The effects of acupuncture versus sham/placebo acupuncture for insomnia: A systematic review and meta-analysis of randomized controlled trials.
Acupuncture has been found to be an effective treatment for insomnia. but it is not clear whether acupuncture is just a placebo effect. We aimed to compare the efficacy and safety of acupuncture and sham/placebo acupuncture.
We searched the Central Register of Controlled Trials of Medline, EMBASE, and Cochrane from database inception through March 16, 2020 for randomized controlled trials (RCTs) that compared acupuncture therapy with sham/placebo acupuncture or no treatment. Restricted to English language. Cochrane risk of bias tool was used to analyze risk of bias of the included randomized controlled trials (RCT). Data analysis was performed with Review Manager 5.3.
A total of 15 studies involving 1108 patients. Meta-analysis results showed that acupuncture therapy was superior to sham/placebo acupuncture in terms of improving Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), total sleep time (TST), sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), even during the follow-up period, acupuncture therapy was superior to sham/placebo acupuncture on PSQI. Due to the obvious heterogeneity of the study, (1) for primary outcome (PSQI):subgroup analysis based on the type of acupuncture and placebo acupuncture showed that acupuncture was superior to placebo acupuncture lower PSQI: acupuncture was superior to placebo acupuncture (3RCTs,MD = -7.34,95% [-8.02,-6.66],I2 = 86%) and minimal acupuncture (5RCTs,MD = -3.29,95% [-3.95, -2.63],I2 = 53%), Auricular acupressure was superior to placebo acupuncture (1RCT,MD = -4.16,95% [-6.57, -1.75]), minimal acupuncture was superior to electroacupuncture (2RCTs, MD = 0.70,95%CI [0.52, 0.87],I2 = 0%), while there was no significant difference between auricular acupressure and minimal acupuncture, between electroacupuncture and placebo acupuncture. trials). (2) for secondary outcome (ISI,TST,WASO,SE,SOL).ISI, the ISI score of minimal acupuncture was lower than that of electroacupuncture (2RCTs,MD = 0.80,95%CI [0.55, 1.04],I2 = 0), acupuncture was lower placebo acupuncture (1RCT, MD = -7.89,95%CI [-10.15, -5.63]), There was no significant difference between electroacupuncture and minimal acupuncture. Conclusion: Based on the outcomes included in this study, the efficacy of acupuncture was superior to that of placebo acupuncture in treating insomnia. Types of acupuncture therapy and placebo may underestimate the efficacy of acupuncture in different ways.
Zhang J
，He Y
，Huang X
，Liu Y
，Yu H
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Acupuncture combined with moxibustion for insomnia after stroke: A protocol for systematic review and meta analysis.
Stroke is the main cause of death and disability in the world and insomnia is a common complication of stroke patients. Insomnia will not only seriously affect the prognosis and quality of life of patients with stroke, but even cause the recurrence of stroke. Many studies have proved that acupuncture and moxibustion can effectively improve insomnia symptoms. This study will systematically evaluate the effectiveness and safety of acupuncture combined with moxibustion in treating insomnia after stroke.
The following 8 databases will be searched from the inception to October 31, 2020, including China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP database), China Biomedical Literature Database (CBM), Wanfang Data Chinese Database, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Allied and Alternative Medicine Database (AMED), Excerpt Medica Database (Embase). We will also search for ongoing trials from the World Health Organization International Clinical Trial Registration Platform search portal, Chinese Clinical Trial Register, Clinical trials.gov. In addition, the reference lists of studies meeting the inclusion criteria will also be searched for achieving the comprehensive retrieval to the maximum. All randomized controlled trials of acupuncture and moxibustion in treating insomnia after stroke will be included. Two reviewers will conduct literature screening, data extraction, and quality evaluation respectively. The main outcome is the Pittsburgh sleep quality index (PSQI), and the secondary outcomes include clinical efficacy, quality of life, and safety. RevMan V.5.4.1 will be used for meta-analysis. We will express the results as risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous data and mean difference (MD) or standard mean difference (SMD) 95% CIs for continuous data.
This study will provide a comprehensive review of the available evidence of acupuncture combined with moxibustion in treating insomnia after stroke.
The conclusion of our study will provide the updated evidence to judge the effectiveness and safety of acupuncture combined with moxibustion for the treatment of insomnia after stroke.
PROSPERO CRD42020216720.
Sun J
，Zuo Z
，Song R
，Bao X
，Zhu M
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ResearchGate
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钛学术
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