Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials

Background: Considering the limitations of Western medicine (WM) in treating Insomnia among adults, and the extensive use of Chinese patent medicines (CPMs), a comprehensive evaluation of the efficacy and safety of Different CPMs used in combination with WM for Insomnia in adults is necessary. To th...

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Main Authors: Ciyan Peng, Jing Chen, Sini Li, Boyin Huang, Wei Cui, Jianhe Li, Liubao Peng
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:Pharmacological Research - Modern Chinese Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667142523000829
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author Ciyan Peng
Jing Chen
Sini Li
Boyin Huang
Wei Cui
Jianhe Li
Liubao Peng
author_facet Ciyan Peng
Jing Chen
Sini Li
Boyin Huang
Wei Cui
Jianhe Li
Liubao Peng
author_sort Ciyan Peng
collection DOAJ
description Background: Considering the limitations of Western medicine (WM) in treating Insomnia among adults, and the extensive use of Chinese patent medicines (CPMs), a comprehensive evaluation of the efficacy and safety of Different CPMs used in combination with WM for Insomnia in adults is necessary. To this end, a systematic investigation was conducted to scrutinize the effectiveness and safety of using 16 different CPMs in conjunction with WM in treating Insomnia in adults. The present study employed a network meta-analysis technique to compare and evaluate the combined therapeutic potential of these 16 CPMs and WM in treating adults with Insomnia. Methods: Literary databases were scrupulously combed through from their commencement until November 2022 to collect all randomized controlled trials (RCTs) that centered on adult patients afflicted with insomnia and treated with a blend of Chinese patent medicines (CPMs) and Western medicine (WM). The investigation analyzed diverse outcomes, comprising total effective rate, Pittsburgh sleep quality index (PSQI), occurrence of somnolence, occurrence of dry mouth, and occurrence of dizziness. The examination utilized advanced statistical tools such as RevMan (5.3), Stata/MP17, and R software, and also calculated the surface under the cumulative ranking curve (SUCRA) probability values, which were employed to rank the examined treatments. In addition, the inquiry executed clustering analysis to contrast the effects and safety of CPMs on distinct outcomes. Results: A total of 283studies involving 27,151patients and 16 CMPs were included. The 16 CMPs were: Wulingjiaonang (WLJN), Anshenbunaoye (ASBNY), Baileminjiaonang (BLWJN), Shenqiwuweizi (SQWWZ), Shensongyangxinjiaonang (SSYXJN), Jiaotaiwan (JTW), Yangxinanshengwan (YXASW), Tianwangbuxindan (TWBXD), Zhushaanshenwan (ZSASW), Yangdanxinnaotong (YDXNT), Yangxueqingnaokeli (YXQNKL), Tianmengjiaonang (TMJN), Zaorenanshenjiaonang (ZRASJN), Shuganjieyujiaonang (SGJYJN), Xiaoyaosan (XYS), Shumianjiaonang (SMJN). The results of the network meta-analysis showed that, with WM treatment as a co-intervention, SSYXJN was most likely to improve the total efficiency rate (SUCRA= 84.70%), ASBNY had the highest probability of being the best option for improving the Sleep quality (SUCRA= 99.20%), JTW had the highest probability of reducing the incidence of somnolence (SUCRA= 94.10%), ZSASW had the highest probability of reducing the incidence of dry mouth (SUCRA= 74.70%), while WLJN had the highest probability of reducing the incidence of dizziness (SUCRA= 73.10%). Conclusions: CPMs combined with WM is proved to be more effective and safer than WM alone, which may be beneficial to adults with Insomnia patients. SQWWZ+WM(Level of evidence, moderate) and ZSASW+WM(Level of evidence, moderate) are most likely the optimal CPM to improve total efficiency rates, Sleep quality, and reduce adverse effects. This study, however, has some limitations as discussed in this article; therefore, higher quality RCTs and real-world evidence are required to support our conclusions.
