본문 바로가기
KERD
논문KCI 등재

불면 장애에 대한 약침술 치료법 제안을 위한 체계적 문헌 고찰과 메타 분석 연구

A Systematic Review and Meta-Analysis of Pharmacopuncture Treatment for Insomnia Disorder

김보경|임정화|조민우
대한한방신경정신과학회 (The Korean Society Of Oriental Neuropsychiatry)|2021.09|동의신경정신과학회지 (The Korean Society of Oriental Neuropsychiatry)|제32권 제3호|pp. 185-206|DOI 10.7231/jon.2021.32.3.185

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

Meta-analysisPharmacopunctureInsomnia disorderSystematic review.
주제분류한의학

초록

Objectives: The objective of this study was to perform a systematic review and meta-analysis of pharmacopuncture treatment for insomnia disorder to derive clinical evidence and recommendation grades. Methods: Studies that verified effects of pharmacopuncture on primary insomnia were included. Characteristics and quality of included studies were assessed using Risk of Bias (RoB). Results: A total of 25 studies were selected. Pittsburgh Sleep Quality Index (PSQI) and effective rate were primarily used for outcome measurement. Vitamin B12 was the most used pharmacopuncture material. The most frequently used acupuncture point was Anmian (Ex-HN). The volume of the acupuncture solution ranged from 0.25 mL to 2 mL. Acupuncture treatment depth was 0.5 cm to 2 cm. In three studies, the procedure was performed at 16:00. Meta-analysis of studies revealed that the effective rate of the pharmacopuncture group was significantly higher than the group using sleeping pills group (RR: 1.21, 95% CI: 1.01 to 1.45, p=0.04, I2=69%). PSQI was decreased in the intervention group (MD=-2.19, 95% CI: -2.90 to -1.48, p<0.00001, I2=0%). Effective rates of pharmacopuncture and acupuncture groups were higher than that of the acupuncture group (RR: 1.11, 95% CI: 1.05 to 1.17, p= 0.0002, I2=0%). PSQI was decreased in the intervention group (MD=-1.87, 95% CI: -2.36 to -1.38, p< 0.00001, I2=0%). Although the effectiveness rate of the pharmacopuncture group was not significantly higher than that of the acupuncture group (RR: 1.12, 95% CI: 0.98 to 1.27, p=0.1, I2=9%), the PSQI was decreased in the pharmacopuncture group (MD=-2.10, 05% CI: -3.29 to -0.91, p=0.0005, I2=34%). The quality of clinical studies was poor. Conclusions: Based on results of this study, it is proper to use 0.5 to 2 mL of pharmacopuncture solution such as Danshen and Ciwujia with a depth of 0.5 to 2 cm at around 4 p.m. to treat insomnia disorder, focusing on Anmian (Ex-HN) and Sameumgyo (SP6).

Abstract

Objectives: The objective of this study was to perform a systematic review and meta-analysis of pharmacopuncture treatment for insomnia disorder to derive clinical evidence and recommendation grades. Methods: Studies that verified effects of pharmacopuncture on primary insomnia were included. Characteristics and quality of included studies were assessed using Risk of Bias (RoB). Results: A total of 25 studies were selected. Pittsburgh Sleep Quality Index (PSQI) and effective rate were primarily used for outcome measurement. Vitamin B12 was the most used pharmacopuncture material. The most frequently used acupuncture point was Anmian (Ex-HN). The volume of the acupuncture solution ranged from 0.25 mL to 2 mL. Acupuncture treatment depth was 0.5 cm to 2 cm. In three studies, the procedure was performed at 16:00. Meta-analysis of studies revealed that the effective rate of the pharmacopuncture group was significantly higher than the group using sleeping pills group (RR: 1.21, 95% CI: 1.01 to 1.45, p=0.04, I2=69%). PSQI was decreased in the intervention group (MD=-2.19, 95% CI: -2.90 to -1.48, p<0.00001, I2=0%). Effective rates of pharmacopuncture and acupuncture groups were higher than that of the acupuncture group (RR: 1.11, 95% CI: 1.05 to 1.17, p= 0.0002, I2=0%). PSQI was decreased in the intervention group (MD=-1.87, 95% CI: -2.36 to -1.38, p< 0.00001, I2=0%). Although the effectiveness rate of the pharmacopuncture group was not significantly higher than that of the acupuncture group (RR: 1.12, 95% CI: 0.98 to 1.27, p=0.1, I2=9%), the PSQI was decreased in the pharmacopuncture group (MD=-2.10, 05% CI: -3.29 to -0.91, p=0.0005, I2=34%). The quality of clinical studies was poor. Conclusions: Based on results of this study, it is proper to use 0.5 to 2 mL of pharmacopuncture solution such as Danshen and Ciwujia with a depth of 0.5 to 2 cm at around 4 p.m. to treat insomnia disorder, focusing on Anmian (Ex-HN) and Sameumgyo (SP6).

