单纯针灸对比西药治疗更年期失眠随机对照试验的Meta分析

Meta-analysis of randomized controlled trials of acupuncture in the treatment of menopausal insomnia

目的:通过综合荟萃分析调查单纯针灸治疗更年期失眠对比西药的安全性和有效性。方法:文献检索、研究选择、资料提取等独立进行,效应大小估计用风险比(RR)和95%置信区间(CI)表示。结果:27篇文章中涉及2 349名更年期女性的摘要数据纳入meta分析。总体分析显示,在临床痊愈率[RR=1.85,95%CI(1.57,2.18),P<0.001]方面单纯针灸疗法是西药疗法的1.85倍,在显效率方面是西药疗法的1.3倍[RR=1.30,95%CI(1.09,1.54),P=0.003]。在匹兹堡睡眠质量指数(PSQI)量表方面,单纯针灸在睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能障碍方面都优于西药疗法。在不良反应测评,单纯针灸相关疗法组的不良事件发生率低于西药治疗,安全性较好。结论:本篇荟萃分析结果显示单纯针灸治疗更年期失眠临床疗效优于西药疗法,有更好的疗效和安全性,适合临床推广使用。

objective:To investigate the safety and efficacy of acupuncture in the treatment of climacteric insomnia com‐pared with western medicine through a comprehensive meta-analysis.Methods:Literature retrieval,research selection and data extraction were done independently and in duplicate.Effect-size estimates were expressed as risk ratio(RR)and 95%confidence interval(CI).Results:Summary data from 27 articles,involving a total of 2349 menopausal women,were meta-analyzed.The overall analysis showed that the clinical cure rate[RR=1.85,95%CI(1.57,2.18),P<0.001]of acupuncture therapy was 1.85 times higher than that of western medicine therapy,and the significantly effective rate was 1.3 times higher than that of western medicine[RR=1.64,95%CI(1.39,1.95),P<0.001].In terms of Pittsburgh sleep quality index(PSQI),simple acupuncture was superior to western medicine in sleep quality,falling asleep time,sleep time,sleep efficiency,and daytime dysfunction.In the evaluation of adverse reactions,the incidence of adverse events in the acupuncture-related therapy group was lower than that in the western medicine group.Conclusion:The results of meta-analysis show that the clinical efficacy of acupuncture in the treatment of climacteric insomnia is better than that of western medicine which has better efficacy and safety.The acupuncture therapy is suitable for clinical application.