针灸治疗肿瘤相关性失眠的系统评价  

Effect of Acupuncture Treating Cancer-related Insomnia:A Systematic Review

作　　者：王田田 程俊[1] 王娟[1] 邹文娟[1] 宋娜[1] WANG Tiantian;CHENG Jun;WANG Juan;ZOU Wenjuan;SONG Na(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院,重庆400021

出　　处：《辽宁中医杂志》2023年第10期196-201,I0005,共7页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家科技部重点研发计划“中医药现代化研究”项目(2018YFC1704104);重庆市科卫联合中医药技术创新与应用发展项目(2021ZY3571);重庆市科委科研院所绩效激励引导专项(cstc2020jxjl0020)。

摘　　要：目的研究针灸治疗对肿瘤相关性失眠(CRI)的有效性和安全性。方法系统检索电子数据库中国知网数据库(CNKI)、万方数据库、重庆维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、PubMed、EMbase、Cochrane Library建库至2021年5月发表的有关针灸治疗CRI的随机对照试验(RCT)文献,由2名评价者根据纳入和排除标准确认文献纳入并进行数据提取。最后采用RevMan5.4软件进行数据的整合分析并得出结论。结果检索到符合纳入标准的文献11篇,共计1020例患者。Meta分析结果显示:(1)以针灸+常规护理/基础治疗的观察组与常规护理/基础治疗对照组相比能明显降低匹兹堡睡眠质量指数(PSQI)评分情况[MD=-3.28,95%CI=-5.67~-0.89,P=0.007],并提高临床有效率[OR=5.75,95%CI=2.72~12.18,P<0.00001];(2)以针灸为主的观察组与单纯西药的对照组相比在治疗时不能明显降低PSQI评分情况[MD=-0.57,95%CI=-2.07~0.93,P=0.46],也不能提高临床有效率[OR=0.46,95%CI=0.21~1.01,P-2.08,95%CI=-2.94~-1.23,P<0.00001],有效率也明显提高[OR=3.06,95%CI=1.80~5.20,P<0.0001];(3)以针灸+西药的观察组与单纯西药的对照组相比能明显降低PSQI评分情况[MD=-2.16,95%CI=-2.65,~-1.68,P<0.00001],但未显示能提高临床有效率[OR=3.75,95%CI=0.91~15.40,P=0.07]。结论针灸治疗肿瘤相关性失眠能降低PSQI评分情况并提高临床有效率,而且具有不易反复性。Objective To systematically evaluate the effect of acupuncture in the treatment of cancer-related insomnia.Methods Randomized controlled trials(RCTs)on the acupuncture treating cancer-related insomnia were retrieved from the electronic databases of CNKI,Wanfang databases,VIP,SinoMed,PubMed,Embase and The Cochrane Library from establishment to May 2021.Two evaluators confirmed the literature inclusion according to the inclusion and exclusion criteria.Finally,the RevMan5.4 software was used for conducting the data integration analysis and obtaining the conclusion.Results There were 11 articles that met the inclusion criteria,and a total of 1020 patients with cancer-related insomnia were included.The Meta-analysis results:(1)Compared with routine nursing or basic treatment in the control group,the acupuncture combined with routine nursing or basic treatment in the observation group could significantly reduce the Pittsburgh sleep quality index(PSQI)score[MD=-3.28,95%CI=-5.67--0.89,P=0.007]and improve the clinical efficacy[OR=5.75,95%CI=2.72-12.18,P<0.00001].(2)Compared with the Western medicine alone in the control group,the observation group with acupuncture as the main treatment could not significantly reduce the PSQI score[MD=-3.28,95%CI=-5.67--0.89,P=0.007]and improve the clinical efficacy[OR=0.46,95%CI=0.21-1.01,P=0.05]during treatment.However,during the follow-up period,the PSQI score of the observation group was significantly lower than that of the control group[MD=-2.08,95%CI=-2.94--1.23,P<0.00001],and the efficiency was also significantly improved[OR=3.06,95%CI=1.80-5.20,P<0.0001].(3)Compared with the western medicine alone in the control group,the observation group with acupuncture combined with medicine could significantly reduce the PSQI score[MD=-2.16,95%CI=-2.65--1.68,P<0.00001],but could not improve the clinical efficacy[OR=3.75,95%CI=0.91-15.40,P=0.07].Conclusion The effect of acupuncture for treating cancer-related insomnia could significantly reduce the PSQI score and improve the clinical efficacy.I

关 键 词：针灸 中医药 肿瘤相关性失眠 随机对照试验 系统评价 

分 类 号：R256.23[医药卫生—中医内科学]