| Objective:To systematically evaluate the clinical efficacy of soothing liver and stomach in the treatment of insomnia,and to analyze the improvement of sleep and the occurrence of adverse reactions after treatment,so as to provide the basis for the clinical application of this method.Methods:Using computer comprehensive retrieval of foreign language database:HighWire Press,PubMed,Behavioral and Brain Sciences,MEDLINE,Cochrance library registration database;search Chinese database:Weipu database,China knowledge network,Wanfang database,Chinese biomedical literature database.Chinese search words:insomnia,soothing liver and stomach,random control,Meta analysis,liver and stomach disharmony.English key words:insomina,sooting liver and Harmonizing stomach,randomization controlled trial,Meta analysis,liver-stomach disharmon.Based on the literature of randomized controlled clinical trials published at home and abroad from January 1999 to January 2019 on the treatment of insomnia by soothing the liver and stomach,the results of this study were analyzed by Meta with Revman 5.3 software.Results:1 The results of literature retrievalA total of 15 domestic literatures that met the inclusion criteria were searched,and the foreign documents that met the inclusion criteria were not included.A total of 1337 patients with insomnia were included,including 688patients in the treatment group(soothing liver and stomach traditional Chinese medicine).649 patients in the control group(western medicine for insomnia drugs).Among them,the effective rate was 15,the cure rate was 5,the PSQI score was 3,the sleep time was 3,the daytime function was 3,and the adverse reaction was 5.2 Meta analysis results2.1 In the aspect of efficiency:the heterogeneity test results P=0.87,I~2=0%,indicating that the data of this study are homogeneous data,so the fixed effect model is used for analysis.Combined effect dose OR combined with 3.31,95%CI=[2.21,4.94],combined effect test:Z=5.83,P<0.00001.The results showed that there was significant difference between soothing liver and stomach in the treatment of insomnia and western medicine control group.The treatment group was better than the control group.Funnel diagram is basically inverted leaky bucket.2.2 In cure rate:heterogeneity test results:P=0.87,I~2=0%,indicating that the data of this study are homogeneous data,so the fixed effect model is used for analysis.Combined effect dose OR combined with 2.20,95%CI=[1.33,3.64],combined effect test:Z=3.07,P=0.002.The results showed that there was significant difference between the cure rate of insomnia treated by soothing liver and stomach and that of western medicine control group.The treatment group was better than the control group.The funnel diagram was basically inverted bucket.2.3 In terms of PSQI score:there was heterogeneity among the studies(P<0.0001,I~2=90%).(3)in terms of funnel score,there was heterogeneity among the studies(P<0.0001,I~2=90%),so the random effect model was selected and the effect dose SMD=-4.16,hypothesis test was Z=15.4,P<0.00001.The results showed that there was significant difference between the treatment of insomnia by soothing liver and stomach and that of western medicine control group.The treatment group was superior to the control group.2.4 In terms of the indicators of the PSQI score:the overall sleep time,sleep time and daytime function analysis of PSQI score after treatment showed that compared with the conventional western medicine group,There was significant difference in improving the overall sleep time of patients(WMD=-0.40,95%CI[-0.49,-0.31],P<0.0001),but in terms of sleep time(WMD=0.07,95%CI[-0.25,0.20],P=0.25)and daytime function(WMD=-0.09,95%CI[-0.02,0.04],P=0.18),There was no significant difference between the two methods.2.5 In the adverse reactions:the analysis of adverse reactions in 5 articles showed that the adverse reactions of soothing liver and stomach in the treatment of insomnia were less than those in the western medicine control group.3 The analysis results of the law of drug use3.1 Frequency of drug useThe general situation of drug use:the regularity of 15 prescriptions was analyzed.A total of 45 traditional Chinese medicines were used in 15prescriptions,with a total frequency of 145 times.The frequency of medication>7 times was Bupleurum chinense,Radix Paeoniae Rubra,Chen Pei,Glycyrrhiza uralensis Fisch,Coptis chinensis,Pinellia ternata,Bamboo Ru.3.2 sexual taste and frequency of drugsThe order of medium frequency from high to low was sweet>bitter>symplectic>acid>light>astringent>salty,and the order of middle frequency of four gases from high to low was flat>cold>temperature>heat>cool.The order of intermediate frequency of drugs from high to low was spleen>stomach>liver>heart>lung>gallbladder>kidney>large intestine>small intestine.Conclusion:1.The method of soothing the liver and stomach is effective in the treatment of insomnia,and the curative effect is better than that of the western medicine control group in terms of effective rate and cure rate.2.The PQSI score of insomnia treated by soothing liver and stomach was better than that of western medicine control group.3.Through the analysis of the overall sleep time,falling asleep time and daytime function of PSQI score after treatment,soothing the liver and stomach can improve the overall sleep time of the patients,but there is no difference in sleep time and daytime function between the treatment group and the western medicine control group.4.There were fewer adverse reactions in the treatment of insomnia by soothing the liver and stomach than those in the western medicine control group. |
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