【摘要】 目的:运用Meta评估针刺配合音乐疗法治疗原发性失眠的疗效与安全性,以明确其临床意义进而指导临床治疗。方法:通过检索中文科技期刊数据库(CCD)、国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)和中国生物医学文献数据库(CBM),统计、收集针刺配合音乐疗法对比单纯针刺或西医疗法治疗原发性失眠的随机对照试验(RCT),对符合纳入条件的研究进行数据提取。采用Cochrane系统评价员手册5.1. 0的偏倚风险评估工具对文献进行质量评价;采用RevMan 5.3软件进行相关数据的Meta分析并针对数据合并结果做出科学的解释。主要研究的结局指标有匹兹堡睡眠质量指数(PSQI)评定量表、临床疗效和不良反应。结果:共纳入7项RCTs,合计577位患者。Meta分析结果显示:PSQI评分、失眠痊愈的差异有统计学意义(均P <0.05),然而失眠好转、不良事件的差异无统计学意义(P> 0.05)。此外,敏感性分析显示各结局指标敏感性较小,结论稳定;发表偏倚检测结果显示漏斗图基本对称,合并结果稳定、可信。结论:针刺联合音乐疗法治疗原发性失眠安全有效,但仍缺乏多中心、高质量RCT的验证。更多还原

【Abstract】 Objective: To clarify the clinical significance of acupuncture combined with music therapy in the treatment of primary insomnia and guide the related work of clinical treatment by system evaluation of its efficacy and safety. Methods: The Chinese Citation Database( CCD),China National Knowledge Infrastructure( CNKI),China Science Periodical Database( CSPD) and China Biology Medicine( CBM) were searched. Randomized controlled trials( RCT) of acupuncture combined with music therapy versus acupuncture alone or western medicine therapy in the treatment of primary insomnia were counted and collected,so as to extract data from the studies that reach the inclusion criteria. The quality of the literatures was evaluated by using bias risk evaluation tool recommended by Cochrane system evaluation manual 5. 1. 0. RevMan 5. 3 software was used for meta-analysis of relevant data and scientific interpretation of the results coming out from data merging. The mainly discussed outcome indicators including Pittsburgh Sleep Quality Index( PSQI),clinical efficacy and adverse events. Results: Seven randomized controlled trials( RCTs) were included,with a total of 577 patients. Meta-analysis showed that the differences in PSQI and recovery of insomnia were statistically significant( Ps < 0. 05),but there was no statistical significance in the differences in the improvement of insomnia and adverse events( P > 0. 05). In addition,sensitivity analysis showed that the sensitivity of each outcome indicator was low and the conclusion was stable. Publication bias test result showed that the funnel chart was basically symmetric and the results were stable and reliable. Conclusion: Acupuncture combined with music therapy is safe and effective in the treatment of primary insomnia,but multi-center,high-quality RCT verification was still in deficiency.更多还原