Huang Jinke, Shen Min, Qin Xiaohui, Huang Yong
The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province 510120, China.
Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, Guangdong Province 510120, China.
Evid Based Complement Alternat Med. 2020 May 13;2020:6920902. doi: 10.1155/2020/6920902. eCollection 2020.
OBJECTIVES: The effectiveness of auricular acupuncture (AA) for insomnia is far from uniform. The aim of this overview was to summarize and critically evaluate the evidence from systematic reviews (SRs)/meta-analysis (MAs) and provide an overall verdict about the therapeutic value of AA for insomnia. METHODS: A search of relevant literature for SRs/MAs was performed on major medical databases. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS: Seven SRs/MAs were deemed eligible for the present overview. According to the evaluation results of AMSTAR-2, the methodological quality of all included SRs/MAs was critically low. Consistent methodological deficiencies were item 2 (the lack of a protocol), item 4 (the lack of a specific search strategy), item 7 (the lack of a list of excluded studies), and item 15 (the lack of an assessment of publication bias). For GRADE, of the 17 outcomes, only 1 (5.9%) was rated of high-quality, 4 (23.5%) were rated of moderate-quality, and the remaining 12 (70.6%) were rated of low-or critically low-quality. Descriptive analysis of the outcomes reveals a positive effect of AA for insomnia. CONCLUSIONS: AA may be beneficial for insomnia, but the evidence is plagued by important limitations, e.g., the poor quality of SRs/MAs and primary studies.
目的:耳针疗法治疗失眠的效果并不一致。本综述的目的是总结并严格评估系统评价(SRs)/荟萃分析(MAs)的证据,并对耳针疗法治疗失眠的治疗价值给出总体结论。 方法:在主要医学数据库中检索相关的SRs/MAs文献。使用系统评价方法学质量评估2(AMSTAR-2)评估方法学质量,使用推荐分级、评估、制定与评价(GRADE)评估证据质量。 结果:七项SRs/MAs被认为符合本综述的要求。根据AMSTAR-2的评估结果,所有纳入的SRs/MAs的方法学质量都极低。一致的方法学缺陷包括第二项(缺乏方案)、第四项(缺乏具体的检索策略)、第七项(缺乏排除研究列表)和第十五项(缺乏发表偏倚评估)。对于GRADE,在17项结果中,只有1项(5.9%)被评为高质量,4项(23.5%)被评为中等质量,其余12项(70.6%)被评为低质量或极低质量。对结果的描述性分析显示耳针疗法对失眠有积极作用。 结论:耳针疗法可能对失眠有益,但证据存在重要局限性,例如SRs/MAs和原始研究的质量较差。
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