杵针疗法治疗失眠症临床疗效的系统评价
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摘要
目的:系统评价杵针疗法治疗失眠症的临床有效性及安全性,为其临床推广提供循证医学的证据支持。方法:计算机检索PubMed、EMBase、Cochrane Library、Web of Science等外文数据库以及中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普网(VIP)和万方网(Wan Fang)等中文数据库,配合补充检索手段,收集所有杵针治疗失眠症的随机对照试验(randomized controlled trial,RCT)。文献筛选后对纳入文献进行资料提取及方法学质量评价,然后实施定性或定量分析。结果:共纳入6篇RCT (356例患者)。(1)定性分析的结果证实杵针疗法治疗失眠症的临床疗效肯定,具备良好的有效性及安全性。(2)定量分析的结果显示杵针疗法能显著改善失眠症患者的匹兹堡睡眠质量指数量表(pittsburgh sleep quality index,PSQI)评分(P<0. 05)。结论:杵针疗法治疗失眠症安全有效,有助于患者睡眠质量的提高,应在临床中大力推广。
Objective: To systematically evaluate the efficacy and safety of pestle needle therapy for insomnia,and to provide the reference of evidence-based medicine for its clinical expansion. Methods: A computer-based retrieval was performed in foreign databases as PubMed,EMbase,Cochrane Library,Web of Science and Chinese ones as CBM,CNKI,VIP and WanFang,and supplementary retrieval was also performed with other sources. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for insomnia. After literature screening,we carried out data extraction and methodologic quality evaluation of the included studies. Finally,qualitative or quantitative analyses were performed according to actual circumstances. Results: A total of 6 RCTs were included,comprising 356 patients.(1)The results of qualitative analysis confirmed the superior effectiveness of pestle needle therapy in the treatment of insomnia,with good clinical efficacy and safety.(2) The results of quantitative analysis showed that pestle needle therapy could significantly reduce the pittsburgh sleep quality index( PSQI) score of insomniacs( P < 0. 05). Conclusions: The pestle needle therapy is secure and effective in the treatment of insomnia,which can help patients improve their sleep quality and should be widely promoted in clinical practice.
Objective: To systematically evaluate the efficacy and safety of pestle needle therapy for insomnia,and to provide the reference of evidence-based medicine for its clinical expansion. Methods: A computer-based retrieval was performed in foreign databases as PubMed,EMbase,Cochrane Library,Web of Science and Chinese ones as CBM,CNKI,VIP and WanFang,and supplementary retrieval was also performed with other sources. All relevant randomized controlled trials( RCTs) were collected to systematically research pestle needle therapy for insomnia. After literature screening,we carried out data extraction and methodologic quality evaluation of the included studies. Finally,qualitative or quantitative analyses were performed according to actual circumstances. Results: A total of 6 RCTs were included,comprising 356 patients.(1)The results of qualitative analysis confirmed the superior effectiveness of pestle needle therapy in the treatment of insomnia,with good clinical efficacy and safety.(2) The results of quantitative analysis showed that pestle needle therapy could significantly reduce the pittsburgh sleep quality index( PSQI) score of insomniacs( P < 0. 05). Conclusions: The pestle needle therapy is secure and effective in the treatment of insomnia,which can help patients improve their sleep quality and should be widely promoted in clinical practice.
