多种针灸疗法治疗原发性失眠的疗效和安全性：一项贝叶斯网络meta分析

IF 3 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research Pub Date : 2025-07-25 DOI:10.1016/j.imr.2025.101206

Liguo Liu , Yiming Chen , Minne Tian , Zhennan Wu , Peiming Zhang , Tiankang Zhang , Jinsong Yang , Haotian Qu , Zhiyong Fan , Shan Wu , Liming Lu , Yu Kui

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引用次数: 0

摘要

背景：针灸治疗是治疗原发性失眠的有效方法。然而，目前还没有全面的研究对多种AT疗法和催眠药物的疗效和安全性进行比较和评估。方法检索PubMed、Web of Science、Embase、Cochrane图书馆、万方数据库、中国国家知识基础设施数据库、VIP中国科技期刊数据库等8个数据库，检索自成立以来至2024年7月AT治疗原发性失眠的随机对照试验（rct）。筛选后，从纳入的随机对照试验中提取匹兹堡睡眠质量指数（PSQI）评分和临床有效率作为结局指标。我们使用Stata和R软件进行网络meta分析。结果共纳入64项随机对照试验，共4443例患者。多种AT治疗对PSQI评分的改善效果优于催眠治疗，其中AT联合艾灸（MOX）和AT联合耳穴治疗（AU）是最佳干预措施。在临床效果方面，穴位埋线（ACE）最有可能成为最佳干预措施，所有研究均未观察到与AT治疗相关的严重不良事件。结论与催眠药相比，大多数AT治疗均能改善睡眠指标，临床疗效较好，尤其是AT联合AU、AT联合MOX和ACE。AT疗法的安全性是可靠的；然而，纳入试验的总体质量较低，需要更高质量的随机对照试验来提供足够的证据。协议注册号prospero， CRD42017067402。

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The efficacy and safety of multiple acupuncture therapies in primary insomnia: A Bayesian network meta-analysis

Background

Acupuncture (AT) therapy is an effective treatment for primary insomnia. However, no comprehensive study has compared and evaluated the efficacy and safety of multiple AT therapies and hypnotics.

Methods

We searched eight databases from inception to July 2024 for randomized controlled trials (RCTs) of AT treatment for primary insomnia, including PubMed, Web of Science, Embase, Cochrane Library, Wanfang database, China National Knowledge Infrastructure database, and VIP Chinese Science and Technique Journals database. After screening, the Pittsburgh Sleep Quality Index (PSQI) score and clinical effectiveness rate were extracted from the included RCTs as outcome measures. We performed network meta-analysis using the Stata and R software.

Results

Sixty-four RCTs involving 4443 patients were included in this study. Multiple AT therapies had better efficacy in improving PSQI scores than hypnotics, with AT combined with moxibustion (MOX) and AT combined with auriculotherapy (AU) as the best interventions. Regarding clinical effectiveness, acupoint catgut embedding (ACE) had the greatest potential of being the best intervention, and no serious adverse events related to AT therapies were observed in any of the studies.

Conclusion

This review suggests that most AT therapies improve sleep indicators and have good clinical efficacy compared to hypnotics, especially AT combined with AU, AT combined with MOX, and ACE. The safety of AT therapies is reliable; however, the overall quality of the included trials was low, and higher-quality RCTs are required to provide sufficient evidence.

Protocol registration

PROSPERO, CRD42017067402.

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来源期刊

Integrative Medicine Research Medicine-Complementary and Alternative Medicine

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

12 weeks

期刊介绍： Integrative Medicine Research (IMR) is a quarterly, peer-reviewed journal focused on scientific research for integrative medicine including traditional medicine (emphasis on acupuncture and herbal medicine), complementary and alternative medicine, and systems medicine. The journal includes papers on basic research, clinical research, methodology, theory, computational analysis and modelling, topical reviews, medical history, education and policy based on physiology, pathology, diagnosis and the systems approach in the field of integrative medicine.