The Herbal Medicine Suanzaoren (Ziziphi Spinosae Semen) for Sleep Quality Improvements: A Systematic Review and Meta-analysis

Abstract

Background: Sleep disturbances are common and bothersome among cancer and noncancer populations. Suanzaoren ( Ziziphi Spinosae Semen) is commonly used to improve sleep, yet its efficacy and safety are unclear. Methods: We systematically searched PubMed, Cochrane Library, and EMBASE from inception through October 5, 2021, to identify randomized trials of Suanzaoren. We included randomized trials comparing Suanzaoren to placebo, medications, cognitive behavioral therapy (CBT), or usual care for improving sleep outcomes in cancer and noncancer patients with insomnia or sleep disturbance. We performed a risk of bias analysis following Cochrane guidelines. Depending on heterogeneity, we pooled studies with similar comparators using fixed- and random-effects models. Results: We included participants with insomnia disorder (N = 785) or sleep disturbance (N = 120) from 9 trials. Compared with placebo, Suanzaoren led to significant subjective sleep quality improvements in participants with insomnia and patients with sleep disturbance combined (standard mean difference −0.58, 95% CI −1.04, −0.11; P < .01); Compared with benzodiazepines or CBT, Suanzaoren was associated with a significant decrease in insomnia severity (mean difference −2.68 points, 95% CI −5.50, −0.22; P = .03) at 4 weeks in the general population and cancer patients. The long-term effects of Suanzaoren were mixed among trials. Suanzaoren did not increase the incidence of major adverse events. The placebo-controlled studies had a low risk of bias. Conclusion: Suanzaoren is associated with short-term patient-reported sleep quality improvements among individuals with insomnia or sleep disturbance. Due to the small sample size and variable study quality, the clinical benefits and harms of Suanzaoren, particularly in the long term, should be further assessed in a sufficiently powered randomized trial. Registration: PROSPERO CRD42021281943

A flexible and dissolving traditional Chinese medicine microneedle patch for sleep-aid intervention

“…In this work, ziziphus jujuba spinosa kernel (Suan Zao Ren), polygala tenuifolia (Yuan Zhi), albizia julibrissin flower (He Huan Hua), polygonum multiflorum stem (Shou Wu Teng), schizandra chinensis (Wu Wei Zi), nelumbo nucifera seed (Lian Zi) and coptis chinensis (Huang Lian) are used as the TCM materials for the MN patch. Here, Suan Zao Ren is utilized to nourish the liver, calm the heart and nerves, and reduce the sweat [ 44 ]. Yuan Zhi is used to calm the nerves, promote the intelligence, dispel the phlegm, and reduce the swelling [ 45 ].…”

“…The production process of the CHM related products mainly includes extraction, concentration, and drying. The active ingredients of these seven herbs can be extracted with alcohol, and the residue can be filtered effectively [ [44] , [45] , [46] , [47] , [48] , [49] , [50] ]. The resulting liquid is concentrated to remove excess water, and dried to obtain the powders.…”

DNA barcoding identification of grafted Semen Ziziphi Spinosae and transcriptome study of wild Semen Ziziphi Spinosae

“…The rapid pace of modern life, increased work pressure, and irregular sleep patterns have led to an increase in insomnia and significantly impacted people's daily lives [2]. SZS is commonly used to improve sleep [3]. Modern research has demonstrated that SZS contains flavonoids, triterpenoid saponins, alkaloids, fatty acids, and other compounds [4][5][6][7], which exhibit certain effects on preventing and treating insomnia.…”