非药物干预改善围绝经期失眠症状疗效的网状Meta分析

Background??The presence of insomnia symptoms reduces the quality of life of perimenopausal women and increases their risk of developing other diseases. Currentlythere are numerous non-pharmacological interventions available to improve perimenopausal insomnia symptomswith disagreement as to which intervention is most effective. Objective??To evaluate the efficacy of non-pharmacological interventions in improving perimenopausal insomnia symptoms using a network meta-analysis. Methods?In March 2022Cochrane LibraryPubMedEmBaseWeb of ScienceCNKIWanfang Data Knowledge Service PlatformVIP and CBM were searched for the randomized controlled trialsRCTson the improvement of perimenopausal insomnia symptoms by non-pharmacological interventions from inception to March 2022. Two investigators independently screened the literatureextracted dataand evaluated the risk of bias of the included literature using the RCT bias risk assessment tool recommended by the Cochrane Manual of Systematic Review 5.1.0. A Bayesian network meta-analysis was performed on the overall response rate to the improvement of perimenopausal insomnia symptomsas well as improvement in Pittsburgh Sleep Quality Index ScalePSQIscoreKupperman score and estradiolE2level under different non?pharmacological interventions by using R 4.1.3 software and the GeMTC package. Results?A total of 44 RCTs including 3386 patients were selectedinvolving 12 non-pharmacological interventionsmoxibustionelectroacupunctureacupoint pressing with beansscrapingfire dragon potthumbtack needlemassagewarm acupuncturebee acupunctureacupoint embeddingmusic therapyacupuncture. The results of meta-analysis showed that moxibustionelectroacupunctureand acupuncture were superior to sedative-hypnotic western drugs in overall response rate to the improvement of perimenopausal insomnia symptomsP<0.05and moxibustion was identified as the most probable superior intervention. Moxibustionelectroacupuncturescrapingand acupuncture were superior to sedative-hypnotic western drugsP<0.05moxibustion was more effective than warm acupunctureP0.05with scraping emerging and acupuncture as the most probable superior interventionrespectively. Conclusion ?Current evidence demonstrates that moxibustion is superior in overall response rate to the improvement of perimenopausal insomnia symptoms and PSQI score in perimenopausal womenwhile scraping is superior in improving Kupperman score and acupuncture has advantages in?improving E2 levelhoweverfurther validation of this conclusion is needed by conducting more high-quality studies.