SynthesisFrontiers in medicine2026
Efficacy of acupuncture, Chinese herbal medicine, combined acupuncture-herbal therapy, and western medication for adult chronic insomnia: a network meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
9 authors.
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Abstract
Background: Chronic insomnia is a prevalent sleep disorder that significantly impairs quality of life and reduces patient confidence in treatment. Acupuncture, Chinese herbal medicine, and their combination have shown promise in the management of this condition. However, comparative research on these Chinese medicine modalities themselves and vs. Western medication remains scarce. Methods: PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and the Chinese Biomedical Literature Database were comprehensively searched from database inception to June 1, 2026. Two reviewers independently screened studies, extracted data, and assessed the risk of bias in the eligible studies. Network meta-analysis was conducted using STATA 16 and R 4.5.3. Results: Fifty-nine randomized controlled trials (RCTs) involving 4 interventions were included. According to the surface under the cumulative ranking curve (SUCRA) analysis, for total efficacy (TE), acupuncture plus herbal medicine ranked the highest (92.0%), followed by acupuncture (74.7%), herbal medicine (33.1%), and Western medicine (0.2%). For Pittsburgh Sleep Quality Index (PSQI), acupuncture ranked first (82.0%), followed by acupuncture plus herbal medicine (76.8%), herbal medicine (36.4%), and Western medicine (4.9%). For adverse events, where a higher SUCRA indicates fewer events, acupuncture ranked first (78.8%), followed by herbal medicine (76.0%), acupuncture plus herbal medicine (45.2%), and Western medicine (<0.1%). Conclusion: Combination therapy (acupuncture plus herbal medicine) showed the highest probability of being the most effective intervention for total efficacy based on SUCRA analysis, and significantly outperformed Western medication and herbal medicine alone. However, no significant difference was observed between combination therapy and acupuncture alone. Acupuncture alone ranked first for improving sleep quality (PSQI) and minimizing adverse events. Given the methodological limitations of the included studies, high-quality, rigorously designed RCTs are warranted to validate these findings. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261413406, Identifier CRD420261413406.
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