孤独症谱系障碍,儿童,睡眠障碍,褪黑素,Meta 分析 ," /> 孤独症谱系障碍,儿童,睡眠障碍,褪黑素,Meta 分析 ,"/> Autism spectrum disorder, Children, Sleep disorders,Melatonin,Meta-analysis,"/> <div> <span style="font-size:14px;line-height:2;">褪黑素治疗孤独症谱系障碍儿童睡眠</span><span style="font-size:14px;">障碍有效性的荟萃分析</span> </div>
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发育医学电子杂志  2021, Vol. 9 Issue (1): 26-31    DOI: 10.3969/j.issn.2095-5340.2021.01.005
  生长发育   论著 |
褪黑素治疗孤独症谱系障碍儿童睡眠障碍有效性的荟萃分析
陈涵彬 贺安妮 惠靖瑞 张柳依 熊振芳
湖北中医药大学 护理学院,湖北 武汉 430065
Meta-analysis of the efficacy of melatonin in the treatment of sleep disorders in children with autism spectrum disorder
Chen Hanbin, He Anni, Hui Jingrui, et al
Nursing College, Hubei University of Chinese Medicine, Wuhan 430065, China
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摘要 
【摘要】 目的  探讨褪黑素治疗孤独症谱系障碍(autism spectrum disorder,ASD)儿童睡眠障碍的有效
性。 方法 采用计算机检索与 ASD 睡眠障碍和褪黑素相关的文献,检索时间从建库起至 2018 年 10 月
31 日。纳入标准:随机对照试验(randomized controlled trials,RCT);研究对象为 ASD 儿童且存在睡眠
障碍;试验组使用褪黑素,对照组使用安慰剂;结局指标为睡眠潜伏期、夜间醒来次数及总睡眠时间。采
用 Cochrane(5.1.0 版)质量评价准则进行文献质量评价。由 2 名研究者各自依据表格独立提取资料。
采用 RevMan 5.3 软件进行荟萃分析,采用 χ2 检验进行异质性分析,根据是否存在异质性选用固定
效应模型或随机效应模型。 结果  共筛选出 149 篇文献,最终纳入 8 篇,总样本量 397 例。褪黑素
对于 ASD 儿童睡眠潜伏期的影响,各研究之间无明显异质性(P=0.13,I2 =39%),选择固定效应模型,试验组对 ASD 儿童睡眠潜伏期的缩短效果优于对照组(SMD=-1.34,95%CI :-1.61~-1.07P<0.00001)。褪黑素对于 ASD 儿童夜间醒来次数的影响,各研究之间无明显异质性(P=0.41,I2 =2%),选择固定效应模型,试验组对 ASD 儿童夜间醒来次数的减少效果优于对照组(SMD=-0.37,95%CI :-0.60~-0.13,P=0.003)。褪黑素对于 ASD 儿童总睡眠时间的影响,按照年龄(<8 岁,≥ 8 岁)做亚组分析,各研究之间有明显异质性(P<0.00001,I2 =81%),选择随机效应模型,试验组延长 ASD 儿童总睡眠时间的效果优于对照组 [ 年龄 <8 岁亚组(SMD=1.06,95%CI :0.27~1.85,P=0.008);年龄≥ 8 岁亚组(SMD=1.37,95%CI :0.43~2.32,P=0.004)。 结论 褪黑素用于缓解 ASD 儿童的睡眠障碍有一定疗效,可缩短睡眠潜伏期、减少夜间醒来次数、延长总睡眠时间。
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Abstract: 
【Abstract】 Objective To explore the efficacy of melatonin in treating sleep disorders in children with
autism spectrum disorder (ASD). Methods The literatures related to ASD sleep disorders and melatonin
were searched by computer from the establishment of the database to October 31, 2018. Inclusion criteria:randomized controlled trials (RCT); study subjects are ASD children with sleep disorders; the experimentalgroup was given melatonin and the control group was given a placebo; the outcome indicators weresleep latency, number of awakenings at night, and total sleep time. The Cochrane (version 5.1.0) qualityevaluation criteria was used to evaluate the quality of the literatures. The data were extracted independentlyby two researchers according to the tables. Meta-analysis was performed using RevMan 5.3 software.Heterogeneity analysis was performed using χ2 test, and fixed-effect model or random-effect model wasselected according to whether there was heterogeneity. Results 149 articles were screened out and 8articles were finally included, with a total sample size of 397 cases. The effect of melatonin on the sleeplatency of children with ASD had no significant heterogeneity among the studies (P=0.13, I2 =39%), so the fixed-effect model was selected. The experimental group had got better effect on shortening the sleep latency of ASD children than the control group (SMD=-1.34, 95%CI: -1.61~-1.07, P<0.00001). The effect of melatonin on the number of night awakenings of children with ASD had no significant heterogeneity
among the studies (P=0.41, I2 =2%), so the fixed-effect model was selected. The experimental group had gotbetter effect on reducing the number of night awakenings of ASD children than the control group (SMD=-0.37, 95%CI: -0.60~-0.13, P=0.003). The effect of melatonin on the total sleep time of children with ASDwas analyzed in subgroups according to age (<8 years, ≥ 8 years), and there was significant heterogeneity between studies (P<0.00001, I2 =81%), so the random-effect model was selected. The effect of prolonging the total sleep time of children with ASD in the experimental group was better than that in the control group[<8 years old (SMD=1.06, 95%CI: 0.27~1.85, P=0.008); ≥ 8 years old (SMD=1.37, 95%CI: 0.43~2.32,P=0.004)]. Conclusions Melatonin has a certain effect on alleviating sleep disorders in children with ASD. It canshorten the sleep latency, reduce the number of night awakenings, and prolong the total sleep time.
Key words:  line-height:2    Autism spectrum disorder')" href="#">">Autism spectrum disorder    Children    Sleep disorders    Melatonin    Meta-analysis
收稿日期:  2019-10-14                     发布日期:  2021-01-28     
基金资助: 
湖北省卫生计生委 2017-2018 年度面上项目(WJ2017M165)
通讯作者:  熊振芳    E-mail:  825286722@qq.com
引用本文:    
陈涵彬 贺安妮 惠靖瑞 张柳依 熊振芳.
褪黑素治疗孤独症谱系障碍儿童睡眠障碍有效性的荟萃分析
[J]. 发育医学电子杂志, 2021, 9(1): 26-31.
Chen Hanbin, He Anni, Hui Jingrui, et al.
Meta-analysis of the efficacy of melatonin in the treatment of sleep disorders in children with autism spectrum disorder
. Journal of Developmental Medicine(Electronic Version), 2021, 9(1): 26-31.
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http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2021.01.005  或          http://www.fyyxzz.com/CN/Y2021/V9/I1/26
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