참고문헌 (54)

  1. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders", pp.392~393 (2013), Hakjisa
  2. "Healthcare Bigdata Hub. National Interest Disease Statistics"[URL]
  3. Choi HY, "Current Clinical Practice of Insomnia", The Ewha Medical Journal, 36(2), pp.84~92 (2013)
  4. 김유진, "불면증 환자의 스트레스, 심리적 강인성, 사회적 지지 및 삶의 질 간의 관계", 스트레스 硏究, 24(3), pp.137~150 (2016), 대한스트레스학회[DOI]
  5. Leger D, "Chronic insomnia, quality-of-life, and utility scores : comparison with good sleepers in a cross-sectional international survey", Sleep Med, 13(1), pp.43~51 (2012)
  6. 임영찬, "불면증 환자에서 스트레스 및 수면 관련 변인이 삶의 질에 미치는 영향", 신경정신의학, 55(3), pp.277~285 (2016), 대한신경정신의학회[DOI]
  7. National College of Korean Medicine’s Neuropsychiatry textbook compilation committee, "Korean Neuropsychiatry", pp.252~255 (2011), Jipmoondang
  8. Korean Pharmacopuncture Institute, "Pharmacopuncturology", pp.3~5 (2011), Elsevier Korea
  9. Lim JH, "The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners", Evidence-Based Complementary and Alternative Medicine, pp.1~11 (2018)
  10. Xi YB, "Sleep Points Inject Treating 56 Cases of Intractable insomnia with Danshen Injection", Journal of Practical Traditional Chinese Medicine Internal Medicine, 25(9), pp.62~63 (2011)
  11. Huang Y, "Evaluation of the curative effect of Danhong injection on senile insomnia", Journal of Clinical Traditional Chinese Medicine, 23(4), pp.309~313 (2011)
  12. Lei R, "Observation of curative effect of acupoint injection of Methycobal injection on insomnia", Xinjiang Traditional Chinese Medicine, 34(3), pp.38~39 (2016)
  13. Zhang P., "Clinical Study on Treatment of Insomnia of Deficiency of Heart and Spleen by Point Injection at Sahwa Point", master’s, pp.2016
  14. Xu W, "Observation on Therapeutic Effect of Wrist Ankle Acupuncture Combined with Point Injection on Insomnia", China’s Naturopathy, 23(7), pp.27~28 (2015)
  15. Wang W, "Treatment of senile functional insomnia with Ciwujia acupoint injection", Guangdong Medical Journal, 33(12), pp.1836~1837 (2012)
  16. Shi L, "Clinical study of acupoint injection of gastrodin in the treatment of insomnia", Chinese Geriatric Healthcare Medicine, 9(3), pp.41~43 (2011)
  17. Fei Y, "Clinical observation of 20 cases of insomnia treated with acupoint injection combined with massage technique", Hebei Traditional Chinese Medicine, 34(4), pp.558~559 (2012)
  18. Bao Z, "60 Cases of Intractable Insomnia Treated by Acupoint Injection and Massage", Henan Traditional Chinese Medicine, 34(5), pp.945~946 (2014)
  19. Kong X, "Observations on the Curative Effect of Acupoint Injection and Acupuncture on Intractable Insomnia", China’s Naturopathy, 25(12), pp.25~ (2017)
  20. Zou X, "Observation on Therapeutic Effect of Acupoint Injection on Insomnia", Practical Integrated Traditional Chinese and Western Medicine Clinic, 10(2), pp.52~ (2010)
  21. Bai X, "Observation on Therapeutic Effect of 50 Cases of Insomnia Treated by Acupoint Injection", Komei University of Chinese medicine, 21(3), pp.39~ (2006)
  22. Huang Y, "Clinical Observation on 50 Cases of Insomnia Treated by Acupoint Injection and Chinese Medicine", Chinese Journal of Practical Internal Medicine, 28(1), pp.150~151 (2008)
  23. Chai Y, "Observation on Curative Effect of Acupoint Injection and Ear Point Pressing on Insomnia", Liaoning Journal of Traditional Chinese Medicine, 37(11), pp.2231~2233 (2010)
  24. Su J, "Acupoint Injection Combined with Chiropractic Therapy in the Treatment of Insomnia with Yang Deficiency Type", Traditional Chinese Medicine Information, 31(2), pp.90~93 (2014)
  25. Bao J, "The clinical curative effect observation of Acupoint injection combined with acupuncture Treated the insomnia of Kidney", Heart Disharmony, Guangxi University of Traditional Chinese Medicine, 2017
  26. Ming X., "Acupoint injection combined with Acupuncture for insomnia with Cardiasplenic Asthenia : a Research Protocol for Clinical trial", master’s, pp.2014
