Optimization ratio between Coptis chinensis and cinnamo of Jiaotai pill plus benzodiazepines for insomnia in China:a network meta-analysis / 中国药理学与毒理学杂志

ABSTRACT

OBJECTIVE To explore the efficacy of Jiaotai pill (JTW) and JTW modified prescriptions (JTW+) plus benzodiazepines (BDZ) for insomnia in China by systematic review and network meta-analysis, especially optimization ratio (m:n) between Coptis chinensis and Cinnamo. METHODS Randomized controlled trials (RCTs) regarding JTW and JTW++BDZ for insomina were comprehensively searched in CNKI, VIP, Wanfang, and PubMed, Cochrane Library, OVID, Embase databases from their inception to December 2017. The risk of bias was assessed by the Cochrane collab?oration's tool and Jadad scale. Systematic review and network meta-analysis were performed to evaluate the relative risk (RR) plus 95％confidence interval (95％CI) or prediction interval (95％PrI), and draw surface under the cumulative rank?ing curves (SUCRA) by Stata 14.0 and RevMan 5.0 software. RESULTS A total of 13 RCTs (1 RCT was omitted by sen?sitivity analysis) with 1040 patients were included. Overall heterogeneity was acceptable, except publication bias. Based on classical meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW5:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ. Based on network meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ; meanwhile, SUCRA showed the best rank of JTW/JTW+ (BDZ<JTWm:n++BDZ<JTW) for insomina, as same as that of JTWm:n+(BDZ<JTW5:1++BDZ<JTW10:1++BDZ<JTW2:1++BDZ<JTW6:1++BDZ). CONCLUSION Based on the existing clinical evidence, JTW has efficacy for insomnia, but the optimization ratio between Coptis chinensis and cinnamo of JTWm:n++BDZ for insomnia needs more supports.