睡眠障害に対する耳介圧点の有効性：システマティックレビューおよびメタアナリシス

Insomnia affects the quality of life of a significant number of individuals worldwide. Despite the fact that pharmaceutical sleep treatments have shown brief enhancements in sleep quality, these are still not recommended for the long-term management of sleep issues. To deal with this problem, our study aims to assess the effectiveness of auricular acupressure for treating insomnia by conducting a systematic review and meta-analysis.

Data from randomized controlled trials (RCTs) of auricular acupressure for insomnia was collected from five English-language databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, and CINAHL) and four Chinese databases (CBM, CNKI, CQVIP, and Wanfang). Relevant data were extracted by two reviewers. I ² statistics were adopted to appraise heterogeneity. A network meta-analysis was applied to compare the effect of auricular acupressure with other methods.

In all, 23 RCTs involving a total of 1,689 patients were included. The results demonstrated a significant decrease in the Pittsburgh Sleep Quality Index (PSQI) score for the intervention group compared to the control group [SMD = -1.30, 95% CI (-1.65, -0.96), I ² = 90%]. Furthermore, the group receiving auricular acupressure in addition to usual care showed a lower PSQI score compared to the usual care group [SMD = -1.13, 95% CI (-1.33, -0.93), I ² = 23%]. Auricular acupressure was found to enhance the effectiveness of estazolam in improving PSQI score, with the combination of auricular acupressure and estazolam resulting in a lower PSQI score [MD = -4.8, 95% CI (-7.4, -2.1)]. Importantly, no serious adverse events were reported. In patients with insomnia following stroke, the intervention group (which received auricular acupressure) exhibited a lower PSQI score compared to the control group [SMD = -0.74, 95% CI (-1.03, -0.46), I ² = 0%]. Similarly, in patients with insomnia related to cancer, the intervention group (receiving auricular acupressure) demonstrated a lower PSQI score compared to the control group [SMD = -0.99, 95% CI (-1.37, -0.61), I ² = 0%].

The effects of auricular acupressure on insomnia are comparable to those of estazolam. Furthermore, auricular acupressure can serve as a complementary treatment to estazolam or other interventions, effectively improving symptoms of insomnia.