Abstract
Objective To systematically evaluate the efficacy and safety of scalp acupuncture in the treatment of insomnia. Methods CNKI, Wanfang database, CQVIP database, CBM, Web of Science, Cochrane Library, and PubMed were searched for the literature on the treatment of insomnia by scalp acupuncture from the establishment of the database to July 23, 2020. Two researchers independently screened the literatures and extracted the data, then evaluated the quality of the literatures, and used RevMan 5.3 software for statistical analysis. Results A total of 21 studies including 1606 cases were included. 21 studies were included in the analysis of effective rate. The heterogeneity test showed that there was no significant heterogeneity. The fixed effect model was used, P < 0.00001. The effective rate of scalp acupuncture in the treatment of insomnia was significantly higher than that of the control group. The analysis of PSQI score was finally included in 19 studies. The heterogeneity test showed that there was obvious heterogeneity. The random effect model was used, and the subgroup analysis was conducted according to the different intervention measures of the control group. The P values of the drug group and the blank group were both less than 0.05, indicating that the improvement of PSQI score in the scalp acupuncture treatment of insomnia was significantly better than that in the drug group and the blank group; P = 0.05 in other acupuncture groups, suggesting in scalp acupuncture treatment, there was no difference between insomnia and other acupuncture in improving the PSQI score. Six studies were included in the analysis of adverse events. The heterogeneity test showed no significant heterogeneity. The fixed effect model was used, P = 0.04 < 0.05, indicating that the adverse events of scalp acupuncture in the treatment of insomnia were better than those of the control group. No publication bias analysis was conducted due to the small number of adverse events included. Publication bias was analyzed for effective rate and PSQI score. Egger's TSTs test (effective rate P = 0.001, PSQI score P = 0.001) and funnel plot showed publication bias. Conclusion Scalp acupuncture is effective and safe in the treatment of insomnia, which is worthy of clinical application. However, due to the limited number of included literature, the methodology of some studies is slightly low and the quality of literature is slightly poor. In the future, we need to design rigorous, large sample, multiple center randomized controlled study to further verify the conclusion of this study.
Highlights
Insomnia refers to a subjective experience of dissatisfaction with sleep time and quality under the appropriate sleep opportunity and sleep environment, which affects the social function during the day [1]
Analysis of the Effective Rate. e outcome indicators of all studies included effective rate; 21 studies were included. e heterogeneity test result is p 0.24, I2 17%, which shows that there is no heterogeneity, so the fixed effects model is selected. e combined effect amount results showed that OR 2.73, 95% CI [2.05, 3.63], P < 0.00001 (Figure 3), the difference was statistically significant, and the effective rate of scalp acupuncture in the treatment of insomnia was significantly higher than that in the control group
Subgroup analysis results (Figure 4) showed that the improvement of Pittsburgh Sleep Quality Index (PSQI) score of insomnia patients by scalp acupuncture was significantly better than that of drug group (MD −1.49, 95% CI [−2.05, −0.92], P < 0.00001, heterogeneity test: P 0.02, I2 56%) and blank group (MD −10.55, 95% CI [−11.56, −9.54], P < 0.00001, because there was only one study; there was no heterogeneity test), compared with other acupuncture groups (MD −1.46, 95% CI [−2.89, −0.03], P 0.05, heterogeneity test: P < 0.00001, I2 93%); there was no significant difference
Summary
Insomnia refers to a subjective experience of dissatisfaction with sleep time and (or) quality under the appropriate sleep opportunity and sleep environment, which affects the social function during the day [1]. Acupuncture, as one of the traditional Chinese medical therapies, can alleviate or cure diseases by stimulating specific acupoints with acupuncture needles It has been recognized by more and more people all over the world because of its advantages such as being easy to carry, quick effect, almost no side effect, and no dependence [3]. It stimulates some acupoints in the head through the application of acupuncture, so as to achieve the purpose of prevention and treatment of systemic diseases At present, it has been widely used in clinical practice. Is study aims to systematically evaluate the efficacy and safety of scalp acupuncture in the treatment of insomnia, so as to provide reference for clinical practice The efficacy and safety of scalp acupuncture in the treatment of insomnia has not been unified, and no one has conducted a systematic evaluation on it. is study aims to systematically evaluate the efficacy and safety of scalp acupuncture in the treatment of insomnia, so as to provide reference for clinical practice
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