黄连阿胶汤治疗失眠的Meta分析  

A Meta-analysis of treating insomnia with the Huanglian Ejiao decoction

作　　者：王雪男 刘剑 文晓东[2] 左耀玮 陈晓锋[2] Wang Xuenan

机构地区：[1]广西中医药大学,广西南宁530000 [2]广西中医药大学附属瑞康医院,广西南宁530000

出　　处：《中医临床研究》2020年第16期131-136,共6页Clinical Journal Of Chinese Medicine

基　　金：广西教育厅立项项目(KY2015LX145)。

摘　　要：目的:系统评价黄连阿胶汤治疗失眠的临床疗效及安全性。方法:通过计算机检索中国知识资源总库(CNKI)、万方(Wanfang)、维普(VIP)及PubMed数据库,纳入以黄连阿胶汤治疗失眠的临床随机对照试验(RCTs),文献检索时间截止至2019年8月,由2名研究者独立对文献进行筛选及数据提取,采用Cochrane系统评价手册对纳入文献进行质量评价,采用Revman5.3软件进行Meta分析。结果:最终纳入14篇RCTS文献,包含1248名患者,Meta分析结果示使用黄连阿胶汤治疗失眠的临床疗效显著,即总有效率OR=3.92,95%CI[2.76,5.57],P<0.00001;总治愈率OR=1.82,95%CI[1.38,2.42],P<0.0001;匹兹堡睡眠质量指数评分MD=-4.64,95%CI[-6.44,-2.84],P<0.00001;中医证候积分MD=-7.43,95%CI[-13.92,-0.95],P=0.02;不良反应OR=0.31,95%CI[0.18,0.54],P<0.0001,和对照组相比,差异均有统计学意义。结论:黄连阿胶汤治疗失眠临床疗效明显,但因纳入研究试验的整体质量水平较低,存在一定偏倚风险,希望今后有更多大样本、高质量、多中心的RCT试验进行更深入的研究。Objective:To systematically evaluate the clinical efficacy and safety of the Huanglian Ejiao decoction(黄连阿胶汤)on insomnia.Methods:We collected randomized controlled trials(RCTs)of the Huanglian Ejiao decoction on insomnia from CNKI,Wanfang database,VIP database and PubMed by computer retrieval and combine manual retrieval of relevant references.The time is limited to the construction of the library until August 2019.The literature was screened and extracted by two independent researchers.The quality of selected literature was evaluated with the Cochrane Reviewer’s Handbook for systematic review,and Revman 5.3 software was adopted to perform Meta-analysis.Results:A total 14 RCTs were enrolled,including 1248 patients.Meta-analysis results show that the Huanglian Ejiao decoction has advantages in clinical efficacy{total efficiency:OR=1.82,95%CI[1.38,2.42],P﹤0.0001,cure rate:OR=1.82,95%CI[1.38,2.42],P﹤0.0001,pittsburgh sleep quality index score MD=-4.64,95%CI[-6.44,-2.84],P﹤0.00001,TCM syndrome scores MD=-7.43,95%CI[-13.92,-0.95],P﹤0.00001,adverse reactions OR=0.31,95%CI[0.18,0.54],P﹤0.0001},compared with the control group,the difference was statistically significant).Conclusion:The efficacy of the Huanglian Ejiao decoction on insomnia is exact,however,due to the low overall quality level of the research trials,there is a certain risk of bias.I hope that there will be more large-scale,high-quality,multi-center RCT trials for more in-depth research in the future.

关 键 词：黄连阿胶汤 失眠 META分析 

分 类 号：R256.23[医药卫生—中医内科学]