耳穴疗法治疗卒中后失眠的随机对照试验Meta分析  

Meta analysis of auricular acupuncture in the treatment of post- stroke insomnia

作　　者：张霜梅 吉晶 胡丽竹[3] 刘红宇[3] 邱朝阳 祝维峰[3] ZHANG Shuangmei;JI Jing;HU Lizhu;LIU Hongyu;QIU Zhaoyang;ZHU Weifeng(Guangzhou University of Chinese Medicine, Guangzhou 510006, China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021 , China;Guangzhou Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Guangzhou 510006. China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji'nan 250000, China)

机构地区：[1]广州中医药大学,广东广州510006 [2]上海中医药大学附属曙光医院,上海200021 [3]广州中医药大学附属广州市中医医院,广东广州510006 [4]山东中医药大学附属医院,山东济南250000

出　　处：《上海中医药大学学报》2019年第3期10-18,23,共10页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(81303013);广东省中医药管理局名中医传承工作室(祝维峰工作室)建设项目

摘　　要：目的:系统评价耳穴疗法治疗卒中后失眠的临床疗效。方法:检索中文、英文数据库,纳入耳穴疗法对比单纯西药治疗卒中后失眠的随机对照试验(randomized control trials, RCTs)。采用Cochrane协作网的风险偏倚评估工具对纳入研究进行方法学质量评价,采用Cochrane协作网提供的Rev Man 5.3版软件进行Meta分析。结果:本研究共纳入18篇文献,共计1 443例患者。Meta分析结果显示:与单用西药比较,耳穴疗法(包括单纯耳穴治疗、耳穴疗法联合西药治疗、耳穴疗法联合其他疗法治疗)能提高临床有效率[RR=1.64,95%CI(1.45,1.85),P<0.01]、痊愈率[RR=1.73, 95%CI(1.41, 2.13),P<0.01],改善患者的匹兹堡睡眠质量指数(PQSI)评分[SMD=1.23, 95%CI(0.69,1.76),P<0.01]。结论:耳穴相关疗法治疗卒中后失眠较单纯西药治疗具有更好的临床疗效,适合临床推广使用。Objective: To systematically evaluate the clinical efficacy of auricular acupuncture therapy in the treatment of post-stroke insomnia. Methods: The Chinese and English databases were searched and the clinical randomized controlled trials(RCTs) of auricular acupuncture therapy compared with western medicine alone in the treatment of post-stroke insomnia were included. The methodological quality of the included researches was evaluated by the risk bias assessment tool provided by Cochrane, and the Meta analysis was carried out by Review Manager 5.3 software provided by Cochrane. Results: A total of 18 RCTs including 1 443 patients were included in the study. The results of Meta-analysis showed that compared with western medicine alone, the auricular acupuncture therapy(including auricular acupuncture therapy alone, auricular acupuncture therapy combined with western medicine and auricular acupuncture therapy combined with other therapies) could enhance the clinical effective rate [RR=1.64,95%CI(1.45,1.85),P<0.01] and the cure rate [RR=1.73, 95%CI(1.41, 2.13),P<0.01], and improve the scores of Pittsburgh sleep quality index(PSQI)[SMD=1.23, 95%CI(0.69, 1.76), P<0.01]. Conclusion: Compared with western medicine, the auricular acupoint related therapy shows better clinical effecacy in the treatment of post-stroke insomnia, which is suitable for clinical promotion.

关 键 词：耳穴 卒中后 失眠 META分析 

分 类 号：R246.6[医药卫生—针灸推拿学]