黄连阿胶汤治疗失眠临床疗效的Meta分析

Meta-analysis of the Clinical Efficacy of Huanglian Ejiao Decoction(黄连阿胶汤)in the Treatment of Insomnia

目的系统评价黄连阿胶汤治疗失眠的临床疗效和安全性。方法在知网检索主要的中英文医学文献中有关黄连阿胶汤与其他疗法分别单独治疗失眠的随机对照试验(RCT)。由2名研究者独立进行文献筛选、资料提取,进行偏倚风险评价后,运用采用RevMan5.2软件进行Meta分析。结果最终纳入RCT共12篇,共计1130例患者。Meta分析结果显示:黄连阿胶汤组的总有效率(中医标准)明显高于以中成药为主的对照组[RR(95%CI)=1.21[1.14,1.28],P<0.000 01],以PSQI减分率为标准的有效率可能更优于对照组,能够降低失眠患者的PSQI评分(MD=-3.17,95%CI(-3.58,-2.75),P<0.000 01)。结论黄连阿胶汤可有效提高失眠的有效率,有效缓解失眠相关的症状。但由于纳入文献的质量不高,其疗效和安全性仍需高质量、大样本、规范、资料完善、多中心的随机对照试验研究进一步支持。

Objective To systematically evaluate the clinical efficacy and safety of Huanglian Ejiao Decoction(黄连阿胶汤) in the treatment of insomnia. Methods A randomized controlled trial(RCT) of huanglian ejiao tang and other treatments for insomnia was conducted in the main chinese-english medical literature. By Two researchers independently conducted literature screening, data extraction and risk assessment of bias, and then Meta analysis using RevMan5.2 software.Results A total of 12 RCTS were finally included, a total of 1130 patients. The results of Meta analysis showed that the total effective rate(TCM standard) of huanglian E-jiao tang group was significantly higher than that of the control group dominated by Chinese traditional medicine(RR(95%CI) =1.21[1.14, 1.28], P<0.000 01), and the effective rate of PSQI score reduction rate was probably better than that of the control group, which could reduce the PSQI score of insomnia patients(MD=-3.17, 95%CI[-3.58,-2.75], P<0.000 01). Conclusion Huanglian Eejiao Decoction can effectively improve the efficiency of insomnia and relieve insomnia related symptoms. However, due to the low quality of the included literature, its efficacy and safety still need to be further supported by high-quality, large-sample, standardized, well-documented, multi-center randomized controlled trials.