背景:电针常用于治疗失眠。
目的:评价电针治疗失眠的有效性和安全性。
方法:包括PubMed、科克伦图书馆,Embase,WebofScience,中国生物医学文献数据库,中国国家知识基础设施,截至2023年1月15日,万方数据和VIP全文电子期刊数据库进行了搜索。
方法:如果比较电针与假针刺的临床疗效和安全性,则纳入随机临床试验,没有治疗或常规护理(UC)和一般针灸。
方法:对研究的全文进行综述,以删除不合格的文献。提取的数据包括作者,出版年份,诊断标准,样本量,人口特征,干预措施和结果。上述步骤由两名审阅者独立进行,并交叉核对数据。采用Stata15.0软件对提取的结果数据进行分析。对于连续数据(匹兹堡睡眠质量指数[PSQI]评分和失眠严重程度指数评分),在应用相同量表时,计算加权平均差(WMD)并报告95%置信区间(CI).对于二分变量(临床反应率和不良事件),以风险比(RR)为效应指标进行荟萃分析.
结果:纳入了31项试验,共2226名受试者。荟萃分析表明,与对照组相比,电针在改善失眠方面更有效(假针刺,没有治疗,UC和普通针灸)(RR=1.21;95%CI:[1.16,1.27]),治疗后和随访时失眠患者的PSQI评分显着降低(WMD=-3.23;95%CI:[-4.29,-2.17];P<0.001)。EA组和对照组之间的不良事件发生率没有显着差异(假针刺和不治疗或UC。RR=1.48;95%CI:[0.91,2.40];P=0.117)。此外,回归结果显示,电针治疗7~9周疗效最好(P<0.05)。
结论:电针可显著改善失眠患者的睡眠质量,适用于各种类型失眠的治疗。然而,纳入的文章是小样本量的单中心试验,有些文章质量很差。因此,仍需要进一步的研究来证实这些发现。请引用这篇文章为:徐HY,WuLN,张勇,BaT,赵XF.电针治疗失眠的有效性和安全性:系统评价和荟萃分析。JIntegrMed。2024年;Epub提前打印。
BACKGROUND: Electroacupuncture is often used to treat insomnia.
OBJECTIVE: To evaluate the efficacy and safety of
electroacupuncture for insomnia.
METHODS: Databases including PubMed, Cochrane Library, Embase, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data and VIP Full-text e-Journals Database were searched up to January 15, 2023.
METHODS: Randomized clinical trials were included if they compared the clinical efficacy and safety of electroacupuncture with sham acupuncture, no treatment or usual care (UC) and general acupuncture.
METHODS: The full texts of the studies were reviewed to remove ineligible literature. The extracted data included authors, publication year, diagnostic criteria, sample size, population characteristics, interventions and outcomes. The above steps were performed independently by two reviewers and the data were cross-checked. Stata15.0 software was used to analyze the extracted outcome data. For continuous data (Pittsburgh Sleep Quality Index [PSQI] score and Insomnia Severity Index score), weighted mean difference (WMD) was calculated and 95% confidence interval (CI) was reported when the same scale was applied. For dichotomous variables (clinical response rate and adverse events), a meta-analysis was performed using risk ratio (RR) as the effect indicator.
RESULTS: Thirty-one trials with 2226 subjects were included. The meta-analysis suggested that
electroacupuncture was more effective in improving insomnia compared with the control group (sham acupuncture, no treatment, UC and general acupuncture) (RR = 1.21; 95% CI: [1.16, 1.27]), significantly reducing the PSQI score in insomnia patients after treatment and at follow-up (WMD = -3.23; 95% CI: [-4.29, -2.17]; P < 0.001). There was no significant difference in the incidence of adverse events between the EA and control groups (sham acupuncture and no treatment or UC. RR = 1.48; 95% CI: [0.91, 2.40]; P = 0.117). In addition, the regression results revealed that receiving electroacupuncture for seven to nine weeks provided the best efficacy (P < 0.05).
CONCLUSIONS: Electroacupuncture can significantly promote better sleep quality in insomnia patients and is suitable for the treatment of various types of insomnia. However, the articles included were single-center trials with small sample sizes, and some articles were of poor quality. Therefore, further research is still needed to confirm these findings. Please cite this article as: Xu HY, Wu LN, Zhang Y, Ba T, Zhao XF. Efficacy and safety of
electroacupuncture for insomnia: A systematic
review and meta-analysis. J Integr Med. 2024; Epub ahead of print.