| 冯欣夷,周春清,马小琴.不同针灸疗法治疗心脾两虚型失眠症的网状Meta分析[J].浙江中医药大学学报,2025,49(2):241-248. |
| 不同针灸疗法治疗心脾两虚型失眠症的网状Meta分析 |
| Different Acupuncture Therapies for Insomnia with Heart and Spleen Deficiency: A Network Meta-analysis |
| DOI：10.16466/j.issn1005-5509.2025.02.018 |
| 中文关键词: 针灸疗法 失眠症 心脾两虚 睡眠质量 网状Meta分析 循证护理学 针刺 艾灸疗法 |
| 英文关键词: acupuncture therapy insomnia heart and spleen deficiency sleep quality network Meta-analysis evidence-based nursing acupuncture moxibustion therapy |
| 基金项目:浙江省中医药科技计划项目(2024ZL041) |
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| 中文摘要: |
| [目的] 评估不同针灸疗法治疗心脾两虚型失眠症的效果，为临床实践选择最佳治疗方案提供循证证据。[方法] 系统检索中国知网(China National Knowledge Infrastructure，CNKI)、万方数据库(WanFang Database)、中国生物医学文献数据库(China Biomedical Literature Database，SinoMed)、维普数据库(China Science and Technology Journal Database，VIP)、PubMed、the Cochrane Library、Web of Science、Embase中各类针灸疗法治疗心脾两虚型失眠症的随机对照试验，检索时限为建库至2024年8月。使用Review Manager 5.3和Stata 17.0软件对数据进行网状Meta分析。[结果] 共纳入28项研究，包括10种不同的针灸疗法，共2 117例患者。根据网状Meta分析结果，艾灸疗法、温针灸、针刺+艾灸疗法、耳穴贴压+艾灸疗法和耳穴压豆+针刺在改善匹兹堡睡眠质量指数(Pittsburgh sleep quality index，PSQI)评分方面优于常规镇静催眠药物治疗，从高到低排序为温针灸、耳穴压豆+针刺、耳穴压豆+艾灸疗法、艾灸疗法、针刺+艾灸疗法、电针、单纯针刺、穴位埋线。在临床有效率方面，温针灸、针刺+艾灸疗法、耳穴压豆+针刺、单纯针刺、电针和穴位埋线优于常规镇静催眠药物治疗，排序为电针、温针灸、穴位埋线、耳穴压豆+针刺、单纯针刺、针刺+穴位注射、穴位注射、针刺+艾灸疗法、耳穴压豆+艾灸疗法。[结论] 电针能有效提高失眠的临床总有效率，温针灸能有效改善患者的PSQI评分，临床实践时可结合患者自身情况，选择合适的治疗方案。 |
| 英文摘要: |
| [Objective] To evaluate the efficacy of different acupuncture therapies in treating patients with insomnia with heart and spleen deficiency， thereby providing evidence-based guidance for clinical practice in selecting optimal treatment regimens. [Methods] A systematic search was performed across China National Knowledge Infrastructure(CNKI)， WanFang， China Biomedical Literature Database(SinoMed)， China Science and Technology Journal Database(VIP)， PubMed， the Cochrane Library， Web of Science and Embase for randomized controlled trials assessing different acupuncture interventions for heart-spleen deficiency insomnia. The retrieval time limit was from the establishment date of the databases to August 2024. Data were analyzed by using Review Manager 5.3 and Stata 17.0 software. [Results] Ultimately，28 studies were included， encompassing 10 distinct acupuncture modalities and involving a total of 2 117 patients. According to the network Meta-analysis， moxibustion， warm acupuncture， acupuncture plus moxibustion， ear acupuncture with moxibustion， as well as ear acupressure beads combined with acupuncture demonstrated superior effectiveness compared with conventional sedative-hypnotic medications in enhancing Pittsburgh sleep quality index(PSQI) scores， and the ranking from high to low was warm acupuncture， ear acupoint pressure bead plus acupuncture， ear acupoint pressure bead plus moxibustion， moxibustion， acupuncture plus moxibustion， electroacupuncture， simple acupuncture， acupoint catgut embedding. Regarding clinical efficacy rates， warm acupuncture， acupuncture plus moxibustion， ear acupoint pressure bead plus acupuncture， pure acupuncture， electroacupuncture， and acupoint catgut embedding exhibited greater efficacy than conventional sedative-hypnotic medications. And the ranking in terms of clinical efficacy was electroacupuncture， warm acupuncture， acupoint catgut embedding， ear acupoint pressure bead plus acupuncture， simple acupuncture， acupuncture plus acupoint injection， acupoint injection， acupuncture plus moxibustion， ear acupoint pressure bead plus moxibustion. [Conclusion] Electroacupuncture can effectively increase the total clinical effective rate of insomnia treatment， warming moxibustion can effectively improve the PSQI score of patients. In clinical practice， an appropriate treatment plan can be selected based on the patient’s own condition. |
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