Zhao Huimin, Li Dan, Yang Ying, Liu Yueting, Li Jie, Mao Jing
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Qiaokou District, Wuhan 430030, China.
Department of Pathology, Taihe Hospital, Hubei University of Medicine, No 32 South People's Road, Shiyan 442000, China.
Evid Based Complement Alternat Med. 2019 Jan 15;2019:7120169. doi: 10.1155/2019/7120169. eCollection 2019.
Although the effectiveness of auricular plaster therapy (APT) on primary insomnia has been systematically reviewed, no systematic review of studies has focused on the effect on comorbid insomnia.
To evaluate the efficacy and safety of APT for comorbid insomnia.
Fifteen databases were searched from inception to July 2018. Randomized controlled trials (RCTs) of APT as an exclusive intervention for comorbid insomnia against Western medications, sham APT or no treatment were identified.
Fourteen studies involving 928 participants were identified. The pooled outcomes revealed that APT was superior to control conditions for the global score on PSQI (SMD = -1.13, and 95% CI = -1.48--0.78) and the effective rate (RR = 1.24, 95% CI = 1.13-1.36, NNT = 5, and 95% CI =4-7). Furthermore, the results of subgroup analyses were similar to the pooled results. Additionally, the pooled results were verified to be stable by sensitivity analyses. Regarding safety, no significant difference was identified between APT and Western medications.
APT appears to be an effective and safe treatment for comorbid insomnia. However, the benefits of APT for comorbid insomnia could not be ascertained due to the paucity of the quantity and quality of the included studies. Large-scale studies using proper methodology are needed to yield a firm conclusion.
虽然耳穴贴压疗法（APT）对原发性失眠的有效性已得到系统评价，但尚无针对共病性失眠影响的系统评价研究。
评估耳穴贴压疗法治疗共病性失眠的疗效与安全性。
检索了从建库至2018年7月的15个数据库。纳入了将耳穴贴压疗法作为共病性失眠唯一干预措施，与西药、假耳穴贴压疗法或不治疗进行对比的随机对照试验（RCT）。
共纳入14项研究，涉及928名参与者。汇总结果显示，耳穴贴压疗法在匹兹堡睡眠质量指数（PSQI）总分（标准化均数差= -1.13，95%可信区间= -1.48--0.78）和有效率（相对危险度= 1.24，95%可信区间= 1.13 - 1.36，需治疗人数= 5，95%可信区间= 4 - 7）方面优于对照措施。此外，亚组分析结果与汇总结果相似。另外，通过敏感性分析验证了汇总结果的稳定性。在安全性方面，耳穴贴压疗法与西药之间未发现显著差异。
耳穴贴压疗法似乎是治疗共病性失眠的一种有效且安全的方法。然而，由于纳入研究的数量和质量不足，耳穴贴压疗法对共病性失眠的益处尚无法确定。需要采用适当方法进行大规模研究才能得出确凿结论。
