[논문]불면 장애에 대한 약침술 치료법 제안을 위한 체계적 문헌 고찰과 메타 분석 연구

조민우; 임정화; 김보경

doi:10.7231/jon.2021.32.3.185

불면 장애에 대한 약침술 치료법 제안을 위한 체계적 문헌 고찰과 메타 분석 연구
A Systematic Review and Meta-Analysis of Pharmacopuncture Treatment for Insomnia Disorder 원문보기

동의신경정신과학회지 = Journal of oriental neuropsychiatry, v.32 no.3, 2021년, pp.185 - 206

조민우 (부산대학교 한의학전문대학원 한의학과) , 임정화 (부산대학교 한의학전문대학원 신경정신과, 부산대학교 한방병원) , 김보경 (부산대학교 한의학전문대학원 신경정신과, 부산대학교 한방병원)

Abstract ▼ AI-Helper

Objectives: The objective of this study was to perform a systematic review and meta-analysis of pharmacopuncture treatment for insomnia disorder to derive clinical evidence and recommendation grades. Methods: Studies that verified effects of pharmacopuncture on primary insomnia were included. Characteristics and quality of included studies were assessed using Risk of Bias (RoB). Results: A total of 25 studies were selected. Pittsburgh Sleep Quality Index (PSQI) and effective rate were primarily used for outcome measurement. Vitamin B12 was the most used pharmacopuncture material. The most frequently used acupuncture point was Anmian (Ex-HN). The volume of the acupuncture solution ranged from 0.25 mL to 2 mL. Acupuncture treatment depth was 0.5 cm to 2 cm. In three studies, the procedure was performed at 16:00. Meta-analysis of studies revealed that the effective rate of the pharmacopuncture group was significantly higher than the group using sleeping pills group (RR: 1.21, 95% CI: 1.01 to 1.45, p=0.04, I2=69%). PSQI was decreased in the intervention group (MD=-2.19, 95% CI: -2.90 to -1.48, p<0.00001, I2=0%). Effective rates of pharmacopuncture and acupuncture groups were higher than that of the acupuncture group (RR: 1.11, 95% CI: 1.05 to 1.17, p=0.0002, I2=0%). PSQI was decreased in the intervention group (MD=-1.87, 95% CI: -2.36 to -1.38, p<0.00001, I2=0%). Although the effectiveness rate of the pharmacopuncture group was not significantly higher than that of the acupuncture group (RR: 1.12, 95% CI: 0.98 to 1.27, p=0.1, I2=9%), the PSQI was decreased in the pharmacopuncture group (MD=-2.10, 05% CI: -3.29 to -0.91, p=0.0005, I2=34%). The quality of clinical studies was poor. Conclusions: Based on results of this study, it is proper to use 0.5 to 2 mL of pharmacopuncture solution such as Danshen and Ciwujia with a depth of 0.5 to 2 cm at around 4 p.m. to treat insomnia disorder, focusing on Anmian (Ex-HN) and Sameumgyo (SP6).

주제어

표/그림 (18)

그림 Fig. 1. Flow chart of the selection process of study.
표 Table 1. Characteristics of Included Randomized Control Trials
표 Table 1. Continued 1
표 Table 1. Continued 2
표 Table 1. Continued 3
표 Table 2. The frequency of pharmacopuncture material
표 Table 3. Analysis of Pharmacopuncture Treatment
그림 Fig. 2. Risk of Bias graph.
그림 Fig. 3. Risk of Bias summary.
그림 Fig. 4. Forest plot of comparison: 1 Pharmacopuncture vs Sleeping pill, outcome: effective rate. CI: confidential interval.
그림 Fig. 5. Forest plot of comparison: 1 Pharmacopuncture vs Sleeping pill, outcome: PSQI. CI: confidential interval.
그림 Fig. 6. Forest plot of comparison: 2 Pharmacopuncture+Acupuncture vs Acupuncture, outcome: effective rate. CI: confidential interval.
그림 Fig. 7. Forest plot of comparison: 2 Pharmacopuncture+Acupuncture vs Acupuncture, outcome: PSQI. CI: confidential interval.
그림 Fig. 8. Forest plot of comparison: 3 Pharmacopuncture vs Acupuncture, outcome: effective rate. CI: confidential interval.
그림 Fig. 9. Forest plot of comparison: 3 Pharmacopuncture vs Acupuncture, outcome: PSQI. CI: confidential interval.
표 Table 4. Summary of Findings Table (Pharmacopuncture vs Sleeping pill)
표 Table 5. Summary of Findings Table (Pharmacopuncture+Acupuncture vs Acupuncture)
표 Table 6. Summary of Findings Table (Pharmacopuncture vs Acupuncture)

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