Compiled by Joseph Brady MSTCM, L.Ac., Dipl. OM

Contact: taichiproj@earthlink.net | joe.brady@faculty.ccmu.edu

1529 York Street, Denver, CO 80206

Acknowledgements

Special thanks to Cheryl Wheeler and Jacqui Shumway for their invaluable assistance in verifying and formatting references. Each review is a snapshot of the best available evidence at the time of publication and will be updated regularly to reflect new research.

Author’s Note on AI Use

Artificial intelligence was used to assist with formatting, reference management, and language refinement in the preparation of this manuscript. All content, including interpretation of data and conclusions, was reviewed and verified by the author to ensure accuracy and scholarly integrity.

Chinese Medicine in Pediatric Care: Safety, Efficacy, and Emerging Evidence

Chinese Medicine in Pediatric Care: Evidence Review

Overview

Chinese Medicine (CM) shows promising potential in pediatric care, particularly for conditions such as respiratory infections, allergic rhinitis, and fever management. While several high-quality meta-analyses and registry studies suggest efficacy and safety, variability in methodological quality across studies necessitates cautious interpretation. CM interventions—including herbal formulas, Tuina massage, and integrative therapies—are generally well tolerated, but concerns persist around injectable forms.

Evidence Synthesis GRADE High Quality)

•            Mycoplasma pneumonia: A 2024 meta-analysis found that CM combined with azithromycin significantly improved cure rates (OR = 2.34; 95% CI: 2.06–2.64) and reduced adverse events (OR = 0.37; 95% CI: 0.32–0.44) in children with Mycoplasma pneumonia (Lyu et al., 2024).

•         Community-acquired pneumonia: A high-quality RCT showed Maxing Ganshi Decoction reduced fever duration and improved clinical response (Zheng et al., 2022).

•         Pneumonia recovery: Meta-analysis confirmed reduced symptom duration and improved overall recovery rates with Chinese herbal medicine (Guo et al., 2022).

•         Allergic rhinitis: A 2024 review of Cang-Er-Zi-San found improved symptom scores (RR = 1.21; 95% CI: 1.15–1.26) and fewer adverse effects (Zeng et al., 2024).

•         Atopic dermatitis: A 2022 analysis of eight high-quality RCTs found significant improvement in eczema severity and sleep quality, though with a slightly higher rate of mild adverse events (Hong, 2022).

•         Henoch–Schönlein Purpura: Herbal therapies reduced renal complications and recurrence risk (Li et al., 2019; Fan et al., 2020).

Real-World and Registry Data (GRADE: Moderate Certainty)

•         A massive registry study of Reduning injection in over 100,000 pediatric cases documented safety concerns—especially anaphylactic reactions—prompting strong caution around injectable forms (NCT03461692).

•         Tuina massage for pediatric fever shows excellent safety and effectiveness, with meta-analyses reporting reduced fever duration and no major adverse events (Liu et al., 2025).

•         Chinese medicine baths combined with conventional treatments demonstrate good results for atopic dermatitis, with low recurrence and favorable safety (Han et al., 2013).

Safety Evaluation

While oral herbal therapies and external applications (Tuina, baths) are generally safe, injectable CM therapies such as Shuanghuanglian or Qingkailing have been repeatedly linked to serious adverse events in children, including anaphylaxis (Safety concerns…, 2019). Pediatric pharmacokinetics and immune responses necessitate age-specific dosing and monitoring.

Limitations and Research Gaps

•         Most trials suffer from small sample sizes, lack of blinding, and heterogeneous outcome measures.

•         Placebo-controlled RCTs remain rare, particularly for chronic and neurological conditions.

•         Long-term safety data are limited.

•         Standardized dosing guidelines and herb-drug interaction studies are underdeveloped.

Clinical Implications

CM can be safely and effectively integrated into pediatric care—especially for respiratory and allergic conditions—when guided by evidence-based protocols and used adjunctively with conventional treatments. Tuina massage and herbal therapies offer low-risk, non-invasive options for symptom management and quality-of-life improvements.

