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KMID : 0387420170280040319
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Korean Society of Oriental Neuropsychiatry
2017 Volume.28 No. 4 p.319 ~ p.332
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Herbal Medicine (Hyeolbuchukeo-tang, Xuefu Zhuyu Decoction) for Insomnia Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials
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Kim Dong-Hee
Lee Seung-Hwan
Lim Jung-Hwa
Kim Sang-Ho
Lee Sang-Hyup
Kim Bo-Kyung
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Abstract
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Objectives: The present study aimed to provide clinical evidence on the effect of herbal medicine, Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia using a sys-tematic review and meta-analysis of randomized controlled trials (RCTs).
Methods: This study included RCTs that verified the effects of Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia. Literature searches of English, Chinese and Korean databases were performed, and the selected literature was assessed for investigating the risk of bias.
Results: The analysis included 10 RCTs. The Chinese Classification of Mental Disorders-3 was most fre-quently used to define the diagnostic criteria for Hyeolbuchukeo-tang or Xuefu Zhuyu decoction inter-vention in patients with primary insomnia. The effective rate was the most commonly used outcome measure. A meta-analysis revealed that the effective rate, the Pittsburgh Sleep Quality Index, and the Athens Insomnia Scale in the Modified Xuefu Zhuyu decoction (MXZD) group were higher compared to Western Medicine (WM) group (RR: 1.17, 95% Cl: 1.08 to 1.26, p＜0.0001, I2=0 / MD: ?1.29, 95% Cl: ?2.09 to ?0.49, p=0.002, I2=0% / MD: ?0.99, 95% Cl: ?1.81 to ?0.18, p=0.02, I2=15%). The effective rate of the MXZD＋WM group was significantly different compared to the WM group (RR: 1.28, 95% Cl: 1.11 to 1.47, p=0.0006, I2=2%). The included RCTs were of relatively poor quality and had small sample sizes.
Conclusions: Treatment with Hyeolbuchukeo-tang or Xuefu Zhuyu decoction was found to be effec-tive in treating primary insomnia. However, the included RCTs were of relatively poor quality and had small sample sizes. It is hypothesized that this study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for primary insomnia based on Korean medicine.
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KEYWORD
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Primary insomnia, Herbal medicine, Hyeolbuchukeo-tang, Xuefu Zhuyu decoction, Randomized controlled trial, Meta-analysis, Systematic review
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