清热化痰法治疗痰热扰心型失眠的Meta分析

Meta-analysis of the Treatment of Phlegmheat Disturbing Heart-type Insomnia Patients with the Method of Clearing Away Heat and Removing Phlegm

目的应用Meta分析系统对清热化痰法治疗痰热扰心型失眠的临床疗效及其安全性做出评价。方法计算机检索CNKI,VIP、PubMed和万方数据库,由2位研究者根据纳入排除标准对所有检索出来的文献分别进行筛选、提取数据,质量评价采用Cochrance偏倚风险评估工具,运用RenMan5.3软件对文献进行Meta分析。结果最终纳入19篇随机对照试验,合计1534例患者。(1)临床总有效率分析:清热化痰法治疗痰热扰心型失眠的临床总有效率高于单纯西药治疗(OR=4.00,95%CI[2.94,5.43],P<0.00001)。(2)临床治愈率分析:清热化痰法治疗痰热扰心型失眠的临床治愈率高于单纯西药治疗(OR=1.82,95%CI[1.02,3.23],P<0.00001)。(3)匹兹堡睡眠质量指数量表(PSQI)评分:清热化痰法治疗痰热扰心型失眠在降低PSQI评分方面优于常规西药对照组(MD=-2.65,95%CI[-3.78,-1.53],P<0.00001)。(4)不良反应分析:(OR=0.14,95%CI[0.08,0.24],P<0.00001)。结论此次Meta分析证明清热化痰法治疗痰热扰心型失眠总有效率及治愈率均高于西药对照组,在降低PSQI评分方面优于常规西药对照组,安全性较高。

Objective:To evaluate the clinical effect and safety of the heat-clearing and phlegm-removing method in the treatment of phlegm-heat-disturbing insomnia patients by using Meta analysis system.Methods:CNKI,VIP,PubMed and Wanfang databases were searched by computer retrieval and all the retrieved documents were screened and the data extracted by 2 researchers according to the inclusion and exclusion criteria.The quality evaluation was made by Cochrance’s bias risk assessment tool and RenMan5.3 software was used to make Meta-analysis of the literature.Results:19 randomized controlled trials were finally included,with a total of 1534 patients.(1) Analysis of clinical total effective rate:The total clinical effective rate of the method in the treatment of phlegm-heat disturbing insomnia was higher than that of western medicine alone(OR=4.00,95%CI[2.94,5.43],P<0.00001).(2) Clinical cure rate analysis:The clinical cure rate of the heat-clearing and phlegm-removing method in the treatment of the phlegm-heat disturbing insomnia was higher than that of western medicine alone(OR=1.82,95%CI[1.02,3.23],P<0.00001).(3) Pittsburgh Sleep Quality Index(PSQI) score:The heat-clearing and phlegm-removing method for treating phlegm-heat-disturbing insomnia was superior to the conventional western medicine control group in the reduction of the PSQI score(MD=-2.65,95%CI[-3.78,-1.53],P<0.00001).(4) Adverse reaction analysis:(OR=0.14,95%CI[0.08,0.24],P<0.00001).Conclusion:This meta-analysis proves that the total effective rate and cure rate of the heat-clearing and phlegm-removing method in the treatment of phlegm-heat-disturbing insomnia are higher than those of the western medicine control group,and it is better than the conventional western medicine control group in reducing the PSQI score,with higher safety.