针刺法治疗阴虚失眠疗效的 Meta 分析

摘要

Objective It is to systematically evaluate the clinical curative effect of acupuncture on insomnia of Yin defi-ciency type. Methods The random control trial( RCT)about insomnia of Yin deficiency type treated with acupuncture were selected from The Cochrane Library,PubMed,VIP,Wanfang Dota,CNKI and CBM by computer searching,the searching time was from build time of every database to April one,2014. The trails were screened according to inclusion and exclusion criteria and their study quality was evaluated to do statistical analysis. Results 6 Chinese RCT were finally selected,the Meta analysis results according to end index showed that:there were 6 RCT about clinical effect and total effective rate,the differ-ences were significant between the two groups[OR = 3. 49,95% CI(2. 15,5. 66)];there were 3 RCT about acupuncture and drug control,the differences were significant between the two groups[OR = 3. 49,95% CI(2. 92,12. 90)];there were 3 RCT about acupuncture + medicine and simple drug control,the differences were significant between the two groups[ OR = 1. 12, 95% CI(0. 99,1. 28)]. 2 RCT described the improvement of PSQI total scores,the differences were significant between the two groups[MD = - 4. 77,95% CI( - 5. 56,- 3. 99)];2 RCT described the improvements of quality,fall-sleep time,lasting time effectiveness,dysfunction and daily function of insomnia,in which there were significant differences in quality,fall-sleep time,and daily function and no difference in lasting time and dysfunction between the two group. Conclusion Acupuncture has more advantages in the treatment for insomnia than medicine,but these conclusions still need more large sample,high quality RCT to identify.%目的：系统评价针刺疗法治疗阴虚失眠的临床疗效。方法计算机检索 The Cochrane Library、PubMed、VIP、WanFang Data、CNKI 和 CBM，收集采用针刺治疗阴虚失眠的随机对照试验（RCT），检索时限从各库建库起至2014年4月1日。按纳入和排除标准筛选试验、提取资料并评价研究质量后进行统计分析。结果共纳入6个中文 RCT，按结局指标分别进行 Meta 分析，结果显示：①临床疗效总有效率共纳入了6个 RCT，2组比较差异有统计学意义[OR ＝3.49，95％ CI（2.15，5.66）]；针刺与药物对照共纳入了3个 RCT，2组比较差异有统计学意义[OR ＝3.49，95％ CI（2.92，12.90）]；针刺＋药物干预措施与药物对照共纳入了3个 RCT，2组比较差异有统计学意义[ OR ＝1.12，95％ CI（0.99，1.28）]。②2个 RCT 描述了PSQI 总分改善情况，2组比较差异有统计学意义[MD ＝-4.77，95％ CI（-5.56，-3.99）]；2个 RCT 描述了睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能改善情况，其中睡眠质量、入睡时间、睡眠效率、日间功能2组比较差异均有统计学意义，睡眠时间、睡眠障碍2组比较差异无统计学意义。结论针刺法治疗阴虚失眠较药物对照组更具优势，但上述结论仍需大样本、高质量的随机对照双盲试验验证。