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Comparative effectiveness of traditional Chinese medicine treatment strategies for insomnia: a systematic review and network meta-analysis

اثربخشی مقایسه‌ای راهبردهای درمانی طب سنتی چینی برای بی‌خوابی: مرور نظام‌مند و فراتحلیل شبکه‌ای

Yan Liu, Xiuying Wang, Yaqin Zhang, Yanfang Li, Yini Huang

Frontiers in Neurology 2026 Vol. 17
https://doi.org/10.3389/fneur.2026.1912776

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چکیده

Objective Insomnia causes daytime impairment and reduced quality of life. We evaluated the comparative efficacy and safety of Traditional Chinese Medicine (TCM) treatment strategies for insomnia. Methods Nine databases (PubMed, Embase, Web of Science, Cochrane CENTRAL, ClinicalTrials.gov , CNKI, Wanfang, VIP, SinoMed) were searched through January 2026 for randomized controlled trials (RCTs). Primary outcomes were ISI and PSQI scores; secondary outcomes included clinical efficacy and adverse events (AEs). Data were synthesized using frequentist network meta-analysis. Results Twelve RCTs involving 1,260 participants were included, evaluating five strategy nodes: TCM alone, TCM plus Western medicine (WM), WM alone, placebo, and CBT-I. For ISI, TCM plus WM ranked highest (SUCRA 89.7%) and significantly improved scores versus placebo (OR 2.84, 95% CI 1.42–5.68) and WM (OR 1.96, 95% CI 1.08–3.56). For PSQI, TCM plus WM showed the highest probability of improvement (SUCRA 71.9%) with greater reduction versus placebo (MD −2.31, 95% CI −3.65 to −0.97). For clinical efficacy, SUCRA values were 86.6% for TCM plus WM, 77.2% for TCM, 20.9% for WM, and 15.3% for placebo. For AEs (higher SUCRA indicating better safety), SUCRA values were 94.8% for WM, 43.9% for TCM plus WM, 31.1% for placebo, and 30.2% for TCM. Sensitivity analysis excluding secondary insomnia confirmed robust findings. Conclusion Integrated TCM-WM and TCM therapies demonstrate clinical efficacy and acceptable safety for insomnia management. Systematic review registration The review protocol was prospectively registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (Registration number: INPLASY202680041; DOI: 10.37766/inplasy2026.8.0041 ).

چکیده به فارسی

هدف: بی‌خوابی موجب اختلال در عملکرد روزانه و کاهش کیفیت زندگی می‌شود. ما اثربخشی و ایمنی نسبی راهبردهای درمانی طب سنتی چینی (TCM) را برای بی‌خوابی ارزیابی کردیم. روش‌ها: نه پایگاه داده (PubMed، Embase، Web of Science، Cochrane CENTRAL، ClinicalTrials.gov، CNKI، Wanfang، VIP، SinoMed) تا ژانویه ۲۰۲۶ برای کارآزمایی‌های تصادفی‌سازی‌شده کنترل‌شده (RCT) جست‌وجو شدند. پیامدهای اولیه، نمرات ISI و PSQI بودند؛ پیامدهای ثانویه شامل اثربخشی بالینی و عوارض جانبی (AEs) بود. داده‌ها با استفاده از فراتحلیل شبکه‌ای فریکوئنسیستی ترکیب شدند. نتایج: دوازده RCT با مشارکت ۱۲۶۰ نفر وارد مطالعه شدند که پنج گره راهبردی را ارزیابی کردند: TCM به‌تنهایی، TCM به‌علاوه داروی غربی (WM)، WM به‌تنهایی، دارونما و درمان شناختی-رفتاری برای بی‌خوابی (CBT-I). برای ISI، TCM به‌علاوه WM بالاترین رتبه را داشت (SUCRA ۸۹.۷٪) و به طور معناداری نسبت به دارونما (OR ۲.۸۴، ۹۵٪ CI ۱.۴۲–۵.۶۸) و WM (OR ۱.۹۶، ۹۵٪ CI ۱.۰۸–۳.۵۶) نمرات را بهبود داد. برای PSQI، TCM به‌علاوه WM بالاترین احتمال بهبود را نشان داد (SUCRA ۷۱.۹٪) با کاهش بیشتر نسبت به دارونما (MD ‎−۲.۳۱، ۹۵٪ CI ‎−۳.۶۵ تا ‎−۰.۹۷). برای اثربخشی بالینی، مقادیر SUCRA به ترتیب ۸۶.۶٪ برای TCM به‌علاوه WM، ۷۷.۲٪ برای TCM، ۲۰.۹٪ برای WM و ۱۵.۳٪ برای دارونما بود. برای عوارض جانبی (SUCRA بالاتر نشان‌دهنده ایمنی بیشتر)، مقادیر SUCRA به ترتیب ۹۴.۸٪ برای WM، ۴۳.۹٪ برای TCM به‌علاوه WM، ۳۱.۱٪ برای دارونما و ۳۰.۲٪ برای TCM بود. تحلیل حساسیت با حذف بی‌خوابی ثانویه، یافته‌های قوی را تأیید کرد. نتیجه‌گیری: درمان‌های ترکیبی TCM-WM و TCM اثربخشی بالینی و ایمنی قابل قبولی برای مدیریت بی‌خوابی نشان می‌دهند. ثبت مرور نظام‌مند: پروتکل این مرور به طور پیش‌نگر در پلتفرم بین‌المللی ثبت پروتکل‌های مرور نظام‌مند و فراتحلیل (INPLASY) ثبت شده است (شماره ثبت: INPLASY202680041؛ DOI: 10.37766/inplasy2026.8.0041).