Key References

Adams, D., Cheng, F., Jou, H., Aung, S., Yasui, Y., & Vohra, S. (2011). The safety of pediatric acupuncture: A systematic review. Pediatrics, 128(6), e1575–e1587. https://doi.org/10.1542/peds.2011-1091

Carnazza, E., Werner, R. N., Begley, A., Yang, Y., Tiwari, N., Geliebter, A., & Li, X. (2025). Traditional Chinese medicine for pediatric allergic diseases. Current Allergy and Asthma Reports, 25(4), 1208. https://doi.org/10.1007/s11882-025-01208-7

Chen, Y., Wang, J., Wu, L., Zhang, Y., Cheng, H., & Zhang, Z. (2023). Efficacy of Chinese herbal medicine on nasal itching in children with allergic rhinitis: A systematic review and meta-analysis. Frontiers in Pharmacology, 14, 1240917. https://doi.org/10.3389/fphar.2023.1240917

Converse, A. K., Ahlers, E. O., Travers, B. G., & Davidson, R. J. (2014). Tai Chi training reduces self-report of inattention in healthy young adults. Frontiers in Human Neuroscience, 8, 13. https://doi.org/10.3389/fnhum.2014.00013

Guo, J., Bai, X., Zhang, H., Zhang, N., Liang, J., Guo, Z., & Cui, X. (2022). Efficacy and safety of Chinese herbal medicine for pneumonia convalescence in children: A systematic review and meta-analysis. Frontiers in Pharmacology, 13, 956736. https://doi.org/10.3389/fphar.2022.956736

Hernandez-Reif, M., Field, T., & Thimas, E. (2000). Attention deficit hyperactivity disorder: Benefits from Tai Chi. Journal of Bodywork and Movement Therapies, 5(2), 120–123. https://doi.org/10.1054/jbmt.2000.0219

Li, X., Li, S., Xu, Y., Wei, D., Shi, Q., Zhu, Q., Yang, T., Ding, J., Tian, Y., Huang, J., Wang, K., Wen, T., & Zhang, X. (2017). Effect of integrated Chinese and Western medicine therapy on severe hand, foot and mouth disease: A prospective, randomized, controlled trial. Chinese Journal of Integrative Medicine, 23(2), 90–96. https://doi.org/10.1007/s11655-016-2504-3

Liu, Y., Lin, Y., Yu, H., Wu, H., Zhang, Y., Liu, Q., Sun, W., & Zhang, H. (2025). Effectiveness and safety of Tuina massage therapy for paediatric fever: A systematic review and meta-analysis of randomised controlled trials. BMC Pediatrics, 25, 5441. https://doi.org/10.1186/s12887-025-05441-x

Lyu, J., Fan, F., Li, J., Wang, Q., Xu, J., & Wang, B. (2024). Efficacy and safety of traditional Chinese medicine combined with azithromycin sequential therapy for mycoplasma pneumonia among children: A meta-analysis of randomized controlled trials. Frontiers in Pharmacology, 15, 1431706. https://doi.org/10.3389/fphar.2024.1431706

U.S. National Library of Medicine. (n.d.). A registry study of 100 thousand cases of pediatric patients on Reduning injection (a Chinese medicine injection) used in hospitals in China (ClinicalTrials.gov Identifier: NCT03461692). ClinicalTrials.gov. Retrieved August 6, 2025, from https://clinicaltrials.gov/study/NCT03461692

Yang, C., Hao, Z., Zhang, L. L., & Guo, Q. (2015). Efficacy and safety of acupuncture in children: An overview of systematic reviews. Pediatric Research, 78(2), 112–119. https://doi.org/10.1038/pr.2015.91

Zeng, Q., Li, J., Wu, Q., Li, X., Yan, H., Bi, Y., Gao, Y., & Zhuo, Y. (2024). Evaluation of the efficacy and safety of Chinese medicine Cang-Er-Zi-San in the treatment of allergic rhinitis in children: A meta-analysis and systematic review. Medicine, 103(13), e40491. https://doi.org/10.1097/MD.0000000000040491

Zheng, Y., Shi, C., Han, Y., Li, X., Dong, L., Li, Y., Chen, H., Wang, Y., Li, J., Liu, G., Ma, R., Lin, F., & Tong, X. (2022). Efficacy and safety of a Chinese herbal formula Maxing Ganshi Decoction in children with community-acquired pneumonia: A randomized, double-blind, placebo-controlled, multicenter trial. Frontiers in Pharmacology, 13, 948831. https://doi.org/10.3389/fphar.2022.948831