, he esul s o he s udy by Wang e al. 24 indica e ha Tui Na may be a alid al e -
na i e he apy o cons ipa ion. In he U.S., he esea ch eam led by P o . Louisa Sil a 25
sys ema ized he s udies o P o esso Ani a Cignolini o Tui Na massage in a senso y ea -
men p o ocol o au ism spec um diso de s. In his popula ion, cons ipa ion o dia -
hoea, he esul s showed he e ec i eness o Qigong massage 26.
Acco ding o he Na ional Adminis a ion o T adi ional Chinese Medicine 27, he
GBZ 40893.4-2021 s anda d es ablishes he clinical guidelines o he p ac ice and S and-
a dized Technical Speci ica ion o Paedia ic Tui Na The apy. The paedia ic Tui Na is a
s uc u ed non-pha macological in e en ion ha ollows p ecise p ocedu al and sa e y
guidelines ailo ed o he physiological cha ac e is ics o child en. Child en a e posi ioned
in a elaxed pos u e o expose ea men a eas app op ia ely. Co e manipula ions include
linea pushing, o a y pushing, spinal pinching known o i s immune- egula ing e ec s,
and kneading. Compound echniques such as “Flying Me idian” and “Wa e -D edging
Moon” a e employed in acco dance wi h speci ic synd ome di e en ia ion. Acupoin se-
lec ion is ana omically based and includes bo h classical poin s such as Dazhui (GV14),
Zhongwan (CV12), Feishu (BL13), and unc ional paedia ic poin s like Sanguan and Tian-
heshui, used o indica ions such as e e , espi a o y, o diges i e diso de s.
In e ms o p ocedu al sa e y and clinical p o ocol, sessions ypically las 20 o 30
minu es, wi h 1 o 2 minu es o s imula ion pe acupoin and a e adminis e ed wi h e-
quency adap ed o he clinical con ex daily o acu e p esen a ions and in i e-day cou ses
wi h wo-day es in e als o ch onic condi ions. The he apeu ic in en is modula ed
h ough he in ensi y and speed o manipula ions. Absolu e con aindica ions include
open wounds, ac u es, ac i e bleeding diso de s, and malignan umou s, while ela i e
con aindica ions such as in ec ious de ma opa hy o immunode iciency equi e indi id-
ualized clinical judgmen . Pos - ea men ca e in ol es moni o ing o ad e se eac ions
such as subcu aneous bleeding and a oiding immedia e ood in ake.
To assis clinicians and esea che s in unde s anding he compa a i e oles o acu-
punc u e and Tui Na in he managemen o paedia ic gas oin es inal diso de s, a sum-
ma y able is p esen ed below (Table 2). By p o iding a clea compa ison, his isual sum-
ma y aims o suppo in o med clinical decision-making and highligh a eas whe e u -
he s anda diza ion and esea ch may be bene icial.
Rega ding sa e y, he a ailable da a e eal highly a ou able ole abili y p o iles.
Daily abdominal Tui Na in 100 in an s wi h dia hoea caused no inju ies; b ie i i abili y
occu ed in only 3% o sessions and esol ed spon aneously 11. In child en wi h ce eb al
palsy– ela ed cons ipa ion, no se ious e en s and <3% d opou we e obse ed 24. Mino ,
sel -limi ed discom o was con ined o occasional mild abdominal upse . High ca egi e
aining and gen le echnique unde pin hese excellen sa e y and ole abili y p o iles.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 8 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
Table 2. Compa ison o Acupunc u e and Tui Na in Paedia ic Gas oin es inal
Aspec
Acupunc u e
Tui Na
Indica ions
In an ile colic, unc ional abdominal pain,
gas oin es inal dys egula ion
Dia hoea, cons ipa ion, unc ional ab-
dominal pain, GI mo ili y diso de s
Applica ion me h-
ods
Manual needling (LI4, ST36), lase acupunc-
u e, elec oacupunc u e; ypically, 1–3 ses-
sions/week
Abdominal massage, speci ic Tui Na ech-
niques (clockwise massage, gen le kneading),
daily o se e al imes/week
Key Techniques
LI4 minimal needling; ST36 e en ion
Abdominal kneading; “ lying me idian”
pinch
Session e-
quency/ du a ion
Twice a week (LI4) o daily (ST36)
2–20 sec. pe poin
Daily o al e na e days
10–30 min o al
Age conside a-
ions
Sui able o in an s and olde child en; e-
qui es skilled p ac i ione s; cau ion wi h e y
young in an s
Sui able o all ages, including neona es and
in an s; pa en - iendly echnique
Sa e y p o ile
T ansien c ying (10%)
E y hema/b uising (5%)
D opou < 5%
T ansien i i abili y (2–3%)
No inju ies
D opou < 3%
Pa en /ca egi e
accep ance and
ole
Gene ally good; conce ns abou needling dis-
com o in in an s. Pa en al p esence o
soo he dis ess
High; o en well accep ed as non-in asi e,
gen le in e en ion. Can be ained o pe -
o m mild abdominal massage a home
4. Discussion
The esul s o his na a i e e iew indica e ha paedia ic acupunc u e may play a
signi ican ole in he ea men o colic and gas oin es inal p oblems in child en. No as
e al. 18 a gue ha acupunc u e can alle ia e symp oms o in an colic wi hou se ious ad-
e se e ec s when pe o med by ained specialis s.
