酸枣仁汤加减治疗肝血亏虚型失眠Meta分析

Meta Analysis of Therapeutic Effect of Suanzaoren Decoction on Insomnia of Liver and Blood Deficiency

摘要: 目的：从循证医学的角度出发，系统评价酸枣仁汤加减治疗肝血亏虚型失眠的疗效，为临床用药提供理论依据。途径：采用计算机检索知网、万方、中国生物医学文献数据库、维普、PubMed、EMbase和Cochrane Library等数据库，检索文献为数据库收录起始年至2023年3月所录入文献，严格根据纳入和排除标准筛选文献，使用风险偏倚评估工具(Cochrane Collaboration)对符合纳排标准的文献进行评价，利用软件RevMan5.4进行数据统计分析。结果：纳入19篇文献，文献语言均为中文，共涉及1916例患者，其中试验组958例，对照组958例。Meta分析结果显示，与常规西药治疗相比，酸枣仁汤加减治疗肝血亏虚型失眠在提高总有效率(RR = 1.20, 95%CI [1.15, 1.25], P < 0.00001)、改善睡眠质量指数(PSQI) (SMD = −1.71, 95%CI [−2.09, −1.34], P < 0.00001)和睡眠状况自评量表(SRSS) (SMD = −1.94, 95%CI [−2.49, −1.38], P < 0.00001)方面取得的成效更好。结论：与常规西药治疗相比，酸枣仁汤加减或联合常规西药治疗肝血亏虚型失眠具有较好的临床效果，优势显著。但纳入该研究的文献质量较低，存在一定的局限性，会对分析结果产生不同程度的影响，仍需更多高质量的研究加以佐证。

Abstract: Objective: To systematically evaluate the efficacy of Suanzaoren decoction in the treatment of in-somnia with liver and blood deficiency, and to provide evidence for clinical medication from the point of view of evidence-based medicine. Methods: The computer was used to search CNKI, Wan-fang, Chinese Biomedical Literature Database, VIP, PubMed, EMbase and Cochrane Library. The time range of searching literature was from the initial year to March 2023. The literatures were selected strictly according to the inclusion and exclusion criteria. The risk bias assessment tool (Cochrane Collaboration) was used to evaluate the literatures that met the criteria, and the software RevMan5.4 was used for data statistical analysis. Results: 19 articles were included, all of which were in Chinese, involving 1916 patients, including the experimental group (n = 958) and the con-trol group (n = 958). The results of Meta analysis showed that compared with conventional western medicine treatment, Suanzaoren decoction could improve the total effective rate of clinical symp-toms (RR = 1.20, 95%CI [1.15, 1.25], P < 0.00001), improve sleep quality index (PSQI) (SMD = −1.71, 95%CI [−2.09, −1.34], P < 0.00001) and sleep status self-rating scale (SRSS) (SMD = −1.94, 95%CI [−2.49, −1.38], P < 0.00001). Conclusion: Suanzaoren decoction has obvious advantages in the treatment of insomnia of liver and blood deficiency compared with conventional western medi-cine, and has better clinical effect. However, the literature included in this study is of low quality and has some limitations, and the analysis results will be affected to varying degrees, which still needs to be supported by more high-quality research.