Efficacy and safety of acupuncture in the treatment of poststroke insomnia: A systematic review and meta-analysis

针灸治疗中风后失眠的疗效和安全性:系统评价和荟萃分析

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Abstract

BACKGROUND: Insomnia is an adverse factor affecting the quality of life of stroke survivors, and acupuncture is widely used in the treatment of poststroke insomnia, but there is a lack of systematic and comprehensive collated analysis of the efficacy of acupuncture. Therefore, this study evaluated the effectiveness of acupuncture in treating poststroke insomnia through a systematic review and meta-analysis of randomized controlled trials. METHODS: The randomized controlled trials of acupuncture for poststroke insomnia in PubMed, Cochrane Library, Embase, Web of Science, China Knowledge Infrastructure, China Science Journal Database, Wanfang Database, and China Biomedical Literature Service System were searched for randomized controlled trials of acupuncture treatment for poststroke insomnia, screened according to the inclusion and exclusion criteria, extracted the relevant data and performed Meta-analysis using RevMan 5.4 software. RESULTS: A total of 13 studies involving 1046 patients were included. Meta-analysis showed that acupuncture was more effective in improving pittsburgh sleep quality index (mean difference [MD] = -3.49, 95% CI: -5.09 to -1.89, I2 = 96%, P < .00001), sleep efficiency (MD = 5.03, 95% CI: 1.02-9.04, I2 = 51%, P = .15) and Hamilton depression scale (MD = -3.25, 95% CI: -4.14 to -2.36, I2 = 0%, P = .40) were better. Acupuncture had a nonsignificant advantage in improving norepinephrine (MD = -0.04, 95% CI: -0.12 to -0.04, I2 = 5%, P = .31). CONCLUSION: Compared with conventional medications, acupuncture had significant advantages in improving pittsburgh sleep quality index, Hamilton depression scale, and sleep efficiency, but no significant advantage in improving norepinephrine in patients with poststroke insomnia.

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