中医理疗对围绝经期妇女睡眠质量影响的Meta分析

目的探讨中医理疗对围绝经期妇女睡眠质量的影响。方法使用计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane图书馆等资源,收集应用中医理疗对围绝经期妇女的睡眠障碍进行干预的随机对照试验,检索时限均为建库至2019年7月。采用RavMan 5.3软件进行统计处理。结果研究共纳入文献8篇,Meta分析结果显示,针灸、刮痧能改善围绝经期睡眠障碍妇女的总体睡眠质量WMD=-2.45,95%CI(-4.05,-0.84),P<0.05,提高主观睡眠质量WMD=-0.47,95%CI(-0.81,-0.13)、睡眠效率WMD=-0.49,95%CI(-0.91,-0.07),缩短入睡时间WMD=-0.60,95%CI(-0.96,-0.24),减轻睡眠障碍WMD=-0.35,95%CI(-0.58,-0.12)以及日间功能障碍WMD=-0.40,95%CI(-0.70,-0.11)。亚组分析表明,相对于联合其他药物治疗,单纯的理疗能更好地改善围绝经期妇女的睡眠障碍WMD=-2.45,95%CI(-4.05,-0.84),且当干预频次≥3次/周时,睡眠质量结果有统计学意义WMD=-2.66,95%CI(-4.11,-1.22)。结论中医理疗对改善围绝经期妇女的睡眠情况疗效显著,但对延长睡眠时间、减少催眠药物使用无明显改善。

Effect of Chinese Medicine Physiotherapy on Sleep Quality of Perimenopausal Women:a Meta-analysis

Objective To explore the effect of Chinese medicine physiotherapy on the sleep quality of perimenopausal women.Methods We searched databases including CNKI,Wanfang data,VIP,SinoMed,PubMed,Web of Scie-nce,Embase and Cocbrane Library(form database inception to July,2019)for randomized controlled trials(RCTs).The data analyses were performed by Revman 5.3.Results A total of 8 articles were included in the study.The results of Meta-analysis showed that acupuncture and scraping significantly improved the overall scores of the Pittsburgh Sleep Quality IndexWMD=-2.45,95%CI(-4.05,-0.84),P<0.05],the subjective sleep qualityWMD=-0.47,95%CI(-0.81,-0.13)],and the sleep efficiencyWMD=-0.49,95%CI(-0.91,-0.07)].The sleep latency shortenedWMD=-0.60,95%CI(-0.96,-0.24)],sleep disturbance decreasedWMD=-0.35,95%CI(-0.58,-0.12)]and daytime function disorder alleviatedWMD=-0.40,95%CI(-0.70,-0.11)].Subgroup analysis showed that single physiotherapy could better improve sleep disorders in perimenopausal women compared with other drug treatmentsWMD=-2.45,95%CI(-4.05,-0.84)].And when the frequency of intervention was 3 or more than 3 times a week,the results were statistically significantWMD=-2.66,95%CI(-4.11,-1.22)].Conclusion Chinese medicine physiotherapy has better efficacies in improving overall sleep quality.But it has no obvious improvement on prolonging sleep time and reducing the usage of sleep medication.