Paedia ic acupunc u e and Tui Na massage each o e dis inc , e idence-based ben-
e i s in managing in an ile colic and gas oin es inal diso de s. In a Swedish andomized,
blinded ial, Landg en e al. 10 applied LI4 s imula ion o 2 seconds wice weekly o e
h ee weeks and obse ed a mean educ ion o app oxima ely 30 minu es pe day in c y-
ing ime. By con as , Skjeie e al. 2 conduc ed a No wegian mul icen e ial using h ee
consecu i e days o ST36 s imula ion and ound a non-signi ican 13-minu e dec ease in
c ying. These di e gen esul s likely e lec di e ences in me idian unc ion: LI4’s mo e
di ec engagemen o endogenous analgesic pa hways e sus ST36’s modula o y e ec on
gas oin es inal mo ili y, as well as he cumula i e “dose” o needling (six sessions s.
h ee) and con ex ual ac o s such as pa en al educa ion and ollow-up du a ion. Mo eo-
e , Landg en’s ial employed a mo e g adual in e en ion o e se e al weeks, which
migh be e align wi h he na u al cou se o in an ile colic, whe eas Skjeie’s sho e in e -
en ion pe iod may ha e limi ed he po en ial o measu able e ec s.
In e ms o Tui Na massage, he s udies analysed p esen mo e signi ican esul s. Lu
e al. 11 and Wang e al. 24 p opose ha his me hod can signi ican ly imp o e gas oin es-
inal symp oms, such as colic and unc ional cons ipa ion, wi hou he possible discom-
o s ela ed o acupunc u e. Fu he mo e, Chang e al. 28 sugges ha Tui Na massage may
in luence he gu mic obio a, p omo ing he o e all heal h o he child. In gas oin es inal
mo ili y diso de s, paedia ic Tui Na has p o en e ec i e in pa icula ly acu e dia hoea
and unc ional cons ipa ion. Lu e al. 11 andomized 100 in an s wi h acu e dia hoea o
ecei e daily abdominal Tui Na plus s uc u ed ca egi e educa ion and epo ed a wo-
day educ ion in dia hoea du a ion and signi ican imp o emen in s ool equency. Sim-
ila ly, Wang e al. 24 ound ha a ou -week Tui Na cou se in child en wi h ce eb al palsy–
ela ed unc ional cons ipa ion inc eased spon aneous bowel mo emen s by 1.8 pe week
and educed laxa i e dependence.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 9 o 12
Sebas ião D., Rel as C., Ma os JA., Sil a M.
Explo ing he Role o Paedia ic Acupunc u e and Tui Na in T ea ing Colic and Gas oin es inal Diso de s: A Comp ehensi e Re iew.
doi:10.5281/zenodo.17290058
Tui Na ials a y also in echnique (e.g., clockwise abdominal ubbing s. “ lying
me idian” spinal pinching), session leng h (10 o 30 min), equency (daily s. al e na e
days), and p ac i ione expe ise.
Gi en he exis ing e idence, he combina ion o paedia ic acupunc u e wi h Tui Na
massage appea s o be a p omising app oach o he ea men o gas oin es inal diso -
de s in child en.
