Efficacy And Safety Of Acupuncture Therapies For Depressive Insomnia:A Systematic Review And Network Meta-analysis

Objective:To evaluate the effectiveness and safety of acupuncture in the treatment of depressive insomnia using Systematic review and Network Meta-analysis.Methods:The system searches PubMed、Embase、Cochrane Library、CBM、Wed of science、CNKI、VIP、Wan Fang databases,with a search time frame of build to S eptember 2022.Double independent literature screening,data extraction,reportage and methodological quality evaluation.Review Manager 5.3,R4.0.3 and STATA15.0 software was used for data analysis.Results:A total of 42 studies were included,with a total of 3143 patients with depressive insomnia,involving 14 intervention measures.Among them,28 studies report ed overall effectiveness,35 studies reported overall PSQI scores and 28 studies reported overall HAMD scores.In the CONSORT statement,items with a reporting rate of>50%(13)accounted for 35.14%of all items,and items with a reporting rate of<10%(9)accounted for 24.32%of all items.In the STRICTAlist,items with a reporting rate of>50%(12)account for 70.59%of all items,and items with a reporting rate of<10%(2)account for 11.76%of all items.In the methodological quality assessment,36 studies had an uncertain risk of bias and 6 studies had a potentially high risk of bias.Network Meta-analysis showed that in terms of improving the overall efficiency,the top 3 interventions are likely to be>warm acupuncture+auricular acupressure>acupuncture+fire acupuncture>electroacupuncture;in terms of reducing the overall PSQI score,the top 3 interventions are likely to be electroacupuncture+auricular acupressure>auricular acupressure+western medicine>acupuncture+fire acupuncture;in terms of reducing the overall HAMD score,the top 3 interventions are likely to be warm acupuncture+auricular acupressure>acupuncture+auricular acupressure>acupuncture+acupuncture cuppingConclusion:1.Compared with the simple application of acupuncture and moxibustion and western medicine,the combination of acupuncture and moxibustion and moxibustion has more advantages.2.Warming acupuncture and moxibustion+auricular plaster therapy may be the best treatment for depressive insomnia.3.Compared with western medicine,acupuncture and moxibustion and its combination therapy are safer.