OBJECTIVE To explore the efficacy of Jiaotai pill(JTW)and JTW modified prescriptions(JTW^(+))plus benzodiazepines(BDZ)for insomnia in China by systematic review and network meta-analysis,especially optimization ratio(...OBJECTIVE To explore the efficacy of Jiaotai pill(JTW)and JTW modified prescriptions(JTW^(+))plus benzodiazepines(BDZ)for insomnia in China by systematic review and network meta-analysis,especially optimization ratio(_(m:n))between Coptis chinensis and Cinnamo.METHODS Randomized controlled trials(RCTs)regarding JTW and JTW^(+)+BDZ for insomina were comprehensively searched in CNKI,VIP,Wanfang,and PubMed,Cochrane Library,OVID,Embase databases from their inception to December 2017.The risk of bias was assessed by the Cochrane collaboration′s tool and Jadad scale.Systematic review and network meta-analysis were performed to evaluate the relative risk(RR)plus 95%confidence interval(95%CI)or prediction interval(95%PrI),and draw surface under the cumulative ranking curves(SUCRA)by Stata 14.0 and RevMan 5.0 software.RESULTS A total of 13 RCTs(1 RCT was omitted by sensitivity analysis)with 1040 patients were included.Overall heterogeneity was acceptable,except publication bias.Based on classical meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(5:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ.Based on network meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ;meanwhile,SUCRA showed the best rank of JTW/JTW+(BDZ<JTW_(m:n)^(+)+BDZ<JTW)for insomina,as same as that of JTW_(m:n)+(BDZ<JTW_(5:1)^(+)+BDZ<JTW_(10:1)^(+)+BDZ<JTW_(2:1)^(+)+BDZ<JTW_(6:1)^(+)+BDZ).CONCLUSION Based on the existing clinical evidence,JTW has efficacy for insomnia,but the optimization ratio between Coptis chinensis and cinnamo of JTW_(m:n)^(+)+BDZ for insomnia needs more supports.展开更多
目的探讨失眠认知行为治疗(cognitive behavioral therapy for insomnia,CBT-I)对不同程度失眠障碍合并抑郁、焦虑患者的疗效。方法2020年7月至2023年1月,采用便利抽样法选取上海市精神卫生中心126例失眠障碍伴抑郁、焦虑症状的患者,分...目的探讨失眠认知行为治疗(cognitive behavioral therapy for insomnia,CBT-I)对不同程度失眠障碍合并抑郁、焦虑患者的疗效。方法2020年7月至2023年1月,采用便利抽样法选取上海市精神卫生中心126例失眠障碍伴抑郁、焦虑症状的患者,分为中度失眠组和重度失眠组,两组均接受8周的CBT-I治疗。分别在基线、2周、4周及8周时,使用匹兹堡睡眠指数量表(Pittsburgh sleep quality index,PSQI)、汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)以及睡眠信念和态度量表(dysfunctional beliefs and attitudes about sleep scale,DBAS-16)等进行评估。结果治疗后,中度组和重度组患者的PSQI[5.00(4.00,8.00)vs.7.48(7.00,10.25)]分、HAMD-17[6.00(2.00,6.44)vs.6.44(5.00,8.00)]分、HAMA[5.10(2.00,5.20)vs.5.20(3.00,7.25)]分;两组治疗效果差异无统计学意义(P=0.216)。中度组所有指标在2周末均明显改善(均P<0.05);重度组DBAS-16后果因子和药物因子在4周末明显改善(均P<0.05),且睡眠潜伏期和生活质量存在波动现象。结论CBT-I对失眠、抑郁和焦虑均有显著疗效,但不同失眠严重程度患者的失眠改善幅度存在差异。展开更多
基金National Science and Technology Major Project of China(SQ2017ZX090301064)National Natural Science Foundation of China(81302887)+1 种基金Shandong Science and Technology Development Program(2014GSF119034)and Shandong Science and Technology Development Program of Traditional Chinese Medicine(2017-115,2019-0222)。
文摘OBJECTIVE To explore the efficacy of Jiaotai pill(JTW)and JTW modified prescriptions(JTW^(+))plus benzodiazepines(BDZ)for insomnia in China by systematic review and network meta-analysis,especially optimization ratio(_(m:n))between Coptis chinensis and Cinnamo.METHODS Randomized controlled trials(RCTs)regarding JTW and JTW^(+)+BDZ for insomina were comprehensively searched in CNKI,VIP,Wanfang,and PubMed,Cochrane Library,OVID,Embase databases from their inception to December 2017.The risk of bias was assessed by the Cochrane collaboration′s tool and Jadad scale.Systematic review and network meta-analysis were performed to evaluate the relative risk(RR)plus 95%confidence interval(95%CI)or prediction interval(95%PrI),and draw surface under the cumulative ranking curves(SUCRA)by Stata 14.0 and RevMan 5.0 software.RESULTS A total of 13 RCTs(1 RCT was omitted by sensitivity analysis)with 1040 patients were included.Overall heterogeneity was acceptable,except publication bias.Based on classical meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(5:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ.Based on network meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ;meanwhile,SUCRA showed the best rank of JTW/JTW+(BDZ<JTW_(m:n)^(+)+BDZ<JTW)for insomina,as same as that of JTW_(m:n)+(BDZ<JTW_(5:1)^(+)+BDZ<JTW_(10:1)^(+)+BDZ<JTW_(2:1)^(+)+BDZ<JTW_(6:1)^(+)+BDZ).CONCLUSION Based on the existing clinical evidence,JTW has efficacy for insomnia,but the optimization ratio between Coptis chinensis and cinnamo of JTW_(m:n)^(+)+BDZ for insomnia needs more supports.
文摘目的探讨失眠认知行为治疗(cognitive behavioral therapy for insomnia,CBT-I)对不同程度失眠障碍合并抑郁、焦虑患者的疗效。方法2020年7月至2023年1月,采用便利抽样法选取上海市精神卫生中心126例失眠障碍伴抑郁、焦虑症状的患者,分为中度失眠组和重度失眠组,两组均接受8周的CBT-I治疗。分别在基线、2周、4周及8周时,使用匹兹堡睡眠指数量表(Pittsburgh sleep quality index,PSQI)、汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)以及睡眠信念和态度量表(dysfunctional beliefs and attitudes about sleep scale,DBAS-16)等进行评估。结果治疗后,中度组和重度组患者的PSQI[5.00(4.00,8.00)vs.7.48(7.00,10.25)]分、HAMD-17[6.00(2.00,6.44)vs.6.44(5.00,8.00)]分、HAMA[5.10(2.00,5.20)vs.5.20(3.00,7.25)]分;两组治疗效果差异无统计学意义(P=0.216)。中度组所有指标在2周末均明显改善(均P<0.05);重度组DBAS-16后果因子和药物因子在4周末明显改善(均P<0.05),且睡眠潜伏期和生活质量存在波动现象。结论CBT-I对失眠、抑郁和焦虑均有显著疗效,但不同失眠严重程度患者的失眠改善幅度存在差异。
