Banxia Shumi decoction for the treatment of insomnia: A systematic review and meta-analysis

The efficacy of Banxia Shumi decoction (BSD) and its combination with Chinese medicine (acupuncture, formulas, etc) in treating insomnia remains controversial, with varying research conclusions. This study presents a systematic review and meta-analysis of its impact on insomnia.

We conducted a comprehensive search of databases, including PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. Studies meeting the criteria for the insomnia population, intervention, comparison, and outcome were independently screened and data extracted. Fixed- or random-effects models were used to calculate the standardized mean difference and 95% confidence interval (CI). Publication bias and research quality were evaluated to ensure reliability.

BSD was effective in treating method, as shown by improvements in clinical effective rate (risk ratio = 1.16, 95% CI: 1.10-1.23), Pittsburgh Sleep Quality Index (mean standard deviation [MD] = -3.22, 95% CI: -4.41 to - 2.03), Insomnia Severity Index (MD = -5.52, 95% CI: -6.29 to - 4.74), and Athens Insomnia Scale (MD = -1.62, 95% CI: -2.18 to - 1.06) were analyzed. According to the indicators, it has shown good effects in improving the symptoms of patients with insomnia. Compared to Western Medicine, the clinical efficacy of BSD + TCM (MD = 0.16, 95% CI: 0.08-0.24) was more significant than that of BSD alone. For primary insomnia, BSD was more effective (MD=-6.27, 95% CI: -6.43 to - 6.11, P < .0001).

Based on the clinical efficiency index, BSD can effectively improve sleep and quality of life in patients with insomnia, shorten sleep onset time, increase sleep time and efficiency, and alleviate sleep and daytime dysfunction. However, the results should be considered carefully owing to some methodological weaknesses, including study diversity. Future research should employ standardized methods in large-scale, multicenter, randomized controlled trials to confirm these findings.