针灸对围绝经期抑郁症汉密顿抑郁量表评分影响的Meta及TSA分析
Meta-analysis and Trial Sequence Analysis of Hamilton Scale in the Treatment of Perimenopausal Depression Disorder by Acupuncture and Moxibustion
邓嘉颖 1林丽霞 2黄雨欣 1陈思达 3沈俏嫔 4张美娟 1刘步平5
作者信息
- 1. 广州中医药大学针灸康复临床医学院,广州 510000
- 2. 广西中医药大学第一附属医院中医治未病中心,南宁 530000
- 3. 广州中医药大学第二附属医院,广州 51000
- 4. 广州中医药大学公共卫生与管理学院,广州 510000
- 5. 广州中医药大学针灸康复临床医学院,广州 510000;广州中医药大学公共卫生与管理学院,广州 510000
- 折叠
摘要
目的:评价针灸与西药改善围绝经期抑郁症(PDD)三个版本汉密顿抑郁量表(HAMD)评分的有效性及可靠性.方法:检索建库至2022年12月1日中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方、PubMed、Cochrane、Embase中针灸对比西药治疗PDD的随机对照试验(randomized controlled trials,RCTs).以HAMD 17、21、24版本作为结局指标.采用独立改良Jaded量表进行证据质量评价,Revman5.3进行Meta分析,TSA V 0.9进行试验序贯分析(sequential analysis of the test,TSA).结果:纳入39篇文献(2729例),针灸治疗PDD 的HAMD 17和24版有效率高于西药治疗,HAMD-17和HAMD-21的第4周、第8～12周、随访评分均低于单纯西药治疗,差异均有统计学意义;针灸在提高HAMD-21有效率、降低HAMD-21评分上与西药相比无明显优势;TSA显示HAMD-17有效率结果可信,HAMD-21、24有效率均需进一步验证.结论:针灸治疗PDD在改善HAMD-17、HAMD-24评分及提高有效率上优西药,用HAMD-17评价更为可靠.
Abstract
Objective To systematically evaluate and sequentially analyze the efficacy of acupuncture and moxibustion in treating perimenopausal depressive disorder(PDD)with Hamilton Depression Scale(HAMD).Methods A comprehensive search for randomized controlled trials(RCTs)involving acupuncture and moxibustion for PDD published until December 1,2022,was conducted in CNKI,VIP,CBM,WANFANG,PubMed,Cochrane Library and Embase.Improved Jaded score was used to evaluate the quality of evidence,.Meta-analysis was performed with Revman5.3,and TSA 0.9.5.10 Beta software was used for trial sequential analysis(TSA).Results 39 literatures(2729 cases)were included.The effective rate of HAMD-17、HAMD-24 in acupuncture and moxibustion were higher than western medicine.HAMD-17and HAMD-24 score of acupunc-ture and moxibustion at 6 weeks,8～12 weeks and follow-up were lower than that of western medicine alone.But there was no significant difference in the the effective rate of HAMD-21 and in decreasing HAMD-21 score.TSA confirms result of effective rate of HAMD-17,but which of HAMD-21 and HAMD-24 need further verification.Conclusion Acupuncture and moxibus-tion has advantages in improving HAMD-17、HAMD-24 score compared with Western medicine alone in PDD treatment.
关键词
围绝经期抑郁症/针灸/汉密顿量表/Meta分析/试验序贯分析Key words
perimenopause depression/acupuncture/Hamilton depression scale/Meta-analysis/sequential analysis of the test引用本文复制引用
基金项目
广东省重点领域研发计划"岭南中医药现代化"重点专项(2020B1111100008)
国家中医药管理局创新团队和人才培养计划(ZYYCXTD-C-202004)
出版年
2024
NETL
NSTL
万方数据