Randomized Controlled Clinical Trials of Warm Herbal Foot Bath Therapy for Insomnia: A Literature Review Based on the CNKI

Abstract

Objectives: This review investigated the research on warm herbal foot bath therapy (WHFT) for insomnia.Methods: A search was conducted on the China National Knowledge Infrastructure (CNKI) database to collect relevant studies published up to August 29, 2023. Randomized controlled trials (RCTs) comparing WHFT and sleeping pills in patients with insomnia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool. The results of the meta-analysis were presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence intervals (CIs).Results: A total of 11 RCTs were included. WHFT as monotherapy resulted in a significantly higher total effective rate (TER) (RR, 1.25; 95% CI, 1.15 to 1.36; I<sup>2</sup>=25%) and an improved Pittsburgh Sleep Quality Index (PSQI) global sore (MD, -3.10; 95% CI, -4.24 to -1.95; I<sup>2</sup>=73%) compared to benzodiazepines. Additionally, WHFT as a combined therapy with benzodiazepines resulted in a significantly higher TER (RR, 1.15; 95% CI, 1.04 to 1.27; I<sup>2</sup>=0%) and an improved PSQI global score (MD, -2.23; 95% CI, -4.09 to -0.38; I<sup>2</sup>=80%) compared to benzodiazepines alone. In network analysis visualizing the components of HWFT, four clusters were discovered, and <i>Polygoni Multiflori Ramuls</i> and <i>Ziziphi Spinosae Semen</i> were the key herbs used in WHFT. Overall, the methodological quality of the included studies was poor.Conclusions: There was limited evidence that WHFT as a monotherapy or combined therapy was effective in improving insomnia. The findings can be used as basic data for future WHFT research in South Korea.