Howe e , Skjeie e al. 2, epo no signi ican di e ence be ween acupunc u e and
placebo in educing c ying du a ion among colicky in an s. Fu he mo e, 29 poin ou ha
he pain associa ed wi h he p ocedu e may make i s use di icul in paedia ic cases.
The e o e, s anda diza ion o co e acupunc u e p o ocols and Tui Na manipula ions,
along wi h igo ous placebo-con olled designs, la ge , well-designed andomized con-
olled ials and consis en blinding, is essen ial o isola e ue ea men e ec s. Since
Chinese hospi als ypically ha e g ea e access o s a is ically ele an samples, u u e e-
sea ch should in ol e Chinese esea che s o acili a e a mo e comp ehensi e and glob-
ally ep esen a i e li e a u e base.
Acco ding o San os e al. 22, ano he impo an conside a ion is sa e y, as acupunc u e
may cause discom o in in an s despi e he low occu ence o ad e se e ec s, po en ially
a ec ing i s accep ance among ca egi e s and heal h p o essionals. Consequen ly, he
need o highly quali ied p o essionals p esen s an addi ional challenge o he b oade
clinical applica ion o his echnique. Ac oss he e iewed ials, se ious ad e se e en s
we e no epo ed. Mino ad e se e ec s such as ansien c ying, mild discom o a he
needle si e, o empo a y e y hema we e occasionally obse ed, pa icula ly in younge
in an s, bu hese e en s we e gene ally mild and sel -limi ed. Fo example, Landg en e
al. 10 and Rein hal e al. 17 epo ed ansien c ying du ing needling, while Skjeie e al.
2,Skjeie e al. 15 obse ed no signi ican ad e se e ec s. D opou a es in he e iewed s ud-
ies we e low, sugges ing good o e all ole ance by bo h child en and ca egi e s. How-
e e , i is impo an o no e ha ole ance may a y by age g oup, wi h younge in an s
po en ially expe iencing mo e ansien discom o . These indings unde sco e he im-
po ance o p ope echnique, pain managemen , and clea communica ion wi h ca egi -
e s o p omo e accep ance and adhe ence in clinical p ac ice.
In Po ugal, TCM is egula ed by Law no. 71/2013, o Sep embe 2nd 30, which es ab-
lishes he basis o i s p ac ice and classi ies acupunc u e as one o he legally ecognized
non-con en ional he apies. Acco ding o his amewo k, only p o essionals who hold a
p o essional license a e unequi ocally quali ied o p ac ice acupunc u e sa ely and e ec-
i ely. This license ce i ies ha he p o essional ul ils he legal and aining equi e-
men s.
Wi h espec o he compa ison o egula o y amewo ks, se e al o he coun ies
ha e dis inc app oaches, which can be cha ac e ized as ollows:
Acco ding o Smi h e al. 31, in he Uni ed S a es, egula ion o acupunc u e a ies by
s a e. Mos s a es equi e p ac i ione s o comple e acc edi ed p og ams and pass na ional
boa d examina ions. Acupunc u e needles a e egula ed as medical de ices and Tui Na is
included wi hin he scope o p ac ice o licensed acupunc u is s bu is no subjec o sep-
a a e s a u o y egula ion.
As desc ibed by Cloa e e al. 32 in he Uni ed Kingdom, acupunc u e is no subjec o
s a u o y egula ion. P ac i ione s may olun a ily egis e wi h p o essional bodies,
which ope a e unde a olun a y egis y sys em app o ed by he P o essional S anda ds
Au ho i y. A p esen , Tui Na is no subjec o speci ic s a u o y equi emen s and is gen-
e ally p ac iced wi hin he scope o TCM o complemen a y he apy.
Seo e al. 33 demons a ed ha in China, bo h acupunc u e and Tui Na a e ully in e-
g a ed in o he na ional heal hca e sys em and p ac i ione s mus comple e s anda dized
educa ional p og ams a acc edi ed ins i u ions. The p ac ice and p omo ion o TCM in
China is s ongly suppo ed by go e nmen ini ia i es and egula o y bodies, wi h an in-
c easing emphasis on quali y con ol and in e na ional s anda diza ion.
