From the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; the University of Texas, Austin, Texas; the University of California, San Francisco, San Francisco, California; and the University of Arizona, Tucson, Arizona.
Obstet Gynecol. 2010 Mar;115(3):511-520. doi: 10.1097/AOG.0b013e3181cc0816.
To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial.
A total of 150 pregnant women who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). Junior acupuncturists, who were not told about treatment assignment, needled participants at points prescribed by senior acupuncturists. All treatments were standardized. The primary outcome was the Hamilton Rating Scale for Depression, administered by masked raters at baseline and after 4 and 8 weeks of treatment. Continuous data were analyzed using mixed effects models and by intent to treat.
Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (P<.05) compared with the combined controls (Cohen's d=0.39, 95% confidence interval [CI] 0.01-0.77) or control acupuncture alone (P<.05; Cohen's d=0.46, 95% CI 0.01-0.92). They also had significantly greater response rate (63.0%) than the combined controls (44.3%; P<.05; number needed to treat, 5.3; 95% CI 2.8-75.0) and control acupuncture alone (37.5%; P<.05: number needed to treat, 3.9; 95% CI 2.2-19.8). Symptom reduction and response rates did not differ significantly between controls (control acupuncture, 37.5%; massage, 50.0%).
The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.
Clinicaltrials.gov, www.clinicaltrials.gov, NCT00186654.
在一项随机对照试验中评估针刺治疗妊娠期抑郁症的疗效。
共有 150 名符合《精神障碍诊断与统计手册（第四版）》（DSM-IV）重性抑郁障碍标准的孕妇被随机分为接受针刺治疗抑郁症、接受两种对照治疗之一：对照针刺或按摩。治疗持续 8 周（12 次）。初级针灸师根据资深针灸师的规定为参与者进行针刺，他们并不知道治疗分配。所有治疗都标准化了。主要结局是汉密尔顿抑郁评定量表（HAMD），由盲法评估者在基线和治疗 4 周和 8 周后进行评估。连续数据采用混合效应模型和意向治疗进行分析。
52 名女性被随机分配到针对抑郁症的特定针刺组，49 名女性被分配到对照针刺组，49 名女性被分配到按摩组。接受针对抑郁症的特定针刺治疗的女性在症状严重程度下降方面的速度更快（P<.05），与联合对照组（Cohen's d=0.39，95%置信区间[CI] 0.01-0.77）或单纯对照针刺组（P<.05；Cohen's d=0.46，95% CI 0.01-0.92）相比。她们的反应率也显著高于联合对照组（44.3%；P<.05；需要治疗的人数，5.3；95% CI 2.8-75.0）和单纯对照针刺组（37.5%；P<.05：需要治疗的人数，3.9；95% CI 2.2-19.8）。对照组之间的症状缓解和反应率没有显著差异（对照针刺组，37.5%；按摩组，50.0%）。
短期针刺方案显示出与类似长度的标准抑郁症治疗相当的症状缓解和反应率，可能成为妊娠期抑郁症的可行治疗选择。
Clinicaltrials.gov，www.clinicaltrials.gov，NCT00186654。
