Birling Yoann, Wu Yu, Rahimi Matthew
NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
Chinese Medicine and Acupuncture Society of Australia, 23 John St, Cabramatta, NSW, 2166, Australia.
Sleep Breath. 2024 Dec 12;29(1):56. doi: 10.1007/s11325-024-03194-y.
Chinese Herbal Medicine (CHM) may have a place in the treatment of obstructive sleep apnoea (OSA), but the evidence has not been systematically assessed. The objective of this study is to evaluate the evidence for the effectiveness of CHM for OSA.
CENTRAL, EMBase, PubMed, CINAHL, CNKI, Wanfang and Chongqing VIP were searched from database inception to the 13th of August 2023. Randomised-controlled trials in which the effect of CHM on sleep variables was tested in the treatment of OSA were selected. The primary outcomes of this review and meta-analysis were the apnoea hypopnoea index (AHI) measured with polysomnography.
A total of 58 studies, involving 4,590 participants, were included. The meta-analysis showed that CHM reduced AHI more significantly than placebo (mean difference = -7.10 events/hour, 95% CI = -11.95, -2.25, P < 0.01, 7 studies, 583 participants) and the combination of CHM and Continuous Positive Airway Pressure (CPAP) more effective than CPAP alone (mean difference = -4.71 events/hour, 95% CI = -5.62, -3.80, P < 0.001, 28 studies, 2,267 participants). CHM improved sleepiness, quality of life, body weight, oxidative biomarkers, inflammatory biomarkers, cognitive function, blood pressure and respiratory function.
Our results suggest that CHM, alone and as an adjunct treatment, can improve various aspects of OSA and its comorbidities and is therefore a viable therapeutic option for OSA.
中药可能在阻塞性睡眠呼吸暂停（OSA）的治疗中占有一席之地，但相关证据尚未得到系统评估。本研究的目的是评估中药治疗OSA有效性的证据。
检索CENTRAL、EMBase、PubMed、CINAHL、中国知网、万方和重庆维普数据库，检索时间从建库至2023年8月13日。纳入在OSA治疗中测试中药对睡眠变量影响的随机对照试验。本综述和荟萃分析的主要结局是通过多导睡眠图测量的呼吸暂停低通气指数（AHI）。
共纳入58项研究，涉及4590名参与者。荟萃分析表明，与安慰剂相比，中药能更显著降低AHI（平均差值=-7.10次/小时，95%置信区间=-11.95，-2.25，P<0.01，7项研究，583名参与者），且中药与持续气道正压通气（CPAP）联合使用比单独使用CPAP更有效（平均差值=-4.71次/小时，95%置信区间=-5.62，-3.80，P<0.001，28项研究，2267名参与者）。中药改善了嗜睡、生活质量、体重、氧化生物标志物、炎症生物标志物、认知功能、血压和呼吸功能。
我们的结果表明，中药单独使用或作为辅助治疗均可改善OSA及其合并症的各个方面，因此是OSA的一种可行治疗选择。
