耳穴贴压治疗血液透析患者失眠症状的Meta分析

Meta Analysis of the curative effect of ear point pressing on insomnia symptoms in maintenance hemodialytic patients

目的:系统评价耳穴贴压治疗维持性血液透析患者失眠症状的治疗效果。方法:检索中英文数据库中关于耳穴贴压治疗维持性血液透析患者失眠症状的随机对照试验,对所纳入的研究进行资料提取及质量评价,采用RevMan 5.3软件对结果进行统计学分析。结果:最终纳入7个RCT,共469例研究对象。Meta分析结果显示:干预组在改善失眠症状的总有效率[RR=6.42,95%CI(3.32,12.42),Z=5.53,P<0.00001];匹兹堡睡眠质量指数(PSQI)量表总评分[MD=-2.51,95%[-3.17,-1.86],P=0.41,I^2=0%];日间功能[MD=-0.67,95%[-0.92,-0.41],P=0.16,I^2=45%];优于对照组,且差异具有统计学意义。结论:与单用镇静催眠药物或心理宣教相比,耳穴贴压可更有效降低PSQI量表分数,改善日间功能。

Objective:To systematically evaluate the therapeutic effect of auricular point pressing on insomnia in maintenance hemodialytic patients.Methods:A randomized controlled trial on insomnia symptoms of maintenance hemodialytic patients treated with auricular point pressing was searched in Chinese and English database.The data were extracted and the quality of the study was evaluated.The results were statistically analyzed by RevMan 5.3 software.Results:A total of 469 subjects were included in 7 RCT,subjects.Meta-analysis showed that the total effective rate of the treatment group in improving insomnia symptoms[RR=6.42,95%CI(3.32,12.42),Z=5.53,P<0.00001],the total score of Pittsburgh Sleeping quality Index(PSQI)[MD=-2.51,95%[-3.17,1.86],P≤0.41,I^2=0%],daytime function[MD=-0.67,95%[-0.92,0.41],P≤0.16,I^2=45%],which was better than that of the control group,and the difference was statistically significant.Conclusion:Compared with sedative and hypnotic drugs or psychological education alone,auricle pressing can effectively reduce the score of PSQI scale and improve the daytime function.