이혈요법의 ADHD에 대한 안전성과 유효성 연구: 체계적 문헌고찰과 메타분석

Abstract

Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition in children. While pharmacological and behavioral treatments are effective, issues such as residual symptoms, tolerability, and accessibility persist. Auriculotherapy has been suggested as a neuromodulatory approach that may influence autonomic and arousal regulation. This review systematically evaluated the efficacy and safety of auriculotherapy for alleviating ADHD symptoms. Methods: We searched six databases for randomized controlled trials (RCTs) up to November 10, 2025. The risk of bias was assessed using Cochrane RoB 2.0. Effect sizes were calculated using standardized mean differences (SMD) or risk ratios (RR) with random-effects models. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: Four RCTs met the inclusion criteria. Auriculotherapy did not demonstrate a statistically significant effect on attention problems (SMD -0.89, 95% CI -2.79 to 1.01; I2 = 95%) or hyperactivity/ impulsivity (SMD -0.29, 95% CI -0.89 to 0.30). However, sleep problems, assessed in one study, showed a statistically significant improvement with auriculotherapy (SMD -1.32, 95% CI -1.97 to -0.67). The total effective rates did not differ significantly between the groups (RR 1.04, 95% CI 0.86 to 1.25), and reported adverse events were mild. The certainty of evidence ranged from low to very low. Conclusions: Current evidence does not indicate a statistically significant effect of auriculotherapy on core ADHD symptoms. A potential benefit for sleep problems was noted in a single study; however, the overall certainty of the evidence is low. Further well-designed, adequately powered RCTs are needed to clarify these findings.