头针与常规疗法治疗失眠疗效比较的随机对照试验的系统评价与Meta分析  

Systematic Assessment and Meta-analysis of Randomized Controlled Trials Comparing the Efficacy of Scalp Acupuncture Versus Conventional Treatment for Insomnia

作　　者：朱增越 高旸[2] ZHU Zeng-yue;GAO Yang(Tianjin University of Traditional Chinese Medicine,Tianjin 300110,China;Tianjin University of Traditional Chinese Medicine First Hospital,Tianjin 300110,China)

机构地区：[1]天津中医药大学,天津300110 [2]天津中医药大学第一附属医院,天津300110

出　　处：《上海针灸杂志》2018年第6期713-719,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家中医临床研究基地业务建设第二批科研专项课题(JDZX2015018)

摘　　要：目的系统评价头针治疗失眠的有效性。方法通过检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、Pubmed、Embase数据库,检索头针治疗失眠的相关随机对照试验(RCT),按照纳入及排除标准对检索到的文献进行筛选。文献筛选完成后,由2名评价者独立阅读文献题目并提取有效信息。本研究应用Cochrane偏倚风险评估工具对纳入RCT进行方法学质量评价。本研究所有统计计算需求由Rev Man软件充分完成。结果最终纳入19个RCT,共1410例患者。我们根据这些研究干预措施的不同,将其分为两个亚组,(1)头针与西药比较;(2)头针与常规针刺比较。Meta分析结果显示,(1)头针组与西药组比较,有效率明显提高,差异有统计学意义(P<0.00001),且治疗后患者匹兹堡睡眠质量指数(PSQI)明显降低,差异有统计学意义(P=0.00)。(2)头针组与常规针刺组比较有效率明显提高,差异有统计学意义(P=0.0002),治疗失眠后患者匹兹堡睡眠质量指数(PSQI)明显降低,差异有统计学意义(P<0.00001)。(3)头针组与总体常规疗法比较有效率明显提高,差异有统计学意义(P=0.0002),治疗后失眠患者PSQI明显降低,差异有统计学意义(P<0.00001)。结论头针治疗或头针联合常规治疗失眠效果优于单纯西药治疗或单纯常规针刺治疗。Objective To systematically evaluate the effectiveness of scalp acupuncture in treating insomnia. Method China National Knowledge Infrastructure, Wanfang Database, Pubmed and Embase were searched for randomized controlled trials（RCTs） of scalp acupuncture treatments for insomnia. The retrieved literature was sifted according to the inclusion and exclusion criteria. After the completion of literature screening, two independent reviewers read literature titles and extracted effectiveinformation. In this study, the methodological quality of the included RCTs was evaluated using the Cochrane risk of bias assessment tool and all statistical calculations were completed using Rev Man software. Result Finally, 19 RCTs were included with a total of 1410 patients. According to different interventions in these studies, we allocated them to two groups：（1）comparison between scalp acupuncture and Western drugs;（2）comparison between scalp acupuncture and conventional acupuncture. The results of meta-analysis showed：（1）the efficacy rate was significantly higher in the scalp acupuncture group than in the Western drug group（P〈0.00001） and the Pittsburgh Sleep Quality Index（PSQI） score decreased significantly in the patients after treatment（P=0.00）;（2）the efficacy rate was significantly higher in the scalp acupuncture group than in the conventional acupuncture group（P=0.0002） and the Pittsburgh Sleep Quality Index（PSQI） score decreased significantly in the patients after treatment of insomnia（P〈0.00001）;（3）the efficacy rate was significantly higher in the scalp acupuncture group than in the overall conventional therapy group（P=0.0002） and the Pittsburgh Sleep Quality Index（PSQI） score decreased significantly in the patients after treatment of insomnia（P〈0.00001）. Conclusion The effect of scalp acupuncture or scalp acupuncture plus conventional treatment on insomnia is better than that of Western drugs or conventional acupuncture alone.

关 键 词：针刺疗法 头针 失眠症 睡眠障碍 不寐 META分析 

分 类 号：R246.6[医药卫生—针灸推拿学]