基于五运六气理论治疗失眠疗效的Meta分析

Meta-Analysis on the Efficacy of Treating Insomnia Based on the Theory of Five Movements and Six Qi

摘要: 目的：基于meta分析评估运用五运六气理论治疗失眠的临床疗效。方法：检索PubMed、CLINicnlkey、Web of Science (WOS)核心合集、中国科技、中国学术期刊数据库(万方数据)、中国知识资源总库(CNKI)，收集建库至2024年12月31日基于五运六气理论治疗失眠的随机对照试验(RCT)，使用RevMan5.3和Stata17.0软件进行meta分析。结果：共纳入21篇RCTs，总样本量1787例。其中16项研究报告了临床有效率，20项研究报告了匹兹堡睡眠质量指数评分(PSQI)，14项研究报告了中医证候积分，5项研究报告了复发率，4项研究报告了不良事件发生率。meta分析显示，五运六气疗法治疗失眠的临床有效率[MD = 3.19, 95% CI (2.28, 4.47), P < 0.00001]优于对照组；试验组PSQI评分[MD = −5.07, 95% CI (−5.78, −4.36), P < 0.00001]、中医证候积分[MD = −7.72, 95% CI (−13.0, −9.06), P < 0.00001]、复发率[MD = 0.2, 95% CI (0.12, 0.33), P < 0.00001]、不良事件发生率[MD = 0.1, 95% CI (0.04, 0.27), P < 0.00001]均低于对照组。敏感性分析结果表明最终纳入的文章结果较为可靠。结论：五运六气疗法治疗失眠临床有效率提升，PSQI评分和中医证候积分有所降低，但仍需更多大样本、高质量的RCT加以验证。

Abstract: Objective: To evaluate the clinical efficacy of Five Movements and Six Qi (Wuyun Liuqi) theory for insomnia treatment through meta-analysis. Methods: Randomized controlled trials (RCTs) from inception to December 31, 2024, were retrieved from PubMed, CLINicnlkey, Web of Science Core Collection, China Science and Technology Journal Database (CSTJ), Wanfang Data, and China National Knowledge Infrastructure (CNKI). Meta-analysis was performed using RevMan 5.3 and Stata 17.0 software. Results: Twenty-one RCTs involving 1787 participants were included. Outcome measures reported: Clinical response rate (16 studies), Pittsburgh Sleep Quality Index (PSQI) score (20 studies), TCM syndrome score (14 studies), Recurrence rate (5 studies), Adverse event rate (4 studies) Meta-analysis demonstrated: Higher clinical response rate with Five Movements and Six Qi therapy vs. controls [RR = 3.19, 95% CI (2.28, 4.47), P < 0.00001], Lower PSQI scores [MD = −5.07, 95% CI (−5.78, −4.36), P < 0.00001], Reduced TCM syndrome scores [MD = −7.72, 95% CI (−13.00, −9.06), P < 0.00001], Decreased recurrence rate [RR = 0.2, 95% CI (0.12, 0.33), P < 0.00001], Reduced adverse events [RR = 0.1, 95% CI (0.04, 0.27), P < 0.00001]. Sensitivity analysis confirmed result robustness. Conclusion: Five Movements and Six Qi therapy significantly improves clinical response rates while reducing PSQI and TCM syndrome scores in insomnia treatment. However, further validation through large-scale, high-quality RCTs is warranted.