耳穴贴压改善糖尿病伴失眠患者睡眠效果的系统评价

Effect of auricular-plaster therapy indiabetes patients with insomnia：a systematic review

目的：系统评价耳穴贴压改善糖尿病失眠患者睡眠状况的效果,为糖尿病失眠患者的治疗提供参考意见。方法计算机检索Cochrane Library、JBI、PubMed、EMbase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普期刊资源整合服务平台（VIP）数据库中有关耳穴贴压干预糖尿病患者失眠的随机对照试验（ RCT）或半随机对照试验（ CCT）,检索时间限定为各数据库建库至2016年1月1日。利用Review Manger 5.3分析软件进行Meta分析。结果共纳入10篇原始研究,合计1315例患者。根据不同的干预方法和结局指标进行Meta分析。 Meta分析结果显示：①不同干预方法：耳穴贴压组的总有效率高于常规护理组[OR＝7.56,95％CI（3.92,14.58）, P〈0.00001]；综合干预组（耳穴贴压、中药足浴、足底按压）的总有效率高于常规护理组[OR＝3.45,95％CI （2.60,4.57）,P＝0.009]；②不同结局指标：综合干预能够降低糖尿病失眠患者的匹兹堡睡眠质量指数[ MD＝-1.96,95％CI（-2.33,-1.59）,P〈0.00001],同时可以控制患者餐后2 h血糖水平[ MD＝-1.86,95％CI（-1.94,-1.78）,P〈0.00001]。结论耳穴贴压可以改善糖尿病伴失眠患者的睡眠效果,提高患者的睡眠质量。但由于本次研究纳入的文献差异性较大,故研究结果需谨慎对待。

Objective To evaluate the efficacy of auricular-plaster therapy indiabetes patients with insomnia, and provide suggestions for treatment.Methods The relevant randomized controlled trials and quasi-randomized controlled trials about using auricular-plaster therapy in diabetes patients with insomnia were searched in Cochrane Library, JBI, EMbase, Chinese Biological Medical Database （ CBM ） , Wanfang Data, VIP, China National Knowledge Internet（CNKI） and Pub Med. Information was selected. Retrieval time was limited from the foundation of those database to January 1st 2016. We use the Review manager 5. 3 analysis software to conduct Meta-analysis.Results 10 primary studies were included, which involved in 1 315 patients. Meta-analysis was processed based on different intervention methods and various outcome indicators. ①Different intervention methods：the effective rate of the auricular-plaster therapy group were higher than the control group, with significant differences [ OR= 7. 56, 95%CI （ 3. 92, 14. 58 ） , P〈0. 000 01 ]; The effective rate of the comprehensive group （ including auricular-plaster therapy） were higher than the control group, with significant differences [OR=3.45, 95%CI（2.60,4.57）, P=0.009];②Different results of outcome indicators, comprehensive interventionhas significant improvementonthe sleep quality of patients [MD=-1.96,95%CI（-2.33,-1.59）,P〈0.000 01];Moreover, comprehensive intervention could control postprandial blood glucose within twohours,with significant differences [MD=-1.86,95%CI（-1.94,-1.78）,P〈0.000 01].Conclusions Theauricular-plaster therapy can improve the sleep quality and sleep effect of diabetes patients with insomnia. However, because of the large literature difference, the results of the meta-analysis should be critical treated.