Construction Of Evidence System For Massage Treatment Of Insomnia Based On Bayesian Network Meta-analysis

Objective:System collection has been published in recent 10 years The massage in The treatment of insomnia clinical evidence to support The status quo,based on mesh meta-analysis,Evaluation of evidence classification Evaluation,and Evaluation system,The Grading of Recommendations Assessment,Development and Evaluation,GRADE Evaluation system),The massage treatment of insomnia,The effectiveness and safety of evidence will form,provide effective evidence for future clinical massage treatment of insomnia.Methods:1.Systematic collection of evidence of current massage therapy in the treatment of insomnia,based on Systematic evaluation methodology Quality assessment tool Amstar 2(Amstar)to analyze the Methodological Quality of the existing system evaluation and Metaanalysis,to obtain the status of evidence information.2.The system collect the current massage therapy for insomnia of Randomized Controlled trials(Randomized Controlled trials,RCT),and USES the network meta-analysis and GRADE evaluation of quality of evidence classification system,with the total effective rate,Pittsburgh sleep index score and TCM syndrome score and safety evaluation index as a result,through the network meta-analysis summarized the latest body of evidence based on Randomized Controlled trials.Results:1.A total of 7 systematic reviews and meta-analyses on massage therapy for insomnia were included,and it was found that the body quality scores of the included existing evidence were all low after quantitative scoring with the AMSTAR 2 tool.2.A total of 47 randomized controlled trials on massage therapy for insomnia were collected through pre-formulated retrieval strategies.All the included studies did not mention the development of random concealment and blind method,and the risk bias evaluation was relatively large.According to the outcome indexes included in the study,taking the total effective rate,Pittsburgh sleep index score,TCM syndrome score and safety evaluation as the outcome indexes,it was found that among the total effective rate,acupuncture combined with massage was the most effective intervention measure,followed by diazepam and massage.However,the inconsistency is relatively significant.Excluding relevant studies,acupuncture combined with massage is still the best way to intervene,and massage can only rank fourth.Still,acupuncture combined with massage was the best intervention in the Pittsburgh Sleep Index score,with massage ranking third.In the scores before and after treatment of TCM syndromes,acupuncture alone is the best treatment,while massage can only rank third.In the safety evaluation,due to the few included studies,no network meta-analysis was conducted,but the studies that mentioned adverse reactions showed more adverse reactions in the treatment of Chinese and Western drugs.However,due to the low overall methodological quality of the included studies,the risk of publication bias and small sample size effect,and significant inconsistencies after the meta-analysis,the overall results were of low quality.Conclusion:The clinical evidence system of massage therapy for insomnia has been basically constituted-the current low quality evidence shows that in the treatment of insomnia,acupuncture and massage as an intervention is the best treatment,in the total response rate and Pittsburgh sleep index score of the two outcome indicators are the best.However,clinical research on massage treatment of insomnia should be guided by more rigorous methodology,and increase patient preferences,safety evaluation and economic health evaluation,improve the quality of evidence body,can better guide the clinical practice of massage.