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موضوع‌ها و کلیدواژه‌ها

درمانشناختمدیریتAdverse effectAlternative medicineclinical trialsMEDLINEفراتحلیلPlaceboکارآزمایی تصادفی‌شده‌ی کنترل‌شدهTraditional Chinese medicine

ارجاع

Liu, Y., Wang, X., Zhang, Y., Li, Y., & Huang, Y. (2026). Comparative effectiveness of traditional Chinese medicine treatment strategies for insomnia: a systematic review and network meta-analysis. Frontiers in Neurology, 17. https://doi.org/10.3389/fneur.2026.1912776

(Liu et al., 2026)

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  1. با احترام و بدون توهین، تحقیر، برچسب‌زنی یا حمله‌ی شخصی با دیگران گفتگو کنید.
  2. از نوشتن هرگونه اطلاعات هویتی یا قابل‌شناسایی مراجعان، بیماران یا اشخاص ثالث، از جمله نام، شماره‌ی تماس، تصویر، نشانی، محل کار یا جزئیات منحصربه‌فرد پرونده خودداری کنید.
  3. اگر درباره‌ی یک تجربه‌ی بالینی سؤال می‌کنید، اطلاعات را تا حد ممکن بی‌نام و کلی بیان کنید تا امکان شناسایی فرد وجود نداشته باشد.
  4. این بخش برای یادگیری و گفت‌وگوی علمی است و جایگزین ارزیابی، تشخیص، مشاوره یا روان‌درمانی شخصی نیست.
  5. در شرایط بحران یا خطر آسیب به خود یا دیگران، به این بخش اتکا نکنید و برای دریافت کمک فوری با اورژانس اجتماعی ۱۲۳ یا صدای مشاور بهزیستی ۱۴۸۰ تماس بگیرید.
  6. انتشار تبلیغات، معرفی خدمات شخصی، شماره‌ی تلفن، شناسه‌ی شبکه‌های اجتماعی، پیوند تبلیغاتی یا درخواست جذب مراجع در این بخش مجاز نیست.
  7. در بیان ادعاهای علمی، به‌ویژه درباره‌ی اثربخشی درمان‌ها، تشخیص یا یافته‌های پژوهشی، تا حد امکان نام منبع معتبر، مقاله یا راهنمای علمی را ذکر کنید.
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  9. پاسخ‌هایی که کارشناسان فکر بنیان می‌دهند با برچسب «پاسخ فکر بنیان» یا «کارشناس فکر بنیان» نمایش داده می‌شوند و سایر نوشته‌ها بیانگر نظر کاربران هستند.
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Awareness of Youth-Friendly Sexual and Reproductive Health Services among Undergraduate Students at Saint Augustine University of Tanzania, Mwanza, Tanzania: A Cross-Sectional Study

Frank Deus Samson; Paskas Wagana; Johnson Mavole International journal of social sciences and humanities review, 2026

چکیده

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