Stellate ganglion block versus conventional western medication for the treatment of insomnia:a meta-analysis
10.3969/j.issn.1008-794X.2025.01.008
- VernacularTitle:星状神经节阻滞对比常规西药治疗失眠的Meta分析
- Author:
Yanbo SONG
1
;
Yongkang SUN
;
Fangbiao XU
;
Xinzhi WANG
Author Information
1. 450099 河南郑州 河南中医药大学第一附属医院脑病中心
- Keywords:
stellate ganglion block;
insomnia;
meta-analysis;
trial sequential analysis;
GRADE
- From:
Journal of Interventional Radiology
2025;34(1):48-57
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of stellate ganglion block(SGB)with those of conventional western medication in the treatment of insomnia.Methods A computerized retrieval of academic papers concerning the clinical randomized controlled trials of SGB versus conventional western medication in the treatment of insomnia from the databases of PubMed,Embase,Cochrane Library,CNKI,Wanfang Data knowledge service platform,VIP database and CBM database was conducted.The retrieval time period was from the establishment of the database to June 13,2023.NoteExpress v3.5 software was used to make literature screening,Stata17.0 software was used to perform meta-analysis of the obtained data,TSA0.9.5.10 beta software was used to make sequential analysis,and GRADEpro was used to perform the grade classification.Results A total of 11 articles including 875 patients with insomnia were included in this analysis.Compared with the conventional western medication,SGB showed certain advantages in the following aspects:improving total clinical effectiveness(RR total=1.24,95％CI:1.16-1.32,P＜0.01),increasing the proportion of patients who could sleep for more than 3 hours after treatment(RR total=1.24,95％CI:1.09-1.41,P=0.001),increasing total sleep time(SMD=1.53,95％CI:0.89-2.16,P＜0.01),reducing sleep latency(MD=-14.08,95％CI:-18.72--9.43,P＜0.01),decreasing PSQI score(MD=-3.54,95％CI:-4.31--2.78,P＜0.01),and reducing the recurrence rate within 6 months(RR=0.19,95％CI:0.10-0.37,P＜0.01).However,the difference in the proportion of patients who could sleep for more than 6 hours after treatment between the two groups was not statistically significant(RR=1.31,95％CI:0.97-1.76,P=0.078).The traditional SGB therapy had a certain risk of adverse events,ultrasound-guided SGB therapy was much safer.Trial sequential analysis showed that the cumulative sample size of the effective rate crossed the conventional threshold and TSA threshold,the positive results had been obtained in advance although it did not reach RIS.The quality of evidence evaluated by GRADE for the sleep latency,PSQI and recurrence rate within 6 months was medium grade,and the quality for the remaining indexes was low grade.Conclusion Compared with conventional western medication for the treatment of insomnia,the effect of SGB in increasing the total response rate,the proportion of patients who get sleeping for more than 3 hours after treatment and the total sleep duration,in reducing sleep latency,PSQI score and recurrence rate within 6 months has gained some certain evidence supports.The SGB and conventional western medication have similar efficacy in improving the proportion of patients who get sleeping for more than 6 hours after treatment.The results of this study are stable and reliable,but the current level of evidence grade is lower,therefore,large-sample randomized controlled trials need to be conducted before its clinical efficacy can get further evidence-based support.
