针刺疗法对失眠患者睡眠结构影响的Meta分析

Meta-analysis of the Effect of Acupuncture on Sleep Structure in Patients with Insomnia

目的:采用系统评价分析方法研究针刺治疗对睡眠进程及睡眠结构的影响。方法:检索国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中国学术期刊数据库(CSPD)、PubMed、Web of Science国际循证医学图书馆(Cochrane Library)数据库中关于针刺治疗失眠的中、英文随机对照试验研究,检索时限为建库至2024年2月1日。采用RevMan Ver5.4.1对符合纳排标准的文献进行Meta分析。结果:共计检索符合要求的文献12篇,共1068名被试者。Meta分析结果显示:针刺观察组的睡眠时间长于对照组(MD=5.47,95%CI为1.95~8.99,Z=3.05,P=0.002),针刺观察组的睡眠效率优于对照组(MD=3.94,95%CI为3.55~4.32,Z=19.87,P<0.00001),针刺观察组的N3%(MD=5.64,95%CI为3.56~7.71,Z=5.32,P<0.00001)和REM%(MD=5.47,95%CI为1.95~8.99,Z=3.05,P=0.002),占比高于对照组,对照组的N1%(MD=-5.19,95%CI为-8.17~2.22,Z=3.42,P=0.0006)、N2%(MD=-5.59,95%CI为-8.88~2.31,Z=3.33,P=0.0009)占比高于针刺观察组。结论:针刺治疗失眠具有良好的临床疗效,能有效延长睡眠时长,改善睡眠效率,针刺治疗可提升深度睡眠占比,对调节睡眠结构有一定作用。

Objective:To study the effect of acupuncture treatment on sleep process and sleep structure using Meta-analysis.Methods:The Chinese and English randomized controlled trial studies on acupuncture treatment for insomnia were searched in the database of CNKI,CCD,CSPD,PubMed,Web of Science and Cochrane Library.The time limit was from the establishment of these libraries to February 1,2024.Meta-analysis was performed using RevMan Ver5.4.1 on the reports that meet the criteria.Results:A total of 12 articles with 1068 subjects meeting the requirements were retrieved.The results showed that subjects in the acupuncture group slept longer than the control group(MD=5.47,95%CI 1.95 to 8.99,Z=3.05,P=0.002).The sleep efficiency of the acupuncture group was superior to that of the control group(MD=3.94,95%CI 3.55 to 4.32,Z=19.87,P<0.00001).The N3%(MD=5.64,95%CI 3.56 to 7.71,Z=5.32,P<0.00001)and REM%(MD=5.47,95%CI 1.95 to 8.99,Z=3.05,P=0.002)in the acupuncture group is higher than the control group.The N1%(MD=-5.19,95%CI-8.17 to 2.22,Z=3.42,P=0.0006)and N2%(MD=-5.59,95%CI-8.88 to 2.31,Z=3.33,P=0.0009)were higher in the control group than the acupuncture group.Conclusion:Acupuncture for insomnia has good clinical efficacy.It can improve sleep efficiency,enhances the percentage of deep sleep,and regulates sleep structure.