  27. Quan X., "Clinical study on acupoint injection combined with acupuncture in treating insomnia of heart-kidney noninteraction pattern", master’s, pp.2017
  28. Shi R, "Clinical Ｒesearch of Acupuncture Combined with Auricular Point Sticking in Treating Insomnia", Chinese Medicine News, 29(1), pp.143~144 (2014)
  29. Li P., "Clinical Study on Acupoint Injection of Shenmai cooperating with Acupuncture for Treatment of Liver and Kidney Yin Deficiency type of Insomnia", master’s, pp.2014
  30. Zhang C, "Clinical Observation of Qingkailing Acupoint Injection in Treating Insomnia with Internal Disturbance of Phlegm and Heat", China’s Naturopathy, 26(11), pp.30~31 (2018)
  31. Du Y, "Clinical Study on Vitamin B12 Combined with Sanzaoren Decoction in Treating Insomnia", Journal of Practical Chinese Medicine, 34(7), pp.787~788 (2018)
  32. Zhang H, "The clinical study for insomnia by acupuncture adding acupoint injection", master’s, pp.2009
  33. Fu B, "Clinical research of treatment of heart and spleen deficiency type insomnia by acupuncture combined with acupoints injection", Traditional Chinese Medicine clinical research, 7(30), pp.21~23 (2015)
  34. Gong Y, "Clinical Observation on 29 Cases of Anxiety Insomnia Treated by Injecting Normal Saline at Fengchi Point", Practical Integrated Traditional Chinese and Western Medicine Clinic, 10(1), pp.16~17 (2010)
  35. 서동균, "蟾酥약침이 수면장애 환자의 불면 및 우울 증상에 미치는 영향에 대한 임상적 고찰", Journal of Acupuncture Research, 32(3), pp.175~183 (2015), 대한침구의학회
  36. 이유환, "삼기활력약침이 불면, 피로에 미치는 효과", Journal of Acupuncture Research, 29(3), pp.101~113 (2012), 대한침구의학회[DOI]
  37. Lee JH, "A clinical study on the insomnia treatment of Sanjoincho Pharmacopuncture", Journal of the Korean Society for Neuropsychiatry, 11(2), pp.79~86 (2000)
  38. 윤형선, "不眠환자에 대한 紫河車 藥針 효능의 관한 연구", Journal of Acupuncture Research, 21(3), pp.99~106 (2004), 대한침구의학회
  39. Song GE, "Research trend of clinical papers for insomnia treatment using Pharmacopuncture in China", Journal of the Korean Society for Neuropsychiatry, 30(3), pp.265~274 (2019)
  40. "CRIS research"[URL]
  41. NECA’s guidance for undertaking systematic reviews and meta-analysis for intervention, "Kim SY", National Evidence-based Healthcare Collaborating Agency, 64~ (2011)
  42. Higgins J, "Analysing and presenting results. Cochrane handbook for systematic reviews of interventions 4.2.6", pp.79~165 (2008), John Wiley & Sons Inc
  43. National Evidence-based Healthcare Collaborating Agency, "NECA’s guidance for undertaking systematic reviews and meta-analyses for intervention", NECA, 65~78 (2011)
  44. Schunemann H, "GRADE Handbook : handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. 2013", BMJ Open (2018)
  45. T. Ohta, "Treatment of Persistent Sleep-Wake Schedule Disorders in Adolescents with Methylcobalalmin(Vitamin B12)", Association of Professional Sleep Societies, 14(5), pp.414~419 (1991)
  46. Zhang X., "Clinical observation of Danshen Ningshen in treating insomnia (blood stasis type)", master’s, pp.2020
  47. Kim KK, "The Effects of CJS03 on 5-HT2c Receptor and Sleep Structure", master’s, Department of Korean Medicine, pp.2015
  48. 김동희, "불면장애에 대한 혈부축어탕의 체계적 문헌 고찰 및 메타분석 연구", 동의신경정신과학회지, 28(4), pp.319~332 (2017), 대한한방신경정신과학회
  49. Xiao J, "Experimental study on the effects of Ciwujia Injection on sleep in rats", Hebei Medical Journal, 31(9), pp.1031~1032 (2009)
  50. Yi PL, "Effects of Electroacupuncture at"Anmian(Extra)"Acupoints on Sleep Activities in Rats : The Implication of the Caudal Nucleus tractus solitarius", Journal of Biomedical Science, 11, pp.579~590 (2004)
  51. 김원일, "完骨 神門 三陰交 自家指壓이 睡眠障碍와 疲勞에 미치는 效果", Korean Journal of Acupuncture, 21(2), pp.81~94 (2004), 경락경혈학회
  52. "Mechanism of acupuncture at Sanyinjiao, Shenmen and Neiguan on hypothalamic 5-HT content and imbalance of Glu/GABA Gln metabolic pathway in insomnia rats" (2021)[URL]
  53. Mundey K, "Phase-dependent treatment of delayed sleep phase syndrome with melatonin", Sleep, 28(10), pp.1271~1278 (2005)
  54. 한선정, "일주기 리듬 수면장애", Journal of sleep medicine, 5(2), pp.74~81 (2008), 대한수면연구학회

