Efficacy and safety of Chaihu plus Longgu Muli decoction combined with Estazolam in the treatment of insomnia: a meta-analysis

Sleep Breath. 2025 Jun 28;29(4):229. doi: 10.1007/s11325-025-03404-1.

Abstract

Background: Insomnia is a major sleeping disorder that affects the quality of life and overall health in a tremendous way. Those pharmacological therapies of insomnia, which are typically applied, i.e., benzodiazepines, may result in side effects that are rather dangerous, i.e., dependency and the decline of the cognitive status. Chaihu plus Longgu Muli decoction is a traditional Chinese herbal formula (TCM) which has been used in the treatment of insomnia and can be used as a safer alternative or complementary approach in the treatment of this ailment.

Methos: PubMed, Embase, Cochrane library, CNKI, Wanfang, CQVIP and CBM databases have been searched in our meta-analysis since the establishment of the databases to July 2024. The studies containing the combination of Chaihu Longgu Muli decoction and Estazolam in treating insomnia were to be included in the proposed study without taking into consideration the published literatures, unpublished literatures, those which contain in-complete or inadequate information, animal experiments, literature synthesis and the systematic study. Data analysis was done on the STATA 15.1.

Results: The meta-analysis revealed that the blend of Chaihu plus Longgu Muli decoction and Estazolam used to be extra potent than Estazolam treatment in enhancing the quality of sleep, as indicated by higher effective rates (RR = 1.29, 95% CI: 1.20-1.38, P = 0.000) and lower Pittsburgh Sleep Quality Index (PSQI) scores (WMD=-2.98, 95% CI: -4.06 to -1.90, P = 0.000). Also, lesser Traditional Chinese Medicine (TCM) syndrome scores followed the mixture therapy (WMD=-4.04, 95% CI: -4.38 to -3.70, P = 0.000) and reduced incidence of adverse events (RR = 0.35, 95% CI: 0.16-0.76, P = 0.000).

Conclusion: The combination of Chaihu plus Longgu Muli decoction and Estazolam is more effective and safer than Estazolam alone in treating insomnia. This integrative approach could offer a promising alternative for patients seeking effective and safer treatment options for insomnia.

Keywords: Chaihu plus Longgu Muli decoction; Estazolam; Insomnia; Meta-analysis; Traditional Chinese medicine.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Drug Therapy, Combination
  • Drugs, Chinese Herbal* / adverse effects
  • Drugs, Chinese Herbal* / therapeutic use
  • Estazolam* / therapeutic use
  • Humans
  • Sleep Initiation and Maintenance Disorders* / drug therapy
  • Treatment Outcome

Substances

  • Drugs, Chinese Herbal
  • Estazolam