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针刺治疗围绝经期失眠疗效及安全性的系统评价与Meta分析

Systematic review and meta-analysis on the efficacy and safety of acupuncture for perimenopausal insomnia.

作者信息

Song ShiWei, Chen Hao, Fu HongFang

机构信息

Department of Traditional Chinese Medicine, Sichuan Taikang Hospital, Chengdu, China.

Chengdu University of Traditional Chinese Medicine, Chengdu, China.

出版信息

Front Neurol. 2025 Aug 11;16:1649856. doi: 10.3389/fneur.2025.1649856. eCollection 2025.

Abstract

BACKGROUND

Perimenopausal insomnia is a chronic physical and mental health disorder that plagues women. However, there are no systematic reviews or meta-analyses on the treatment of perimenopausal insomnia with acupuncture alone. Therefore, we conducted a meta-analysis to assess the efficacy and safety of acupuncture alone in improving perimenopausal insomnia.

METHODS

This study searched for randomized controlled trials on acupuncture treatment for perimenopausal insomnia from seven major literature databases in both Chinese and English: Web of Science, PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, and Wan-fang database. The quality of the studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was conducted using Rev Man 5.4 software.

RESULTS

The study comprised nine randomized controlled trials involving 968 people. The results showed that acupuncture was superior to the control group in improving the effective rate (OR: 3.30; 95% CI: 2.18-4.98; < 0.00001), PSQI score (MD: -3.26; 95% CI: -4.62- -1.90; < 0.00001), FSH (MD: -11.01; 95% CI: -15.39- -6.63; < 0.00001), KMI score ( < 0.05), 5-HT ( < 0.05), NE ( < 0.05), MENQOL score ( < 0.05), early-wake score ( < 0.05), sleep actigraphy monitoring ( < 0.05), and Traditional Chinese Medicine symptom scores ( < 0.05) in patients with menopausal insomnia. The two groups had no significant differences in regulating serum E2 (MD: 7.70; 95% CI: 2.20-13.19; = 0.06) and LH levels (MD: -5.42; 95% CI: -9.46- -1.37; = 0.009).

CONCLUSION

Acupuncture treatment is significantly effective for patients with perimenopausal insomnia. However, large-sample, multi-center, long-term follow-up trials should be conducted to obtain more reliable results. Considering the particularities of acupuncture treatment, actively constructing a real-world acupuncture clinical research paradigm will bring more authentic, rich, and practical research outcomes to clinical practitioners.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024621267, identifier CRD42024621267.

摘要

背景

围绝经期失眠是一种困扰女性的慢性身心健康障碍。然而,目前尚无关于单纯针刺治疗围绝经期失眠的系统评价或荟萃分析。因此,我们进行了一项荟萃分析,以评估单纯针刺改善围绝经期失眠的疗效和安全性。

方法

本研究从七个中英文主要文献数据库检索针刺治疗围绝经期失眠的随机对照试验:科学网、PubMed、考克兰图书馆、Embase、中国知网、维普数据库和万方数据库。根据《干预措施系统评价考克兰手册》评估研究质量。使用Rev Man 5.4软件进行荟萃分析。

结果

该研究纳入9项随机对照试验,共968人。结果显示,针刺在改善围绝经期失眠患者的有效率(OR:3.30;95%CI:2.18 - 4.98;<0.00001)、匹兹堡睡眠质量指数(PSQI)评分(MD: - 3.26;95%CI: - 4.62 - - 1.90;<0.00001)、促卵泡生成素(FSH)(MD: - 11.01;95%CI: - 15.39 - - 6.63;<0.00001)、中医证候积分(<0.05)、5 - 羟色胺(<0.05)、去甲肾上腺素(<0.05)、更年期生存质量量表(MENQOL)评分(<0.05)、早醒评分(<0.05)、睡眠行为监测(<0.05)方面优于对照组。两组在调节血清雌二醇(E2)水平(MD:7.70;95%CI:2.20 - 13.19;P = 0.06)和促黄体生成素(LH)水平(MD: - 5.42;95%CI: - 9.46 - - 1.37;P = 0.009)方面无显著差异。

结论

针刺治疗围绝经期失眠患者疗效显著。然而,应开展大样本、多中心、长期随访试验以获得更可靠的结果。考虑到针刺治疗的特殊性,积极构建真实世界针刺临床研究范式将为临床医生带来更真实、丰富和实用的研究成果。

系统评价注册

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024621267,标识符CRD42024621267

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/060a/12375488/1490be2f72d8/fneur-16-1649856-g001.jpg

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