관련 논문AI추천

중국에서의 약침을 활용한 불면증 치료 임상논문 연구동향박세진, 송건의, 송금주, 이여경, 임교민대한한방신경정신과학회 · 동의신경정신과학회지2019 · 제30권 제3호불면증에 대한 약침 치료 현황 조사 연구김보경, 임정화, 조준희, 최성열대한한방신경정신과학회 · 동의신경정신과학회지2021 · 제32권 제3호화병환자의 불면증상에 대한 침치료 유효성 평가연구: 환자-평가자 눈가림, 무작위배정, 일반대조군 임상시험강형원, 김남권, 김향이, 이고은대한한방신경정신과학회 · 동의신경정신과학회지2012 · 제23권 제1호갱년기 증후군으로 인한 불면의 침 치료 무작위 대조군 최신 연구의 체계적 문헌 고찰과 메타 분석나지영, 박장경, 윤영진대한한방부인과학회 · 대한한방부인과학회지2022 · 제35권 제3호불면 장애에 대한 족욕 치료법의 체계적 문헌고찰과 메타분석 연구김동현, 김보경, 임정화, 조준희대한한방신경정신과학회 · 동의신경정신과학회지2023 · 제34권 제3호불면장애에 대한 부항요법의 체계적 문헌고찰김보경, 이정한, 임정화, 최미라대한한방신경정신과학회 · 동의신경정신과학회지2023 · 제34권 제3호

이 간행물의 다른 논문 (10건)

불면증에 대한 약침 치료 현황 조사 연구김보경, 임정화, 조준희, 최성열pp. 141-154핵심감정척도 단축형과 MMPI-2의 상관성 연구이재혁, 신혜규pp. 155-166사상성격검사(SPQ)의 한의학적 활용 현황에 대한 체계적 문헌 분석김종우, 박소정, 채한, 김민성, 황요순, 이준희, 이수진pp. 167-184‘기공’의 국외 임상연구 최신동향: 스코핑 고찰을 중심으로 한 예비연구최원영, 김종우, 서효원pp. 207-217노인 인구에 대한 이침치료와 이압요법의 국내 임상연구 동향이보람, 권찬영pp. 219-234
원문 보기