Liu Wenyu, Jing Ruizhi
Shaoxing Keqiao District Traditional Chinese Medcine Hospital Medical Community General Hospital, Shaoxing, 312000, China.
Sleep Breath. 2025 May 31;29(3):199. doi: 10.1007/s11325-025-03357-5.
Post-stroke insomnia is a common and frequently occurring disease that has a significant impact on the quality of life of patients. TCM (traditional Chinese medicine) non-pharmacologic therapy is increasingly being used for patients with post-stroke insomnia. The purpose of this study is to evaluate the efficacy and safety of the TCM non-pharmacologic therapy for post-stroke insomnia.
English and Chinese databases, including PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, VIP, and SinoMed were retrieved to collect randomized controlled trials (RCTs) comparing the TCM non-pharmacologic therapy with Western medicine in the treatment of post-stroke insomnia. The search was conducted until March 26, 2024. Data analysis was conducted using Stata15.0.
This study included a total of 60 RCTs, involving 5 TCM non-pharmacologic therapies and 4,587 patients. The results of the network meta-analysis unveiled that Western medicine combined with massage (SUCRA93.8), Western medicine combined with auricular point sticking (SUCRA80.5), and needle embedding (SUCRA71.5) were the top three measures in clinical efficacy. For improving the Pittsburgh Sleep Quality Index (PSQI), massage (SUCRA86.1) was the most effective, followed by Western medicine combined with auricular point sticking (SUCRA85.4), and Western medicine combined with needle embedding (SUCRA66.4). Regarding adverse reactions, the top three interventions were traditional acupuncture (SUCRA87.7), moxibustion (SUCRA63.2), and Western medicine combined with traditional acupuncture (SUCRA46.0).
TCM non-pharmacologic therapy and Western medicine combined with TCM non-pharmacologic therapy can improve clinical efficacy in post-stroke insomnia, enhance sleep quality, and reduce adverse reactions. Due to the limitations of the included studies, the methodological quality is generally not high, and multicenter, large sample, high-quality RCTs are still needed for validation in the future.
中风后失眠是一种常见且多发的疾病，对患者的生活质量有重大影响。中医非药物疗法越来越多地用于中风后失眠患者。本研究的目的是评估中医非药物疗法治疗中风后失眠的疗效和安全性。
检索英文和中文数据库，包括PubMed、Web of Science、Cochrane图书馆、Embase、中国知网、万方、维普和中国生物医学文献数据库，以收集比较中医非药物疗法与西医治疗中风后失眠的随机对照试验（RCT）。检索截至2024年3月26日。使用Stata15.0进行数据分析。
本研究共纳入60项RCT，涉及5种中医非药物疗法和4587例患者。网状Meta分析结果显示，西医联合按摩（累积排序曲线下面积[SUCRA]93.8）、西医联合耳穴贴压（SUCRA80.5）和埋针（SUCRA71.5）是临床疗效排名前三的措施。对于改善匹兹堡睡眠质量指数（PSQI），按摩（SUCRA86.1）最有效，其次是西医联合耳穴贴压（SUCRA85.4）和西医联合埋针（SUCRA66.4）。关于不良反应，排名前三的干预措施是传统针刺（SUCRA87.7）、艾灸（SUCRA63.2）和西医联合传统针刺（SUCRA46.0）。
中医非药物疗法以及西医联合中医非药物疗法可提高中风后失眠的临床疗效，改善睡眠质量，并减少不良反应。由于纳入研究的局限性，方法学质量普遍不高，未来仍需要多中心、大样本、高质量的RCT进行验证。
