针刺联合归脾汤治疗心脾两虚型失眠的Meta分析

Meta-analysis of Acupuncture Combined with Guipi Decoction in the Treatment of Insomnia with Heart and Spleen Deficiency Type

目的系统评价针刺联合归脾汤治疗心脾两虚型失眠的疗效。方法运用计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、Cochrane数据库中针刺联合归脾汤治疗心脾两虚型失眠的随机对照试验(RCT)文献,检索时间为建库至2023年3月。运用Zotero软件筛选所需文献,并通过Excel将筛选后的文献基本特征进行归纳,对最终纳入文献进行偏倚风险评估,并运用RevMan5.4.1软件行Meta分析。结果共纳入10篇文献,882例患者,针刺联合归脾汤在有效率[RR=1.13,95%CI(1.02,1.26),P=0.02]、匹兹堡睡眠质量指数量表(PSQI)[MD=-2.08,95%CI(-3.42,-0.74),P=0.002]、多导睡眠图(PSG)AT[MD=-2.37,95%CI(-4.76,0.02),P=0.05]、SL[MD=-5.97,95%CI(-7.28,-4.65),P<0.00001]、TST[MD=34.47,95%CI(24.55,44.38),P<0.00001]、中医证候积分[MD=-0.43,95%CI(-0.50,-0.35),P<0.00001]方面优于针刺治疗;针刺联合归脾汤在有效率[RR=1.28,95%CI(1.13,1.44),P<0.0001]与PSQI[MD=-3.18,95%CI(-3.60,-2.77),P<0.00001]方面优于归脾汤治疗。结论针刺联合归脾汤治疗心脾两虚型失眠在提高有效率,改善临床症状及伴随症状方面优于单纯使用针刺和中药汤剂,可见联合疗法优于单一疗法。

Objective To systematically evaluate the efficacy of acupuncture combined with Guipi decoction in the treatment of insomnia with heart and spleen deficiency type.Methods The randomized controlled trial(RCT)literature of acupuncture combined with Guipi decoction in the treatment of insomnia heart and spleen deficiency type was retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed and Cochrane databases by computer.The retrieval time was from the establishment of the database to March 2023.Zotero software was used to screen the required literature,and the basic characteristics of the screened literature were summarized by Excel.The risk of bias was evaluated for the final included literature,and RevMan 5.4.1 software was used for Meta analysis.Results A total of 10 articles and 882 patients were included.The effective rate[RR=1.13,95%CI(1.02,1.26),P=0.02],Pittsburgh sleep quality index(PSQI)[MD=-2.08,95%CI(-3.43,-0.74),P=0.002],polysomnography(PSG)AT[MD=-2.37,95%CI(-4.76,0.02),P=0.05],SL[MD=-5.97,95%CI(-7.28,-4.65),P<0.00001],TST[MD=34.47,95%CI(24.55,44.38),P<0.00001],TCM syndrome score[MD=-0.43,95%CI(-0.50,-0.35),P<0.00001]of acupuncture combined with Guipi decoction were better than those of acupuncture;acupuncture combined with Guipi decoction was superior to Guipi decoction in terms of effective rate[RR=1.28,95%CI(1.13,1.44),P<0.0001]and PSQI[MD=-3.18,95%CI(-3.60,-2.77),P<0.00001].Conclusion Acupuncture combined with Guipi decoction is superior to acupuncture and traditional Chinese medicine decoction in improving the effective rate,clinical symptoms and accompanying symptoms in the treatment of insomnia with heart and spleen deficiency type.It can be seen that the combined therapy is superior to the single therapy.