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Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis

	author = {Chengyong Liu and Hanqing Xi and Wenzhong Wu and Xiaoqiu Wang and Shan Qin and Yanan Zhao and Shiyu Zheng and Qingyun Wan and Liang Xu},
	title = {Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis},
	journal = {Annals of Palliative Medicine},
	volume = {9},
	number = {1},
	year = {2020},
	keywords = {},
	abstract = {Background: Acupuncture is a common alternative therapy for clinical treatment of insomnia. As the underlying mechanism is yet unclear, its efficacy is often considered as placebo effect. To clarify whether acupuncture treatment of insomnia is only due to its placebo effect, a systematic review and a meta-analysis were designed based on the comparison between acupuncture and sham acupuncture.
Methods: Four English (PubMed, Embase, Web of Science, and The Cochrane Library) and three Chinese (CNKI, VIP, and Wanfang) databases were searched, and the validity of the eligible studies was critically appraised. Thirteen eligible randomized controlled trials of moderate-to-high quality that employed polysomnography (PSG), actigraphy, or self-assessment sleep quality tools were included in the present study. A meta-analysis was conducted using a random-effects model with the Pittsburgh Sleep Quality Index (PSQI) as the primary outcome measure (911 adult patients, 13 trials) for trials investigating the effects of acupuncture as compared to the sham acupuncture. Then, a subgroup analysis was performed to detect the sources of heterogeneity, identify the selection of sham acupuncture methods and different crowd characteristics, and explore its contributions to the total score change of PSQI.
Results: Compared to the sham groups, acupuncture significantly decreased the PSQI score (P},
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