针灸治疗心脾两虚型失眠的系统评价和Meta-分析

发布时间：2018-02-10 00:01

本文关键词： 针灸失眠系统评价 Meta-分析　出处：《辽宁中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:检索针灸治疗心脾两虚型失眠的中英文临床随机对照试验(RCTs)的相关研究文献,将干预方式为针灸或针灸配合其他疗法的研究按照循证医学的方法来进行系统评价,得出治疗心脾两虚型失眠的最佳疗法,为临床提供治疗依据。方法:1文献检索:制定纳入标准和排除标准。利用计算机智能检索、手动检索方法进行文献检索,文献语言为中文和英文,收集针灸治疗心脾两虚型失眠的中英文临床随机对照试验。主要检索的数据库:相关期刊论文(CNKI)、维普资讯中文科技期刊数据库(VIP)、万方数据库(Wanfang)、中国生物医学文献数据库(CBMdisc)、Pubmed、Cochrane Library、MEDLINE、EMBASE。手动检索主要杂志,如《中国针灸》、《针刺研究》、《针灸临床杂志》、《上海针灸杂志》,检索年限为2010年1月至2016年1月。2纳入的文献评价质量:将检索到的文献由两位研究者独立对符合纳入标准的随机对照试验进行质量评价和资料提取,当遇到分歧时,通过讨论或由第三方研究者协助解决。3统计学分析:统计学处理采用Cochrane协作网的专用统计软件(Review Manager5.3)对所得数据进行分析。对纳入的研究进行异质性检验、合并效应量的分析和检验;对不能合并的研究进行定性分析。结果:1共检索到76篇,其中有72篇中文文献,4篇英文文献。符合纳入标准的文献有15篇,均为随机对照试验(RCTs),一共有患者1002例。2文献质量评价:纳入的15个研究中有5篇中级文献研究,10篇低级文献研究。3统计学分析:⑴针灸或针灸配合其他疗法在治疗心脾两虚型失眠的有效率上有一定影响,在此次合并研究得出,针灸疗法或针灸配合其他疗法优于单纯服用中药或单纯服用西药。⑵针灸或针灸配合其他疗法对心脾两虚型失眠的PSQI总分有一定影响,在此次合并研究得出,针灸疗法或针灸配合其他疗法对PSQI总分影响优于单纯口服中药或单纯口服西药。⑶次要指标睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能评价结果有的异质性较大,但总体合并效应量中针灸疗法或针灸配合其他疗法优于单纯口服中药或单纯口服西药,只有催眠药物评价结果为西药作用优于针灸疗法。结论:针灸疗法或针灸配合其他疗法在治疗心脾两虚型失眠与单纯服用中药或单纯服用西药比较,发现疗效存在差异,通过比较得出针灸疗法或针灸配合其他疗法对心脾两虚型失眠的有效率及PSQI总分影响优于单纯口服中药或单纯口服西药。
[Abstract]:Objective: to search the literature on acupuncture and moxibustion in treating insomnia with deficiency of both heart and spleen (RCTs) in a randomized controlled trial in both Chinese and English, and to systematically evaluate the intervention of acupuncture and moxibustion combined with other therapies according to the method of evidence-based medicine. The best treatment for insomnia with deficiency of both heart and spleen was obtained, which provided the basis for clinical treatment. Methods: 1. Literature retrieval: make inclusion criteria and exclusion criteria. Use computer intelligence retrieval, manual retrieval method to carry out literature retrieval. The literature languages are Chinese and English, A randomized controlled trial of acupuncture and moxibustion in the treatment of insomnia with deficiency of heart and spleen was conducted in Chinese and English. The main databases searched were: CNKI, VIPN, Wanfangli, Biomedicine, Biomedicine, Chinese Journal of Science and Technology. Scientific literature database Pubmedmedan Cochrane Library MEDLINE EMBASE.Manual search for major journals, For example, Chinese Acupuncture and moxibustion, Acupuncture Research, Clinical Journal of Acupuncture and moxibustion, Shanghai Journal of Acupuncture and moxibustion, quality of literature evaluation included from January 2010 to January 2016. 2. The quality evaluation and data extraction were carried out in the standard randomized controlled trial. When there is a disagreement, the data are analyzed through discussion or with the assistance of third party researchers. 3 statistical analysis: statistical processing, using the special statistical software of Cochrane collaboration Network, Review Manager 5.3). The heterogeneity of the included research is tested. Results 76 articles were retrieved, of which 72 were in Chinese and 4 in English, 15 of which met the inclusion criteria. All were randomized controlled trials. There were 1 002 cases of 2 cases of literature quality evaluation. 5 of the 15 studies included were intermediate literature studies and 10 low-level literature studies. 3. 3 statistical analysis of acupuncture or acupuncture combined with other therapies in treatment. The effective rate of insomnia with deficiency of heart and spleen has certain influence. In this combined study, it is concluded that acupuncture therapy or acupuncture combined with other therapies is superior to taking traditional Chinese medicine alone or taking only western medicine .2 acupuncture or acupuncture combined with other therapies on the total PSQI score of insomnia with deficiency of both heart and spleen. In this combined study, it was concluded that acupuncture therapy or acupuncture combined with other treatments had better effects on the total score of PSQI than on sleep quality, sleep time, sleep efficiency, sleep disorder and sleep quality, sleep time, sleep time, sleep efficiency, sleep disorder, or only oral Chinese medicine or western medicine alone. Some of the results of daytime function evaluation were heterogeneity, but acupuncture and moxibustion combined with other methods were better than traditional Chinese medicine alone or western medicine alone. Conclusion: acupuncture and moxibustion therapy or acupuncture and moxibustion combined with other treatments in the treatment of insomnia of deficiency of both heart and spleen were compared with traditional Chinese medicine alone or western medicine alone, and found that there were differences in curative effect between acupuncture and moxibustion or acupuncture and moxibustion combined with other therapies. It was concluded that the effective rate of acupuncture and moxibustion combined with other therapies on insomnia with deficiency of both heart and spleen and the total score of PSQI were better than those of traditional Chinese medicine alone or western medicine alone.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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