检索历史 清除

Background:Electroacupuncture is often used to treat insomnia.Objective:To evaluate the efficacy and safety of electroacupuncture for insomnia.Search strategy:Databases including PubMed,Cochrane Library,Embase,Web of Science,Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wanfang Data and VIP Full-text e-Journals Database were searched up to January 15,2023.Inclusion criteria:Randomized clinical trials were included if they compared the clinical efficacy and safety of electroacupuncture with sham acupuncture,no treatment or usual care(UC)and general acupuncture.Data extraction and analysis:The full texts of the studies were reviewed to remove ineligible literature.The extracted data included authors,publication year,diagnostic criteria,sample size,population char-acteristics,interventions and outcomes.The above steps were performed independently by two review-ers and the data were cross-checked.Stata15.0 software was used to analyze the extracted outcome data.For continuous data(Pittsburgh Sleep Quality Index[PSQI]score and Insomnia Severity Index score),weighted mean difference(WMD)was calculated and 95％confidence interval(CI)was reported when the same scale was applied.For dichotomous variables(clinical response rate and adverse events),a meta-analysis was performed using risk ratio(RR)as the effect indicator.Results:Thirty-one trials with 2226 subjects were included.The meta-analysis suggested that elec-troacupuncture was more effective in improving insomnia compared with the control group(sham acupuncture,no treatment,UC and general acupuncture)(RR=1.21;95％CI:[1.16,1.27]),significantly reducing the PSQI score in insomnia patients after treatment and at follow-up(WMD=-3.23;95％CI:[-4.29,-2.17];P＜0.001).There was no significant difference in the incidence of adverse events between the EA and control groups(sham acupuncture and no treatment or UC.RR=1.48;95％Cl:[0.91,2.40];P=0.117).In addition,the regression results revealed that receiving electroacupuncture for seven to nine weeks provided the best efficacy(P＜0.05).Conclusion:Electroacupuncture can significantly promote better sleep quality in insomnia patients and is suitable for the treatment of various types of insomnia.However,the articles included were single-center trials with small sample sizes,and some articles were of poor quality.Therefore,further research is still needed to confirm these findings.