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SYSTEMATIC REVIEW article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1476719
The Effectiveness and Safety of Acupuncture Combined with Medication in the Treatment of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis
Provisionally accepted- 1 Heilongjiang University of Chinese Medicine, Harbin, China
- 2 Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China
Introduction: The aim of this study is to evaluate the effectiveness and safety of the combination therapy of acupuncture and medication in the treatment of perimenopausal insomnia (PMI). This research seeks to provide scientific evidence for clinical practice, optimize treatment protocols, and enhance the sleep quality and overall quality of life for women experiencing perimenopausal insomnia.Methods and analysis: A comprehensive search was conducted across 8 databases, including the China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), PubMed, Web of Science, Excerpta Medica Database (EMBASE), and Cochrane Library, from their establishment to July 1, 2024. Outcome measures were analyzed using Review Manager 5.4 and Stata 15.0 software. The included randomized controlled trials (RCTs) involved 1187 patients with perimenopausal sleep disorders (596 in the experimental group and 591 in the control group). The analysis indicated that compared to Western medication alone, the combination therapy showed better efficacy [risk ratio (RR)=1.24, 95% confidence interval (CI) (1.17, 1.31), P<0.00001] and safety [RR=0.31, 95%CI (0.18, 0.53), P<0.0001]. It also demonstrated more significant improvements in Pittsburgh Sleep Quality Index (PSQI) [mean difference (MD)=-2.77, 95%CI (-4.11, -1.43), P<0.0001], Hamilton Anxiety Rating Scale (HAMA) scores [MD=-3.45, 95%CI (-3.94, -2.97), P<0.00001], Kupperman Menopausal Index (KMI) [MD=-1.46, 95%CI (-2.23, -0.70), P=0.0002], Traditional Chinese Medicine Syndromes (TCMS) scores [MD=-2.45, 95%CI (-3.85, -1.04), P=0.0006], and hormone levels, including Luteinizing Hormone (LH) [MD=-4.17, 95%CI (-7.42, -0.93), P=0.01], Follicle-Stimulating Hormone (FSH) [MD=-10.50, 95%CI (-14.80, -6.20), P<0.00001], and Estradiol (E2) [MD=12.15, 95%CI (6.79, 17.51), P<0.00001]. Discussion: The combination therapy demonstrates great efficacy and safety for PMI patients, representing an innovative integrative alternative treatment with high clinical application value.Systematic review registration: PROSPERO CRD42024564357.
Keywords: Acupuncture, medication, combination therapy, Perimenopause, Menopause, insomnia, Systematic review, Meta-analysis
Received: 09 Aug 2024; Accepted: 27 Feb 2025.
Copyright: © 2025 Jiang, Zhang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yingzhe Sun, Heilongjiang University of Chinese Medicine, Harbin, China
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