针灸治疗老年失眠的Meta分析

Acupuncture for Insomnia in the Elderly:A Meta-analysis

目的:系统评价针灸治疗老年失眠的有效性。方法:计算机检索Google Scholar、PubMed、The Cochrane Library、CBM、EBSCO、SinoMed、CNKI、VIP和WangFang Data数据库,查找有关针灸治疗老年失眠的临床对照试验,检索时均限为建库至2015年4月。由两名研究者按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,RevMan 5.3软件进行Meta分析。结果:共纳入11个研究,包括1075例患者。Meta分析结果显示,与对照组相比,针灸治疗老年失眠患者在总有效率[RR=1.22,95%CI(1.15~1.28),P<0.01]、疗后PSQI评分[MD=-1.36,95%CI(-1.93^-0.79),P<0.01]、治愈率[RR=1.49,95%CI(1.27~1.75),P<0.01]、随访后PSQI评分[RR=-2.06,95%CI(-4.12^-0.00),P=0.05]方面具有一定优势,其差异均有统计学意义。结论:当前证据显示,针灸治疗老年失眠具有一定的优势。受纳入研究的质量限制,上述结论仍需大样本和质量更高的研究进一步验证。

Objective：To systematically review the efficacy of acupuncture for insomnia in the elderly.Methods：Databases such as Google Scholar,PubMed,The Cochrane Library,CBM,EBSCO,SinoMed,CNKI,VIP and Wangfang Data were searched for clinical controlled trials concerning the efficacy of acupuncture for insomnia in the elderly up to April 2014.According to the inclusion and exclusion criteria,two reviewers screened literature,extracted data,and assessed methodological quality of included studies.Then meta-analysis was performed using RevMan 5.3software.Results：A total of 11 studies involving 1075 patients were included.The results of meta-analysis showed that acupuncture group was superior to control group in total effectiveness[RR=1.22,95% CI（1.15~1.28）,P〈0.01],posttreatmentPSQIrecords[MD=-1.36,95% CI（-1.93^-0.79）,P〈0.01],cure rate[RR=1.49,95% CI（1.27~1.75）,P〈0.01],follow-up visit PSQI records[RR=-2.06,95% CI（-4.12^-0.00）,P=0.05].Conclusion：Current evidence indicates that acupuncture of insomnia in the old adults is beneficial.Due to the quality of the included studies,the above conclusion is further needed to verify the efficacy.