不同针灸相关疗法对中风后睡眠障碍的比较疗效：随机对照试验的网络荟萃分析。

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-06-09 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S507392

Jiaying Lian, Yanhong Jiang, Lingli Kong, Mingqi Zhou

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引用次数: 0

摘要

背景：卒中后睡眠障碍（PSSD）是卒中最常见的并发症之一，严重阻碍神经系统恢复并增加复发风险。虽然西医主要依靠药物治疗，但这些药物往往有副作用，而且结果不一致。最近的证据支持各种针灸疗法对PSSD的有效性，但最佳治疗策略仍不清楚。目的：采用网络meta分析比较不同针灸疗法治疗PSSD的疗效。方法：我们对多个数据库进行系统检索，包括中国知网（自1994年起）、维普网（自1989年起）、CBM（自1978年起）、万方（自1998年起）、中国临床试验注册中心（自2005年起）、PubMed（自1966年起）、EMBASE（自1974年起）、Cochrane图书馆（自1993年起）、Web of Science（自1900年起）和ClinicalTrials（自2000年起）。截至2024年5月31日，针刺治疗PSSD的随机对照试验（rct）被纳入研究。研究根据预先确定的纳入和排除标准进行筛选，并使用Cochrane干预措施系统评价手册评估其质量。采用RevMan 5.3和Stata 14对数据进行分析。结果：共纳入53项rct，共3973例患者。网络荟萃分析评估了12项干预措施。耳压联合西药对PSQI评分的改善程度最高（累计排名曲线下面[SUCRA]: 96.2%），其次是针灸（68.5%）和艾灸联合西药（63.6%）。在提高血清5-HT水平方面，艾灸联合西药最高（supra: 89.3%），其次是针灸联合西药（79.1%）。针刺结合西药对降低血清NE水平最有效（supra: 97%）。结论：针刺治疗PSSD有效，且配合西药治疗效果更好。这些影响可能是通过调节神经递质水平介导的。然而，需要进一步的大规模、多中心随机对照试验来证实这些发现。本研究遵循PRISMA指南，并在PROSPERO注册（CRD42023470398）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Comparative Efficacy of Various Acupuncture-Related Therapies for Post-Stroke Sleep Disorders: A Network Meta-Analysis of Randomized Controlled Trials.

查看原文本刊更多论文

Comparative Efficacy of Various Acupuncture-Related Therapies for Post-Stroke Sleep Disorders: A Network Meta-Analysis of Randomized Controlled Trials.

Background: Post-stroke sleep disorders (PSSD) are among the most prevalent complications of stroke, significantly impeding neurological recovery and increasing the risk of recurrence. While Western medicine primarily relies on pharmacological treatments, these often come with side effects and inconsistent outcomes. Recent evidence supports the effectiveness of various acupuncture therapies for PSSD, but the optimal treatment strategy remains unclear.

Objective: To compare the efficacy of different acupuncture therapies for PSSD using a network meta-analysis.

Methods: We conducted systematic searches in multiple databases, including CNKI (since 1994), VIP (since 1989), CBM (since 1978), WanFang (since 1998), the Chinese Clinical Trial Registry (since 2005), PubMed (since 1966), EMBASE (since 1974), The Cochrane Library (since 1993), Web of Science (since 1900), and ClinicalTrials (since 2000). Randomized controlled trials (RCTs) on acupuncture therapies for PSSD were included up to May 31, 2024. Studies were screened based on predefined inclusion and exclusion criteria, and their quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed using RevMan 5.3 and Stata 14.

Results: A total of 53 RCTs involving 3973 patients were included. The network meta-analysis evaluated 12 interventions. Auricular acupressure combined with Western medicine ranked highest for improving PSQI scores (surface under the cumulative ranking curve [SUCRA]: 96.2%), followed by acupuncture (68.5%) and moxibustion combined with Western medicine (63.6%). For increasing serum 5-HT levels, moxibustion combined with Western medicine ranked highest (SUCRA: 89.3%), followed by acupuncture combined with Western medicine (79.1%). Acupuncture combined with Western medicine was most effective in reducing serum NE levels (SUCRA: 97%).

Conclusion: Acupuncture therapies are effective for PSSD and it is more effective when used in combination with western medicine. These effects may be mediated by modulating neurotransmitter levels. However, further large-scale, multi-center RCTs are needed to confirm these findings. This study followed PRISMA guidelines and was registered with PROSPERO (CRD42023470398).

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.