A systematic review with meta-analysis: Traditional Chinese tuina therapy for insomnia

Zheng Wang; Hui Xu; Hang Zhou; Yang Lei; Lulu Yang; Juan Guo; Yuxia Wang; Yunfeng Zhou

doi:10.3389/fnins.2022.1096003

A systematic review with meta-analysis: Traditional Chinese tuina therapy for insomnia

Front Neurosci. 2023 Jan 25:16:1096003. doi: 10.3389/fnins.2022.1096003. eCollection 2022.

Authors

Zheng Wang¹, Hui Xu^{1

2}, Hang Zhou¹, Yang Lei¹, Lulu Yang¹, Juan Guo¹, Yuxia Wang³, Yunfeng Zhou¹

Affiliations

¹ College of Acupuncture and Massage, Henan University of Chinese Medicine, Zhengzhou, China.
² Tuina Department, The Third Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
³ The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China.

Abstract

Background: With changes in the way of life and work, an increasing number of people are suffering from insomnia. In China, a traditional Chinese medicine method tuina is widely used for the treatment of insomnia. However, the evidence for tuina therapy for insomnia remains controversial. Therefore, this systematic review aimed to evaluate the effect of tuina therapy on the symptoms of patients with primary insomnia.

Methods: From establishment to January 2022, a comprehensive literature search was conducted using seven electronic databases to identify randomized controlled trials of tuina therapy for insomnia. We used RevMan 5.4 software and the GRADEpro Guideline Development Tool to evaluate the quality of the included randomized controlled trials and perform the meta-analysis. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Subgroup analysis was performed according to the different intervention methods. The I2 statistic was used to assess the heterogeneity.

Results: Eighteen studies conducted from 2011 to 2021 were included, with a total of 1,471 patients. In terms of efficacy, tuina alone was superior to other treatments [odds ratio (OR), 3.46; 95% confidence interval (CI), 2.15, 5.55; P < 0.00001]; tuina combined with other treatments (acupuncture, scraping, auricular acupuncture, Suanzaoren decoction, estazolam) was more effective than other single therapies (OR, 3.99; 95% CI, 2.84, 5.61; P < 0.00001). In terms of Pittsburgh Sleep Quality Scale score, the improvement in insomnia patients by tuina alone was better than that of other treatments [standardized mean difference (SMD), -2.57; 95% CI, -2.98, -2.17; P < 0.00001], and tuina combined with other treatments (acupuncture, scraping, auricular point pressing, Suanzaoren decoction, estazolam) was better than other single therapies (SMD, -2.83; 95% CI, -2.98, -2.68; P < 0.00001).

Conclusion: This meta-analysis revealed that tuina can significantly improve the clinical efficacy and sleep quality of patients with primary insomnia. This study provides a theoretical basis and treatment guidance for patients with primary insomnia.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022355742.

Keywords: Pittsburgh Sleep Quality Scale; effective rate; insomnia; meta-analysis; randomized controlled trial; tuina.

Publication types

Systematic Review

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 8187151703), the Central Plains Thousand Talents Program-Central Plains Famous Doctors (No. ZYQR201912120), the Henan Science and Technology R&D Program Joint Fund (Cultivation of Superior Disciplines) Cultivation Project the (No. 222301420061), Special Project of Henan Province for Scientific Research on Traditional Chinese Medicine (No. 2022ZY1108), Henan Province Science and Technology Tackling Program Project (No. 222102310214), and Key Scientific and Technological Projects of Henan Provincial Department of Science and Technology (No. 192102310426).