本文關(guān)鍵詞： 針灸 失眠 系統(tǒng)評價 Meta-分析　出處：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:檢索針灸治療心脾兩虛型失眠的中英文臨床隨機對照試驗(RCTs)的相關(guān)研究文獻,將干預(yù)方式為針灸或針灸配合其他療法的研究按照循證醫(yī)學(xué)的方法來進行系統(tǒng)評價,得出治療心脾兩虛型失眠的最佳療法,為臨床提供治療依據(jù)。方法:1文獻檢索:制定納入標準和排除標準。利用計算機智能檢索、手動檢索方法進行文獻檢索,文獻語言為中文和英文,收集針灸治療心脾兩虛型失眠的中英文臨床隨機對照試驗。主要檢索的數(shù)據(jù)庫:相關(guān)期刊論文(CNKI)、維普資訊中文科技期刊數(shù)據(jù)庫(VIP)、萬方數(shù)據(jù)庫(Wanfang)、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBMdisc)、Pubmed、Cochrane Library、MEDLINE、EMBASE。手動檢索主要雜志,如《中國針灸》、《針刺研究》、《針灸臨床雜志》、《上海針灸雜志》,檢索年限為2010年1月至2016年1月。2納入的文獻評價質(zhì)量:將檢索到的文獻由兩位研究者獨立對符合納入標準的隨機對照試驗進行質(zhì)量評價和資料提取,當(dāng)遇到分歧時,通過討論或由第三方研究者協(xié)助解決。3統(tǒng)計學(xué)分析:統(tǒng)計學(xué)處理采用Cochrane協(xié)作網(wǎng)的專用統(tǒng)計軟件(Review Manager5.3)對所得數(shù)據(jù)進行分析。對納入的研究進行異質(zhì)性檢驗、合并效應(yīng)量的分析和檢驗;對不能合并的研究進行定性分析。結(jié)果:1共檢索到76篇,其中有72篇中文文獻,4篇英文文獻。符合納入標準的文獻有15篇,均為隨機對照試驗(RCTs),一共有患者1002例。2文獻質(zhì)量評價:納入的15個研究中有5篇中級文獻研究,10篇低級文獻研究。3統(tǒng)計學(xué)分析:⑴針灸或針灸配合其他療法在治療心脾兩虛型失眠的有效率上有一定影響,在此次合并研究得出,針灸療法或針灸配合其他療法優(yōu)于單純服用中藥或單純服用西藥。⑵針灸或針灸配合其他療法對心脾兩虛型失眠的PSQI總分有一定影響,在此次合并研究得出,針灸療法或針灸配合其他療法對PSQI總分影響優(yōu)于單純口服中藥或單純口服西藥。⑶次要指標睡眠質(zhì)量、入睡時間、睡眠時間、睡眠效率、睡眠障礙、日間功能評價結(jié)果有的異質(zhì)性較大,但總體合并效應(yīng)量中針灸療法或針灸配合其他療法優(yōu)于單純口服中藥或單純口服西藥,只有催眠藥物評價結(jié)果為西藥作用優(yōu)于針灸療法。結(jié)論:針灸療法或針灸配合其他療法在治療心脾兩虛型失眠與單純服用中藥或單純服用西藥比較,發(fā)現(xiàn)療效存在差異,通過比較得出針灸療法或針灸配合其他療法對心脾兩虛型失眠的有效率及PSQI總分影響優(yōu)于單純口服中藥或單純口服西藥。
[Abstract]:Objective: to search the literature on acupuncture and moxibustion in treating insomnia with deficiency of both heart and spleen (RCTs) in a randomized controlled trial in both Chinese and English, and to systematically evaluate the intervention of acupuncture and moxibustion combined with other therapies according to the method of evidence-based medicine. The best treatment for insomnia with deficiency of both heart and spleen was obtained, which provided the basis for clinical treatment. Methods: 1. Literature retrieval: make inclusion criteria and exclusion criteria. Use computer intelligence retrieval, manual retrieval method to carry out literature retrieval. The literature languages are Chinese and English, A randomized controlled trial of acupuncture and moxibustion in the treatment of insomnia with deficiency of heart and spleen was conducted in Chinese and English. The main databases searched were: CNKI, VIPN, Wanfangli, Biomedicine, Biomedicine, Chinese Journal of Science and Technology. Scientific literature database Pubmedmedan Cochrane Library MEDLINE EMBASE.Manual search for major journals, For example, Chinese Acupuncture and moxibustion, Acupuncture Research, Clinical Journal of Acupuncture and moxibustion, Shanghai Journal of Acupuncture and moxibustion, quality of literature evaluation included from January 2010 to January 2016. 2. The quality evaluation and data extraction were carried out in the standard randomized controlled trial. When there is a disagreement, the data are analyzed through discussion or with the assistance of third party researchers. 3 statistical analysis: statistical processing, using the special statistical software of Cochrane collaboration Network, Review Manager 5.3). The heterogeneity of the included research is tested. Results 76 articles were retrieved, of which 72 were in Chinese and 4 in English, 15 of which met the inclusion criteria. All were randomized controlled trials. There were 1 002 cases of 2 cases of literature quality evaluation. 5 of the 15 studies included were intermediate literature studies and 10 low-level literature studies. 3. 3 statistical analysis of acupuncture or acupuncture combined with other therapies in treatment. The effective rate of insomnia with deficiency of heart and spleen has certain influence. In this combined study, it is concluded that acupuncture therapy or acupuncture combined with other therapies is superior to taking traditional Chinese medicine alone or taking only western medicine .2 acupuncture or acupuncture combined with other therapies on the total PSQI score of insomnia with deficiency of both heart and spleen. In this combined study, it was concluded that acupuncture therapy or acupuncture combined with other treatments had better effects on the total score of PSQI than on sleep quality, sleep time, sleep efficiency, sleep disorder and sleep quality, sleep time, sleep time, sleep efficiency, sleep disorder, or only oral Chinese medicine or western medicine alone. Some of the results of daytime function evaluation were heterogeneity, but acupuncture and moxibustion combined with other methods were better than traditional Chinese medicine alone or western medicine alone. Conclusion: acupuncture and moxibustion therapy or acupuncture and moxibustion combined with other treatments in the treatment of insomnia of deficiency of both heart and spleen were compared with traditional Chinese medicine alone or western medicine alone, and found that there were differences in curative effect between acupuncture and moxibustion or acupuncture and moxibustion combined with other therapies. It was concluded that the effective rate of acupuncture and moxibustion combined with other therapies on insomnia with deficiency of both heart and spleen and the total score of PSQI were better than those of traditional Chinese medicine alone or western medicine alone.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6

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