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spelling doaj.art-b65e96e4e2bd49809b5bc126dd715ddd2023-09-17T04:57:59ZengElsevierPharmacological Research - Modern Chinese Medicine2667-14252023-09-018100296Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trialsCiyan Peng0Jing Chen1Sini Li2Boyin Huang3Wei Cui4Jianhe Li5Liubao Peng6Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Pharmacy, the First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha 410011, ChinaThe Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong KongDepartment of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, ChinaDepartment of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha 410011, China; Corresponding author.Background: Considering the limitations of Western medicine (WM) in treating Insomnia among adults, and the extensive use of Chinese patent medicines (CPMs), a comprehensive evaluation of the efficacy and safety of Different CPMs used in combination with WM for Insomnia in adults is necessary. To this end, a systematic investigation was conducted to scrutinize the effectiveness and safety of using 16 different CPMs in conjunction with WM in treating Insomnia in adults. The present study employed a network meta-analysis technique to compare and evaluate the combined therapeutic potential of these 16 CPMs and WM in treating adults with Insomnia. Methods: Literary databases were scrupulously combed through from their commencement until November 2022 to collect all randomized controlled trials (RCTs) that centered on adult patients afflicted with insomnia and treated with a blend of Chinese patent medicines (CPMs) and Western medicine (WM). The investigation analyzed diverse outcomes, comprising total effective rate, Pittsburgh sleep quality index (PSQI), occurrence of somnolence, occurrence of dry mouth, and occurrence of dizziness. The examination utilized advanced statistical tools such as RevMan (5.3), Stata/MP17, and R software, and also calculated the surface under the cumulative ranking curve (SUCRA) probability values, which were employed to rank the examined treatments. In addition, the inquiry executed clustering analysis to contrast the effects and safety of CPMs on distinct outcomes. Results: A total of 283studies involving 27,151patients and 16 CMPs were included. The 16 CMPs were: Wulingjiaonang (WLJN), Anshenbunaoye (ASBNY), Baileminjiaonang (BLWJN), Shenqiwuweizi (SQWWZ), Shensongyangxinjiaonang (SSYXJN), Jiaotaiwan (JTW), Yangxinanshengwan (YXASW), Tianwangbuxindan (TWBXD), Zhushaanshenwan (ZSASW), Yangdanxinnaotong (YDXNT), Yangxueqingnaokeli (YXQNKL), Tianmengjiaonang (TMJN), Zaorenanshenjiaonang (ZRASJN), Shuganjieyujiaonang (SGJYJN), Xiaoyaosan (XYS), Shumianjiaonang (SMJN). The results of the network meta-analysis showed that, with WM treatment as a co-intervention, SSYXJN was most likely to improve the total efficiency rate (SUCRA= 84.70%), ASBNY had the highest probability of being the best option for improving the Sleep quality (SUCRA= 99.20%), JTW had the highest probability of reducing the incidence of somnolence (SUCRA= 94.10%), ZSASW had the highest probability of reducing the incidence of dry mouth (SUCRA= 74.70%), while WLJN had the highest probability of reducing the incidence of dizziness (SUCRA= 73.10%). Conclusions: CPMs combined with WM is proved to be more effective and safer than WM alone, which may be beneficial to adults with Insomnia patients. SQWWZ+WM(Level of evidence, moderate) and ZSASW+WM(Level of evidence, moderate) are most likely the optimal CPM to improve total efficiency rates, Sleep quality, and reduce adverse effects. This study, however, has some limitations as discussed in this article; therefore, higher quality RCTs and real-world evidence are required to support our conclusions.http://www.sciencedirect.com/science/article/pii/S2667142523000829Network meta-analysisBayesian modelChinese patent medicinesAdults with insomniaCombined therapyChinese medicine
spellingShingle Ciyan Peng
Jing Chen
Sini Li
Boyin Huang
Wei Cui
Jianhe Li
Liubao Peng
Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
Pharmacological Research - Modern Chinese Medicine
Network meta-analysis
Bayesian model
Chinese patent medicines
Adults with insomnia
Combined therapy
Chinese medicine
title Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
title_full Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
title_fullStr Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
title_full_unstemmed Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
title_short Comparative efficacy and safety of various Chinese patent medicines combined with western medicine for adults with insomnia: A Bayesian network meta-analysis of randomized controlled trials
title_sort comparative efficacy and safety of various chinese patent medicines combined with western medicine for adults with insomnia a bayesian network meta analysis of randomized controlled trials
topic Network meta-analysis
Bayesian model
Chinese patent medicines
Adults with insomnia
Combined therapy
Chinese medicine
url http://www.sciencedirect.com/science/article/pii/S2667142523000829
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