| Objective: Using the method of network Meta-analysis,the direct comparison and indirect comparison of different mind-body therapies(Baduanjin,Tai Chi,mindfulness therapy,yoga and music therapy)to improve chronic insomnia outcome indicators were comprehensively evaluated,analyzed and ranked by probability,aiming to explore the best mind-body therapy for chronic insomnia under different outcome indicators,so as to provide evidence-based medical basis for clinical nursing staff.Methods: By searching a total of 9 databases in Chinese and English: Databases including CNKI,WANFANG,VIP,BMdisc,Cochran Library,Embase,Web of science,Pub Med,Proquest,etc.The search time was from the establishment of the database to September 30,2022.Five randomized controlled trials(RCTS)of different mind-body therapies(Baduanjin,Tai Chi,mindfulness therapy,yoga and music therapy)for chronic insomnia were included.Revman 5.3 software was used to evaluate the quality of the included literature,and STATA 14.0 software was used for data analysis.Results: A total of 26 RCTS involving 2111 patients with chronic insomnia were included.A total of 25 studies were included in the primary outcome index.Among the secondary outcome indicators,10 studies were Sleep quality(SQ)score,11 studies were Sleep latency(SL)score,and 11 studies were Sleep duration(S-DU)score.Sleep efficacy(SE,n = 12),Sleep disturbances(S-DI,n = 12)and Sleep of daytime dysfunction(S-DD,n= 12)scores were used in the meta-analysis.The ranking of network meta-analysis results was expressed by the SUCRA value(area under the cumulative probability curve).The higher the SUCRA value,the better the efficacy,and vice versa.In the evaluation of the total score of PSQI,the order from high to low was mindfulness therapy(94.2),Baduanjin(76.6),music therapy(57.2),Tai chi(54.5),yoga(50.2),usual care(16.2)and waiting group(1.1).In the 6 dimensions of secondary PSQI,the SQ probability ranking from high to low was mindfulness therapy(80.9),Baduanjing(73.7),music therapy(67.6),Tai chi(42.4),yoga(40),waiting group(32.7)and usual care(12.7).The order of SL probability from high to low was mindfulness therapy(87.1),Baduanjin(77.9),yoga(58.1),music therapy(47.4),Tai Chi(38.3),waiting group(31.9)and usual care(9.3).In terms of S-DU,the ranking from high to low was mindfulness therapy(81.8),yoga(58.6),Baduanjin(55.5),Tai Chi(51.6),music therapy(36.6),waiting group(41.9)and usual care(24.1).The SE probability ranking from high to low was mindfulness therapy(93.5),Baduanjin(83.1),music therapy(63.5),yoga(31.5),Tai chi(30.8),waiting group(24.6)and usual care(23.1).The S-DI probability ranking from high to low was mindfulness therapy(90.7),yoga(78),Baduanjin(54.4),waiting group(44.9),usual care(43.3),Tai Chi(20.2),and music therapy(18.6).The S-DD probability ranking from high to low was mindfulness therapy(91.2),Baduan 锦(68.1),yoga(57.1),music therapy(38.7),usual care(37.2),Tai Chi(34)and waiting group(23.8).Conclusion: Based on mesh meta-analysis,Baduanjin,tai chi,mindfulness therapy,yoga and music therapy were all effective in improving chronic insomnia symptoms.In terms of probability ranking,mindfulness therapy showed the best effect in reducing PSQI total score,improving sleep quality,shortening sleep time,increasing sleep duration,improving sleep efficiency,and reducing sleep disorders and daytime dysfunction.Baduanjin was inferior to mindfulness therapy in reducing PSQI total score,improving sleep quality,shortening sleep time,improving sleep efficiency and reducing daytime dysfunction.Yoga is second to mindfulness therapy in terms of increasing sleep duration and reducing sleep disorders.Tai Chi and music therapy were in the middle of the spectrum in improving insomnia symptoms. |
