BackgroundCoronary heart disease（CHD） with insomnia can be called a "psycho-cardiological disease", and the persistent existence of insomnia can induce the onset of CHD or aggravate the development of the condition. In recent years, there have been continuous reports on TCM treatment of CHD with insomnia, but the sample size is small and the relevant evidence-based evaluation is insufficient. ObjectiveTo systematically review the efficacy of Chinese medicine therapies and sedative hypnotic drugs on insomnia associated with CHD. MethodsDatabases including CNKI, CBM, Wanfang Data Knowledge Service Platform, VIP, PubMed, Web of Science, EMBase and Cochrane Library were searched from inception to September 2018 for randomized controlled trials （RCT） about insomnia associated with CHD treated with TCM therapies. RCT screening and enrollment, data extraction, and quality assessment were performed by two researchers independently. Meta-analysis was performed with Rev Man 5.3, Stata 15.1 and ADDIS （V.1.16.8）. ResultsA total of 21 studies with 2496 patients were included, involving 11 interventions（including 9 kinds of TCM therapies）. Traditional meta-analysis found that either Chinese patent medicine plus routine treatment or compound Chinese medicine plus routine treatment was associated with better efficacy compared sedative hypnotic drugs plus routine treatment（P<0.05）. Network meta-analysis demonstrated that for treating insomnia associated with CHD, massage plus five-tone therapy and routine treatment, Chinese patent medicine plus routine treatment, compound Chinese medicine plus routine treatment, and compound Chinese medicine plus massage, five-tone therapy and routine treatment had better efficacy than sedative hypnotic drugs plus routine treatment（P<0.05）. Moreover, the efficacy of routine treatment was inferior to that of moxibustion with moxa plus routine treatment, baduanjin plus massage and routine treatment, massage plus five-tone therapy and routine treatment, finger-pressure therapy plus routine treatment, Chinese patent medicine plus routine treatment, compound Chinese medicine plus routine treatment, compound Chinese medicine plus massage, five-tone therapy and routine treatment（P<0.05）. Of all the interventions, compound Chinese medicine plus massage, five-tone therapy and routine treatment showed best efficacy, while sedative hypnotic drugs plus routine treatment ranked 10th, only superior to routine treatment alone. ConclusionAvailable evidence shows that Chinese medicine therapies have certain effects on insomnia associated with CHD, and the regimen of compound Chinese medicine plus massage, five-tone therapy and routine treatment may be an optimal selection. However, due to limited number and quality of included studies, this conclusion needs to be confirmed by more high-quality multicenter RCT with larger sample sizes.
Original Publcation Date of Chinese Version
Zheng, Yawei; Wu, Lifei; Zhang, Xingxing; Gu, Dongmei; Zhang, Siqi; Liu, Ming; and Fang, Zhuyuan
"Efficacy of Chinese Medicine Therapies on Insomnia Associated with Coronary Heart Disease：a Network Meta-analysis,"
General Practice in China: Vol. 1:
1, Article 12.
Available at: https://gpc.researchcommons.org/journal/vol1/iss1/12