成人原發性失眠針刺治療之實證文獻分析研究

An Evidence Based Articles Review Study regarding Acupuncture Therapy on Primary Insomnia in Adults

李采珍(Tsai-Jean Lee) ； 黃澤宏(Tse-Hung Huang) ； 張子瑜(Zi-Yu Chang)

《中醫藥雜誌》 32卷1期 (2021/06) Pp. 19-39

https://doi.org/10.6940/JCM.202106_32(1).02

摘要

目的：為瞭解現今針刺對成人原發性失眠療效之實證結論，本研究採系統性文獻回顧方法，比較針刺與口服西藥，對於原發性失眠之療效，以提供未來臨床研究及實務應用之參考。方法：以insomnia（失眠、不寐）、acupuncture（針刺）作篇名聯集，在PubMed、Embase、Cochrane Reviews、與華藝中文電子期刊等資料庫，進行文獻查找，蒐尋至2019年12月止，排除重複後，共有七篇合乎研究主題之系統性文獻回顧暨統合分析（SR-MA），以CASP評讀其文獻品質，並就針刺與口服西藥治療失眠，有關療效比較之研究結果，進行分析討論。結果：綜合136個隨機對照試驗（RCTs）的研究結果，顯示針刺治療原發性失眠，不良反應少，有效率優於口服西藥，比口服西藥更能降低PSQIG由0.94至2.76分不等，更能改善睡眠品質。結論：針刺治療之不良反應少，療效優於口服西藥，已獲致廣泛之實證結論，可提供臨床失眠患者，另項非藥物治療之選擇。

關鍵字

失眠 ； 針刺

並列摘要

Objectives: In order to understand the evidence based conclusions of the effectiveness of acupuncture on adult primary insomnia and provide references for further clinical research and practical applications, this study adopted a systematic literature review method to compare the effectiveness of acupuncture and oral western medicine in the treatment of primary insomnia. Methods: Insomnia, acupuncture were used as title collections, and literature searches were performed in PubMed, Embase, Cochrane Reviews, and Airiti Library (CEPS). The searches ended in December, 2019. After ruling out the duplicating literatures, there were seven systematic reviews and meta-analyses (SR-MA) consistent with the research theme. The quality of the literatures was assessed by CASP tool. Analysis and discussion were conducted on the results of comparative studies of effectiveness of acupuncture and oral western medicine in the treatment of insomnia. Results: Based on the comprehensive research results of 136 randomized controlled trials (RCTs), acupuncture in the treatment of primary insomnia had fewer adverse reactions, better effectiveness, lower PSQIG from 0.94 to 2.76 points and better sleep quality improvement than oral western medicine. Conclusions: It has obtained widely recognized evidence based conclusions that acupuncture has fewer adverse reactions and better efficacy than oral western medicine and can provide patients with clinical insomnia an alternative non-drug treatment.

並列關鍵字

Insomnia ； Acupuncture

參考文獻

National Institutes of Health. National Institutes of Health State of the Science Conference statement on manifestations and management of chronic insomnia in adults, June 13-15, 2005. Sleep 28 (9): 1049-1057.

劉勝義，睡眠醫學實務，合記，台北，pp. 1-49，2011。

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, pp. 362, 2016.

Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med. Rev., 2010; 14(1): 19-31.

Buysse DJ. Insomnia. JAMA, 2013. 309(7): 706-716.