针刺治疗肝气郁结型抑郁障碍有效性和安全性的系统评价及Meta分析
Efficacy and Safety of Acupuncture in Treating Major Depressive Disorders:A Systematic Review and Meta Analysis
厉汪涛 1涂明琦 2郭励园 3胡奕颖 3孙颢珉 2郦沛祺 2刘兰英4
作者信息
- 1. 浙江中医药大学第二临床医学院 杭州 310053;上海市中医神志病研究所 上海 201109;上海市精神卫生中心 上海 201109
- 2. 浙江中医药大学第三临床医学院 杭州 310053
- 3. 浙江中医药大学第二临床医学院 杭州 310053
- 4. 上海市中医神志病研究所 上海 201109;上海市精神卫生中心 上海 201109
- 折叠
摘要
目的 系统评价针刺治疗肝气郁结型抑郁障碍患者的有效性和安全性.方法 搜索数据库建库起至2023年4月15日发表的相关文献.筛选符合入组标准的随机对照试验研究,评价文献质量并归类后进行Meta分析与系统评价.结果 共纳入15篇随机对照研究,共计患者1077例.结果 显示针刺治疗与单用抗抑郁药相比,在肝气郁结型抑郁障碍患者的汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分[MD=-0.73,95%CI(-1.22,-0.24),P<0.05]、中医证候量表评分[MD=-1.89,95%CI(-2.35,-1.44),P<0.001]、有效率[RR=1.09,95%CI(1.03,1.153),P=0.001]及治疗副反应量表(Treatment Emergent Symptom Scale,TESS)评分[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]均有统计学意义.针刺治疗与盐酸氟西汀相比,HAMD量表评分有效率的统计结果[RR=1.07,95%CI(1.01,1.14),P<0.05]有统计学意义.结论 针刺疗法与单用抗抑郁药相比,对肝气郁结型抑郁障碍患者HAMD评分及中医症状的改善有优势,不良反应明显少于对照组.本研究认为针刺对肝气郁结型抑郁障碍患者来说可以作为一种安全有效的治疗方式.由于纳入的相关文献的质量和数量的限制,仍需要进一步的高质量的随机对照研究验证上述结论.
Abstract
Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.
关键词
抑郁障碍/针刺/肝气郁结/系统评价Key words
Major depressive disorders/Acupuncture/Stagnation of liver qi/System evaluation引用本文复制引用
基金项目
浙江省卫生计生委中医药防治重大疾病攻关计划(2018ZY001)
上海市卫生健康委中医药科研项目(2022CX004)
出版年
2024
国家科技期刊平台
NSTL
万方数据