摘要
目的:系统评价推拿治疗失眠的临床疗效及安全性。方法:计算机检索CNKI、维普、万方、Web of Science、PubMed数据库,查找关于推拿治疗失眠的随机对照试验(RCT)。由两名评价员按照纳入与排除标准,独立筛选文献,并对纳入的文献进行数据提取、质量评估,运用RevMan 5.3进行Meta分析。结果:最终纳入16项随机对照研究,共1005例患者。所有文献均以总有效率及匹兹堡睡眠质量指数(PSQI)总分为结局指标。根据干预措施的不同,进行异质性分组分析。Meta分析结果显示:单纯推拿治疗失眠总有效率(OR=2.17,95%CI[1.40,3.35],P=0.0005),PSQI总分(SMD=-0.57,95%CI[-0.73,-0.42],P<0.00001),提示单纯推拿治疗失眠的疗效优于其它疗法,其差异均有统计学意义;推拿联合针刺治疗失眠总有效率(OR=2.94,95%CI[1.50,5.77],P=0.002),PSQI总分(SMD=-1.16,95%CI[-1.40,-0.92],P<0.00001),提示推拿联合针刺治疗失眠的疗效优于针刺疗法,其差异均有统计学意义。治疗组均未见不良反应等安全性问题。结论:推拿治疗失眠临床疗效确切,且未出现不良反应;由于本研究的局限性,需进一步深入研究推拿治疗失眠,为临床应用提供更可靠的循证依据。
Objective: To systematically review the effectiveness and safety of Tuina in the treatment of insomnia. Methods: CNKI, VIP, WanFang, Web of Science and PubMed database were searched to find the RCTs of the treatment of insomnia. According to the inclusion and exclusion criteria, the two reviewers independently screened the literature and conducted data extraction and quality assessment of the included literatures, then, Meta-analysis was performed by using RevMan 5.3 for Meta analysis. Results: Sixteen RCTs were included, with a total of 1 005 patients. All literatures are based on total efficiency and PSQI total score. According to the different intervention measures, the heterogeneity was analyzed. Meta analysis results showed that pure Tuina therapy total effective rate of insomnia(OR=2.17, 95%CI[1.40, 3.35], P=0.0005), the total scores of PSQI(SMD=-0.57, 95%CI[-0.73,-0.42], P<0.00001), suggesting pure. Tuina curative effect is better than that of other treatments for the treatment of insomnia, the difference had statistical significance. Tuina combined acupuncture treatment insomnia total effectiveness(OR=2.94, 95%CI[1.50, 5.77], P=0.002), the total scores of PSQI(SMD=-1.16, 95%CI[-1.40,-0.92], P<0.00001), suggesting the Tuina combined acupuncture curative effect is superior to the acupuncture treatment of insomnia, the differences were statistically significant. No adverse reactions were observed in the treatment group. Conclusion: The clinical efficacy of Tuina therapy for insomnia is accurate, and there is no adverse reaction. Due to the limitations of this study, it is necessary to further study the Tuina treatment of insomnia, provide more reliable evidence-based basis for clinical application.
作者
杨涛
梁爽
马亮亮
雷洋
周运峰
YANG Tao;LIANG Shuang;MA Liang-liang;LEI Yang;ZHOU Yun-feng(Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450008,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2019年第2期814-819,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(No.81874513)~~
关键词
推拿
失眠
系统评价
META分析
随机对照试验
Tuina
Insomnia
Systematic review
Meta-analysis
Randomized controlled trial