Xu Chen, Yin Dong-Hao, Han Jia-Hao, Gao Ya-Nan, Li Xiu-Hui, Wang Xiao-Jun
Center of Integrative Chinese and Western Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Department of Rehabilitation Medicine, Beijing Geriatric Hospital, Beijing, China.
J Viral Hepat. 2025 Jun;32(6):e70030. doi: 10.1111/jvh.70030.
To systematically evaluate the efficacy of traditional Chinese medicine (TCM) external therapies in treating insomnia in patients with chronic hepatitis B (CHB). PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, CQVIP and SinoMed were searched for randomised controlled trials (RCTs) on the treatment of insomnia in patients with CHB using TCM external therapies from the establishment of each database until 31 January 2024. A total of six Chinese articles were included, involving 500 patients. The overall response rate of TCM external therapies for CHB combined with insomnia was superior to that of the control group (odds ratio [OR] = 3.08, 95% confidence interval [CI]: [1.86, 5.12], p < 0.001). Additionally, subgroup analysis showed significant effects of acupuncture (OR = 3.51, 95% CI: [1.80, 6.86], p = 0.001) and other external therapies (OR = 2.58, 95% CI: [1.19, 5.62], p = 0.02). Moreover, TCM external therapies substantially improved the Pittsburgh Sleep Quality Index (mean difference [MD] = -2.08, 95% CI: [-2.86, -1.29], p < 0.001) and the Insomnia Severity Index (MD = -3.17, 95% CI: [-4.07, -2.26], p < 0.001). The group using TCM external therapies showed significantly lower SAS scores than the control group (MD = -6.52, 95% CI: [-12.23, -0.82], p = 0.02). One study reported a higher incidence of adverse reactions in the group treated with TCM external therapies than in the control group (p < 0.05). Another study found that the group treated with TCM external therapies had a significantly lower recurrence rate (15.38%) than the control group (35.90%) (p < 0.05). Traditional Chinese medicine external therapies are clinically effective for CHB combined with insomnia, as they can improve sleep quality and relieve insomnia symptoms.
系统评价中医外治法治疗慢性乙型肝炎（CHB）患者失眠的疗效。检索PubMed、Embase、Cochrane图书馆、Web of Science、中国知网、万方、维普和中国生物医学文献数据库，查找从各数据库建库至2024年1月31日期间使用中医外治法治疗CHB患者失眠的随机对照试验（RCT）。共纳入6篇中文文章，涉及500例患者。中医外治法治疗CHB合并失眠的总有效率优于对照组（优势比[OR]=3.08，95%置信区间[CI]：[1.86，5.12]，p<0.001）。此外，亚组分析显示针刺（OR=3.51，95%CI：[1.80，6.86]，p=0.001）和其他外治法（OR=2.58，95%CI：[1.19，5.62]，p=0.02）有显著疗效。而且，中医外治法显著改善了匹兹堡睡眠质量指数（平均差[MD]= -2.08，95%CI：[-2.86，-1.29]，p<0.001）和失眠严重程度指数（MD= -3.17，95%CI：[-4.07，-2.26]，p<0.001）。使用中医外治法的组的SAS评分显著低于对照组（MD= -6.52，95%CI：[-12.23，-0.82]，p=0.02）。一项研究报告中医外治法治疗组的不良反应发生率高于对照组（p<0.05）。另一项研究发现，中医外治法治疗组的复发率（15.38%）显著低于对照组（35.90%）（p<0.05）。中医外治法对CHB合并失眠临床有效，因为它们可以改善睡眠质量并缓解失眠症状。