引文
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[32]钟枢才,刘全让.李仲愚老先生的杵针疗法浅析[J].中医教育,1994,13(6):43+45
[2] Sorscher AJ. Insomnia:Getting to the cause,facilitating relief[J]. J Fam Pract,2017,66(4):216~225
[3] Burman D. Sleep Disorders:Insomnia[J]. FP Essent,2017,460:22~28
[4]失眠定义、诊断及药物治疗共识专家组.失眠定义、诊断及药物治疗专家共识(草案)[J].中华神经科杂志,2006,39(2):141~143
[5]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534~540
[6]熊桂华,张展.中医治疗失眠症的研究进展[J].中国医药科学,2016,6(3):46~48+163
[7]刘珏,刘民.失眠的流行病学研究进展[J].中华健康管理学杂志,2013,7(1):60~62
[8]叶增杰,梁木子,胡蕖,等.失眠障碍的国内外研究进展[J].医学与哲学,2017,38(5):60~63
[9]独家能,刘聪,郝旭亮,等.生理性失眠发病机制的研究进展[J].中国医药导报,2017,14(29):37~40
[10] Dong B,Chen Z,Yin X,et al. The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group:A Systematic Review and Meta-Analysis[J]. Biomed Res Int,2017,2017:9614810
[11]程微尹,沈碧胜,陈波.失眠症针刺疗法临床研究进展[J].亚太传统医药,2017,13(11):55~57
[12]孙杨,储浩然.针灸治疗失眠的研究进展[J].光明中医,2017,32(20):3048~3050
[13]赵晓梅,董凤怡,王冬芝,等.近5年针灸治疗失眠症临床方法研究进展[J].中医药临床杂志,2017,29(8):1351~1353
[14]申治富,余思奕,胡幼平.杵针疗法的理论及临床运用[J].上海针灸杂志,2015,34(6):575~578
[15]刘全让,钟枢才.李仲愚主任医师杵针疗法经验[J].成都中医药大学学报,1996,19(3):6~7
[16]刘栩豪,余洋,钟磊,等.杵针腰阳关八阵、河车命强段治疗腰痹病31例[J].中国针灸,2016,36(3):295~298
[17] Hu Y,Li Z,Mi DH,et al. Chemoradiation combined with regional hyperthermia for advanced oesophageal cancer:a systematic review and meta-analysis[J]. J Clin Pharm Ther,2017,42(2):155~164
[18] Li Z,Yang KH,Mi DH,et al. The research about guidance of systematic review for clinical study[J]. Cochrane Database Syst Rev,2012,2012(9Suppl):P(107)
[19]李仲愚著,钟枢才,李淑仁整理.杵针治疗学[M].成都:四川科学技术出版社,1990:1~349
[20]钟枢才主编.杵针学[M].北京:中国中医药出版社,2006:1~136
[21] Li Z,Mi DH,Yang KH,et al. Comparison between Autocad and Draftsight in data extraction[J]. Cochrane Database Syst Rev,2013,2013(9Suppl):P(56)
[22] Li Z,Yang KH,Mi DH,et al. The method of exracting data from figure with software[J]. Cochrane Database Syst Rev,2012,2012(9Suppl):P(104)
[23]胡月,李征,曲雁,等.胸腔化疗联合热疗治疗癌性胸腔积液有效性和安全性的Meta分析[J].中国全科医学,2017,20(32):4034~4041
[24]胡月,李征,曲雁,等.热疗综合疗法治疗原发性鼻咽癌的系统评价[J].循证医学,2015,15(2):96~101+107
[25]梁小利,梁清芳,王红艳,等.老年失眠症杵针疗法的效果[J].中国老年学杂志,2017,37(4):1005~1006
[26]吴际军,梁清芳,雷玉芳,等.杵针疗法对老年轻度抑郁患者睡眠质量的影响[J].中国疗养医学,2016,25(8):795~798
[27]雷静涵.杵针配合耳穴贴压治疗失眠症疗效观察[J].上海针灸杂志,2013,32(7):548~550
[28]梁清芳.杵针对老年失眠的临床操作规范化研究[D].成都:成都中医药大学,2013
[29]丰芬,阎博华,邓国忠.杵针百会八阵结合足疗治疗失眠症的临床研究[J].辽宁中医杂志,2009,36(4):617~618
[30]胡幼平,李鸿,尹重,等.杵针治疗失眠疗效观察[J].中国针灸,2009,29(5):365~369
[31]刘晓玲,梁凡,王欣欣,等.杵针疗法的临床研究进展[J].四川中医,2015,33(7):190~191
[32]钟枢才,刘全让.李仲愚老先生的杵针疗法浅析[J].中医教育,1994,13(6):43+45