基于GRADE系统的耳穴贴压治疗原发性失眠系统评价  

Auricular acupuncture for primary insomnia:a systematic review based on GRADE system

作　　者：谭惠娟[1] 兰颖[1] 吴扶生 张瀚丹[2] 吴利[3] 吴曦[1] 梁繁荣[1] 

机构地区：[1]成都中医药大学,四川成都610075 [2]成都市双流县中医医院 [3]简阳市中医医院针灸科

出　　处：《中国针灸》2014年第7期726-730,共5页Chinese Acupuncture & Moxibustion

基　　金：四川省科技厅支撑项目:2011SZ 0302;四川省教育厅创新团队项目:12TD 002

摘　　要：评价耳穴贴压治疗原发性失眠的临床疗效和安全性。综合检索国内外大型数据库,经过严格筛选后运用Revman 5.2软件对符合标准的随机对照试验(RCTs)结果进行Meta-分析,采用GRADE profiler 3.6软件对结果证据质量进行评级。最终纳入8篇文献,共894例患者。耳穴贴压与假耳穴、耳穴安慰贴压和空白对照:匹兹堡睡眠质量指数量表(PSQI)总分[WMD=-3.48,95%CI(-3.96,-3.00)],睡眠潜伏期[WMD=-10.14,95%CI(-17.16,-3.12)],觉醒次数[WMD=-9.98,95%CI(-1.10,-0.48)];耳穴贴压与西药对照:PSQI总分[WMD=-3.62,95%CI(-4.59,-2.65)]。证据等级:除耳穴与假耳穴、安慰贴压或空白对照的PSQI总分证据为中级,其余均为极低级;所有研究均无不良事件报道。耳穴贴压治疗原发性失眠安全,可有效提高患者的睡眠质量,但该结论的证据质量等级不高,故该研究结论需谨慎对待,需大样本、高质量的临床试验进一步证实。The clinical efficacy and safety of auricular acupuncture（AA）for treatment of primary insomnia was evaluated.After a comprehensive retrieval in domestic and foreign databases,literatures were strictly screened and Revman 5.2software was applied to perform a Meta-analysis on eligible randomized controlled trials（RCTs）.The evidence quality was assessed with GRADE profiler 3.6software.As a result,8articles were included involving894patients.Compared among AA and sham AA,placebo AA,blank control,there was significant difference in Pittsburgh sleep quality index（PSQI）[WMD=-3.48,95%CI（-3.96,-3.00）],sleep latency [WMD=-10.14,95% CI（-17.16,-3.12）]and sleep awakening times [WMD=-9.98,95% CI（-1.10,-0.48）].Compared between AA and western medication,there was significant difference in PSQI[WMD=-3.62,95%CI（-4.59,-2.65）].The evidence quality was moderate in AA vs.sham AA,placebo AA or blank control,while that of the rest was extremely low.No reports of adverse events were described in all studies.In conclusion,for the treatment of primary insomnia,AA could effectively improve sleep quality,but due to the low evidence quality,cautious attitude should be taken on this conclusion,and clinical trials with large sample and high quality were needed in the further.

关 键 词：原发性失眠 耳穴贴压 系统评价 Meta-分析 GRADE评级 

分 类 号：R246.6[医药卫生—针灸推拿学]