| Objective: To evaluate the clinical efficacy of promoting blood circulation and removing stasis in the treatment of insomnia based on the current clinical treatment guidelines by systematic evaluation method of meta-analysis,and to analyze the sleep improvement and adverse reactions of patients treated by this method,so as to provide real evidence-based medical evidence for clinical application.Methods: According to the research purpose,to define the search terms and construct the search formula,CNKI,CBM,VIP,Wanfang DATA,Pubmed,Cochrane Library and Embase self-built databases were searched until December 31,2021.Literature on the treatment of insomnia by activating blood circulation and removing blood stasis.All literatures were screened according to inclusion and exclusion criteria,and then the data needed to be included were extracted.Revman5.3 software was used to carry out bias risk assessment of literature,meta-analysis of outcome indicators,heterogeneity test,sensitivity analysis,subgroup analysis and publication bias assessment of meta-analysis results.Results:1.A total of 28 literatures were included in this meta-analysis,all of which were in Chinese.A total of 2467 patients were enrolled in this study,including 1270 in the treatment group and 1197 in the control group.The results of bias risk assessment showed that all literatures were biased to varying degrees and of low quality.2 Meta-analysis Results: In the treatment of insomnia related outcome indicators such as clinical efficacy [OR=3.71,95%CI(2.71,5.09),Z=8.15,P <0.00001],PSQI total score [MD=-2.31,95%CI(-3.12,-1.50),Z=5.60,P <0.00001],the sleep quality [MD = 0.23,95% CI(0.42,0.04),Z = 2.39,P =0.02 < 0.05],sleep time [MD = 0.57,95% CI(0.97,0.18),Z = 2.86,P = 0.004< 0.05],sleep time [MD = 0.28,95% CI(0.42,0.14),Z = 3.82,P = 0.0001 <0.05],sleep disorder [MD = 0.25,95% CI(0.43,0.07),Z = 2.71,P = 0.007 <0.05],daytime dysfunction [MD = 0.14,95% CI(0.27,0.02),Z = 2.25,P =0.02 < 0.05],TCM syndrome score [MD = 4.11,95% CI(5.62,2.60),Z = 5.24,P < 0.00001] and The Score of The Asens Insomnia Scale(AIS)[MD=-1.12,95%CI(-1.72,0.53),Z=3.70,P=0.0002 < 0.05] were better than western medicine,and the difference was statistically significant.There was no significant difference in sleep efficiency [MD=-0.16,95%CI(-0.33,-0.00),Z=1.98,P=0.05] compared with western medicine.3.Sensitivity analysis was conducted on all the results,and there was no significant change in the test results,indicating that the results of this study are relatively reliable.The results of publication bias showed that there might be publication bias in clinical efficacy of insomnia,PSQI score,sleep quality,sleep time,sleep time,sleep efficiency,sleep disorder,daytime dysfunction,TCM syndrome score and The Arsens Insomnia Scale(AIS).Conclusion:1 The treatment of insomnia by activating blood circulation and removing stasis may be superior to western medicine.2.Compared with western medicine,the method of activating blood circulation and removing blood stasis may have more advantages in reducing PSQI total score,improving sleep quality,shortening sleep time,prolonging sleep time,improving sleep disorders and daytime dysfunction,but it has no advantages in improving sleep efficiency.3 Promoting blood circulation and removing stasis may be superior to western medicine in reducing TCM syndrome score and AIS score. |
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