八段锦干预失眠症患者疗效的Meta分析

Meta-analysis of the Efficacy of Baduanjin Exercise on Patients with Sleep Initiation and Maintenance Disorders

目的:运用Meta分析的方法评价八段锦干预失眠症患者的疗效。方法:通过检索PubMed、考克兰图书馆、EMBASE、知网、万方以及CBM等6个数据库,从建库至2020年12月4日的关于八段锦治疗失眠症的随机对照试验(RCT),根据严格的纳入和排除标准进行筛选及信息提取,采用Revman 5.4进行Meta分析,评价八段锦对失眠症患者的干预疗效。结果:纳入13篇相关文献,共计1022名患者。Meta分析的结果显示,与对照组相比,八段锦干预后失眠症患者睡眠质量(MD=-0.57,95%CI:-0.81~-0.34,P<0.05)、入睡时间(MD=-0.57,95%CI:-0.79~-0.34,P<0.05)、睡眠时间(MD=-0.41,95%CI:-0.67~-0.16,P<0.05)、睡眠效率(MD=-0.62,95%CI:-0.97~-0.33,P<0.05)、睡眠障碍(MD=-0.46,95%CI:-0.78~-0.13,P<0.05)、日间功能障碍(MD=-0.34,95%CI:-0.62~-0.07,P<0.05)、PSQI总分(MD=-2.28,95%CI:-2.81~-1.76,P<0.05)评分改善,差异有统计学意义,睡眠药物依赖(MD=-0.29,95%CI:-0.59~-0.00,P=0.05)评分改善差异无统计学意义,由于研究间异质性较大,通过敏感性分析、亚组分析探索异质性来源。结论:与对照组相比,八段锦干预组能改善功能性和器质性失眠症患者的睡眠质量、睡眠效率、入睡时间、总睡眠时间,减轻睡眠障碍程度、日间功能障碍程度及器质性失眠患者的催眠药物依赖;对于睡眠时间短的患者可在八段锦的基础上联合常规的治疗方案,干预疗程在3个月及3个月以上疗效较好。

Objective:This study aimed to assess the efficacy of Baduanjin Exercise on patients with sleep initiation and maintenance disorders via a meta-analysis.Methods:Eligible randomized controlled trial(RCT)of Baduanjin in treatment of Insomnia were retrieved from six databases(PubMed,EMBASE,Cochrane Library,CNKI,Wanfang database and CBM)up to December 4,2020 and screened based on rigorous inclusion and exclusion criteria.Afterwards,the pairwise and network meta-analyses were carried out by Revman 5.4 to evaluate the efficacy of Baduanjin Exercise on Patients with Sleep Initiation and Maintenance Disorders.Results:Altogether,a total of 13 RCTs literatures were included with 1022 patients,The results of meta-analysis showed that compared with the control group,the sleep quality of functional insomnia patients after Baduanjin intervention(MD=-0.57,95%CI:-0.81~-0.34,P<0.05),Sleep latency(MD=-0.57,95%CI:-0.79~-0.34,P<0.05),Sleep Time(MD=-0.41,95%CI:-0.67~-0.16,P<0.05),Sleep efficiency(MD=-0.62,95%CI:-0.97~-0.33,P<0.05),Sleep disorders(MD=-0.46,95%CI:-0.78~-0.13,P<0.05),daytime dysfunction(MD=-0.34,95%CI:-0.62~-0.07,P<0.05)PSQI scores(MD=-2.28,95%CI:-2.81~-1.76,P<0.05)score improvement,and the difference was statistically significant.There was no statistical significance in the improvement of sleep drug dependence score(MD=-0.29,95%CI:-0.59~-0.00,P=0.05).Due to the large heterogeneity among studies,sensitivity analysis and subgroup analysis were used to explore the source of heterogeneity.Conclusion:Compared with the control group,the Baduanjin intervention group can improve the sleep quality and sleep efficiency of patients with functional and organic insomnia,shorten the time to fall asleep,prolong the total sleep time,reduce the degree of sleep disorder and daytime dysfunction,as well as the use of hypnotic drugs in patients with organic insomnia.For patients with short sleep duration,Baduanjin can be combined with conventional treatment plan.And the effect of intervention course is better in 3 months or more.