文章摘要
马增斌,倪国栋,郑志坚,程凯,彭晓涛.揿针治疗失眠随机对照试验的Meta分析[J].中国临床保健杂志,2019,22(2):241-246.
揿针治疗失眠随机对照试验的Meta分析
A Meta-analysis of randomized controlled trials of intradermal needle for insomnia
投稿时间:2018-12-20  
DOI:10.3969/J.issn.1672-6790.2019.02.025
中文关键词: 入睡和睡眠障碍  针刺疗法  Meta分析
英文关键词: Sleep initiation and maintenance disorders  Acupuncture therapy  Meta-analysis 〖FL
基金项目:国家自然科学基金项目(81273849)
作者单位E-mail
马增斌 北京医院针灸按摩科 国家老年医学中心,北京100730 zzj3030@126.com 
倪国栋 北京医院针灸按摩科 国家老年医学中心,北京100730 zzj3030@126.com 
郑志坚 北京医院针灸按摩科 国家老年医学中心,北京100730 zzj3030@126.com 
程凯 北京中医药大学 zzj3030@126.com 
彭晓涛 北京医院针灸按摩科 国家老年医学中心,北京100730 zzj3030@126.com 
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中文摘要:
      目的 评价揿针治疗失眠的有效性。 方法 运用计算机检索国内医学数据库(中国知网、维普网、万方数据库、中国生物医学文献数据库)和国外医学数据库(Pubmed),建库至今所有揿针治疗失眠的临床随机对照试验相关文献数据,由两名研究者根据Cochrane系统评价手册,对纳入的研究进行偏倚风险评价和质量评价,并采用RevMan5.3软件对纳入研究项目进行Meta分析。 结果 共纳入11项研究,716例失眠患者。Meta分析结果显示:6项研究通过匹兹堡睡眠质量指数(PSQI)评价揿针治疗失眠的疗效,MD=-1.47,95%CI(-2.59~-0.36),Z=2.58,P=0.01;3项研究通过失眠严重指数量表(ISI)评价揿针治疗失眠的疗效,MD=-3.08,95%CI(-3.98,-2.17),Z=2.58,P<0.001;3项研究通过阿森斯失眠量表(AIS)评价揿针治疗失眠的疗效,MD值为-6.20,95% CI(-11.71~-0.68),Z=2.20,P=0.03;9项研究通过总有效率进行比较,RR=1.11,95%CI(1.01~1.22),Z=2.15,P=0.03,表明揿针治疗失眠总体疗效显著,且揿针组优于非揿针组,差异有统计学意义。 结论 揿针治疗失眠具有较好的临床疗效,优于常规安眠药与针灸组,但鉴于本次研究所纳入研究的质量较低,随机化、盲法描述较少,随访及脱落病例记录较少,一定程度上影响了本次研究结果。建议研究人员设计高质量的随机对照试验,增加受试者随访期的疗效评价和安全性评价,为揿针治疗失眠的有效性和安全性提供可靠的循证医学依据。
英文摘要:
      Objective To evaluate the effectiveness of intradermal needle in the treatment of insomnia. Methods Literature data on clinical randomized controlled trials of all the treatments for insomnia since the establishment of database had been retrieved from domestic medical database and foreign medical database,and the risk of bias and quality of the included studies were assessed by two researchers according to the Cochrane systematic evaluation manual,which were meta-analyzed using the RevMan5.3 software. Results A total of 11 studies were included,with 716 patients suffering from insomnia.Meta-analysis results showed that six studies evaluated the efficacy of acupuncture for insomnia by Pittsburgh sleep quality index (PSQI),MD=-1.47,5% CI (-2.59,-0.36),Z=2.58,P=0.01,three studies evaluated the efficacy of acupuncture in the treatment of insomnia through the insomnia severity index scale (ISI),MD=-3.08,5% CI (-3.98,-2.17),Z=2.58,P<0.001,three studies evaluated the efficacy of acupuncture in the treatment of insomnia by assens insomnia scale (AIS),MD=-6.20,5% CI (-11.71,-0.68),Z=2.20,P=0.03,and nine studies were compared by total effectiveness,RR=1.11,5% CI (1.01,1.22),Z=2.15,P=0.03,the results of which showed that the overall therapeutic effect of acupuncture was significant,and the difference between intradermal needle and non-intradermal acupuncture group was significant. Conclusion Insomnia treatment by intradermal needle has better clinical effect than that of conventional medicine and acupuncture treatment.However,low quality of the research,little randomized and blinded description,few follow-up and fall off records affected the results to some extend.It′s suggested that researchers should design a high quality of randomized controlled trials and increase the curative effect evaluation and safety evaluation during the follow-up period to provide reliable basis of evidence-based medicine for the efficacy and safety of acupuncture therapy for insomnia.
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