Data Sheet 2_Efficacy of multiple acupoint stimulation therapies for primary insomnia patients: a systematic review and network meta-analysis.pdf

BackgroundPrimary insomnia (PI) is a chronic sleep disorder with a complex pathogenesis, and various treatment options are available. In recent years, multiple acupoint stimulation therapies have gained increasing attention as non-pharmacological interventions. This systematic review and network meta-analysis aimed to assess the comparative efficacy of different acupoint stimulation therapies for PI.
MethodsWe searched eight Chinese and English databases and six trial registries from inception to September 22, 2024. Outcomes included total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI) with its six subcomponents, and the change in PSQI scores (ΔPSQI) from baseline to post-treatment. A random-effects model was used for the network meta-analysis. Risk of bias and certainty of evidence were assessed using the ROB2 tool and CINeMA framework. The PROSPERO registration number is CRD42025640547.
ResultsA total of 95 RCTs involving 7,628 patients were included, comparing 14 acupoint stimulation therapies and involving 108 major acupoints. Body acupuncture combined with electroacupuncture ranked highest in improving the TER (SUCRA: 0.874), while moxibustion combined with tuina was most effective in reducing the total PSQI score (0.966). Moxibustion alone demonstrated the greatest improvement in the PSQI score difference (0.933). Electroacupuncture combined with auricular acupressure showed superior effectiveness in improving all six PSQI subcomponents. The most frequently used acupuncture points were Shenmen (HT 7, 62.1%), Baihui (GV 20, 56.3%), and Anmian (EX-HN 22, 45.8%), while the most commonly used ear points included Shenmen (TF4, 17.4%), Xin (CO15, 14.2%), and Pizhixia (AT4, 11.1%). Cluster analysis identified eight prevalent patterns of point compatibility.
ConclusionsThe tolerability and long-term efficacy of different acupoint stimulation therapies for primary insomnia remain unclear. These findings support individualized treatment and acupoint compatibility, laying the groundwork for optimizing intervention protocols and exploring neuroimmune mechanisms.
Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42025640547, identifier CRD42025640547.

背景：原发性失眠（Primary Insomnia, PI）是一种发病机制复杂的慢性睡眠障碍，临床可供选择的治疗方案多样。近年来，多种穴位刺激疗法作为非药物干预手段受到日益广泛的关注。本系统评价与网状meta分析旨在评估不同穴位刺激疗法治疗原发性失眠的相对疗效。
方法：本研究检索了建库至2024年9月22日的8个中英文数据库及6个试验注册库。结局指标包括总有效率（Total Effective Rate, TER）、匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index, PSQI）及其6个维度，以及基线至治疗后PSQI评分变化量（ΔPSQI）。采用随机效应模型开展网状meta分析，使用ROB2工具与CINeMA框架评估偏倚风险与证据确定性。本研究的PROSPERO注册编号为CRD42025640547。
结果：最终纳入95项随机对照试验（Randomized Controlled Trial, RCT），共涉及7628例患者，比较了14种穴位刺激疗法，涉及108个主要穴位。体针联合电针在提升总有效率方面排名最高（SUCRA：0.874），艾灸联合推拿在降低PSQI总分方面效果最优（SUCRA：0.966）。单纯艾灸在改善PSQI评分差值方面效果最为显著（SUCRA：0.933）。耳穴压豆联合电针在改善PSQI全部6个维度方面表现更优。最常用的针灸穴位为神门（HT 7，62.1%）、百会（GV 20，56.3%）与安眠穴（EX-HN 22，45.8%）；最常用的耳穴包括神门（TF4，17.4%）、心（CO15，14.2%）与皮质下（AT4，11.1%）。聚类分析识别出8种主流的穴位配伍模式。
结论：目前不同穴位刺激疗法治疗原发性失眠的耐受性与长期疗效仍不明确。本研究结果支持个体化治疗与穴位配伍方案，为优化临床干预流程及探索神经免疫机制奠定了基础。
系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42025640547，标识符为CRD42025640547。