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针刺治疗高血压患者失眠症状:一项系统评价与荟萃分析

Acupuncture for insomnia symptoms in hypertensive patients: a systematic review and meta-analysis.

作者信息

Zhang Jieying, Zhou Xuancheng, Jiang Hailun, Zhu Weiming, Chi Hao, Jiang Lai, Zhang Shengke, Yang Jinyan, Deng Shizhe, Li Boxuan, Zhuo Bifang, Zhang Menglong, Cao Beidi, Meng Zhihong

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.

Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Front Neurol. 2024 Feb 19;15:1329132. doi: 10.3389/fneur.2024.1329132. eCollection 2024.

Abstract

PURPOSE

In the realm of pain management, traditional Chinese medicine, specifically acupuncture, has garnered increasing attention. This meta-analysis pioneers the evaluation of acupuncture's effectiveness in treating insomnia among hypertensive patients.

METHODS

We conducted a comprehensive search across several databases-PubMed, Web of Science, Cochrane Library, WANFANG, China National Knowledge Infrastructure (CNKI), Sinomed, and the Chinese Journal of Science and Technology (VIP). Additionally, forward and backward articles of studies published from the inception of these databases until 10 September 2023, were reviewed. This systematic review and meta-analysis included all randomized controlled trials (RCTs) focusing on acupuncture for insomnia in hypertensive patients, without imposing language or date restrictions. We rigorously assessed all outcome measures reported in these trials. The evidence was synthesized by calculating the difference between mean differences (MD) in symptom change. The quality of the evidence was determined using the Cochrane Risk of Bias tool. This study is registered with PROSPERO under number CRD42023461760.

RESULTS

Our analysis included 16 RCTs, comprising 1,309 patients. The findings revealed that acupuncture was significantly more effective than the control group in reducing insomnia symptoms, as indicated by a greater decrease in the PSQI score (MD = -3.1, 95% CI [-3.77 to -2.62],  < 0.00001). Additionally, improvements in both systolic and diastolic blood pressure were more pronounced in the acupuncture group compared to the control group (SBP: MD = -10.31, 95% CI [-16.98 to -3.64],  = 0.002; DBP: MD = -5.71, 95% CI [-8.19 to -3.23],  < 0.00001). These results suggest that acupuncture not only improves sleep quality but also lowers blood pressure in patients suffering from hypertension and insomnia. Further research is warranted to elucidate optimal acupuncture points and the duration of treatment for maximized therapeutic effect.https://www.crd.york.ac.uk/prospero, CRD42023461760.

摘要

目的

在疼痛管理领域,传统中医,尤其是针灸,已受到越来越多的关注。本荟萃分析率先评估针灸治疗高血压患者失眠的有效性。

方法

我们对多个数据库进行了全面检索,包括PubMed、科学网、考克兰图书馆、万方、中国知网、中国生物医学文献数据库和维普中文科技期刊数据库。此外,还对这些数据库创建之初至2023年9月10日发表的研究的前后文进行了审查。本系统评价和荟萃分析纳入了所有聚焦于针灸治疗高血压患者失眠的随机对照试验(RCT),不设语言或日期限制。我们严格评估了这些试验中报告的所有结局指标。通过计算症状变化的平均差(MD)之间的差异来综合证据。使用考克兰偏倚风险工具确定证据质量。本研究已在国际前瞻性注册系统(PROSPERO)注册,注册号为CRD42023461760。

结果

我们的分析纳入了16项随机对照试验,共1309例患者。研究结果显示,针灸在减轻失眠症状方面明显比对照组更有效,匹兹堡睡眠质量指数(PSQI)评分下降幅度更大(MD = -3.1,95%置信区间[-3.77至-2.62],P < 0.00001)。此外,与对照组相比,针灸组收缩压和舒张压的改善更为显著(收缩压:MD = -10.31,95%置信区间[-16.98至-3.64],P = 0.002;舒张压:MD = -5.71,95%置信区间[-8.19至-3.23],P < 0.00001)。这些结果表明,针灸不仅能改善睡眠质量,还能降低高血压合并失眠患者的血压。有必要进一步研究以阐明最佳穴位和治疗时长,以实现最大治疗效果。https://www.crd.york.ac.uk/prospero,CRD42023461760。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bfd/10910107/25d6cd719228/fneur-15-1329132-g001.jpg

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