School of Psychiatry University of New South Wales, NSW 2052, Australia.
J Affect Disord. 2013 Jun;148(2-3):179-87. doi: 10.1016/j.jad.2012.11.058. Epub 2013 Jan 19.
Trials of acupuncture for the treatment of depression have produced mixed results. We examined the effectiveness of laser acupuncture compared with placebo acupuncture for the treatment of major depression.
A randomised, double blinded, placebo controlled trial was conducted in Sydney, Australia. Participants aged 18-50 years with DSM-IV major depressive disorder were eligible to join the study. Forty-seven participants were randomised to receive laser acupuncture or placebo laser at acupoints LR14, CV14, LR8, HT7 and KI3. The intervention was administered twice a week for 4 weeks and once a week for another four weeks, for a total of 12 sessions. The primary outcome assessed the change in severity of depression using the Hamilton-Depression Rating Scale (HAM-D), and secondary outcomes assessed the change in severity of depression using the Quick Inventory for Depression-Self Reporting (QID-SR), the Quick Inventory for Depression-Clinician (QIDS-CL), with outcomes assessed at eight weeks. The treatment response (greater than 50% improvement in HAM-D) and remission (HAM-D<8) were analysed.
At eight weeks participants showed greater improvement in the active laser group on the primary and clinician-rated secondary outcome measures (HAM-D (mean 9.28 (SD 6.55) vs. mean 14.14 (SD 4.78 p<0.001); QIDS-CL (mean 8.12 (SD 6.61 versus 12.68 (mean SD 3.77)) p<0.001). The self-report QIDS-SR scores improved in both groups but did not differ significantly between the groups. In the active laser group, QIDS-SR scores remained significantly lower than baseline at 3 months follow-up. Response rates (active laser, placebo laser) on ITT (intention to treat) analyses were 72.0% and 18.2% (p<0.001), respectively. Remission rates on ITT analyses (active laser, placebo laser) were 56.0% and 4.5% (p<0.001). Transient fatigue was the only adverse effect reported.
There was no follow-up for the placebo group at one and 3 months.
Laser acupuncture showed a clinically and statistically significant benefit with reducing symptoms of depression on objective measures.
针刺治疗抑郁症的试验结果喜忧参半。我们研究了与安慰剂针刺相比,激光针刺治疗重性抑郁症的效果。
该研究在澳大利亚悉尼开展了一项随机、双盲、安慰剂对照试验。符合纳入标准的参与者为年龄 18-50 岁、符合 DSM-IV 重性抑郁障碍诊断标准的患者。47 名参与者被随机分配至激光针刺组或安慰剂激光针刺组,针刺穴位为 LR14、CV14、LR8、HT7 和 KI3。干预措施每周实施 2 次,共 4 周,随后每周实施 1 次,共 4 周,总计 12 次。主要结局是使用汉密尔顿抑郁评定量表(HAMD)评估抑郁严重程度的变化,次要结局使用抑郁自评快速清单(QID-SR)、临床医生用抑郁量表(QIDS-CL)评估抑郁严重程度的变化,评估时间为 8 周。分析治疗反应(HAMD 减分>50%)和缓解(HAMD<8)。
8 周时,与安慰剂激光组相比,激光针刺组在主要结局和临床医生评定的次要结局方面有更大的改善(HAMD(均值 9.28(SD 6.55) vs. 均值 14.14(SD 4.78;p<0.001);QIDS-CL(均值 8.12(SD 6.61) vs. 均值 12.68(SD 3.77);p<0.001))。两组的自评 QIDS-SR 评分均有所改善,但组间差异无统计学意义。在激光针刺组中,QIDS-SR 评分在 3 个月随访时仍显著低于基线。意向治疗(ITT)分析的应答率(激光针刺组、安慰剂激光组)分别为 72.0%和 18.2%(p<0.001)。ITT 分析的缓解率(激光针刺组、安慰剂激光组)分别为 56.0%和 4.5%(p<0.001)。仅报告了短暂性疲劳这一不良事件。
安慰剂组在 1 个月和 3 个月时没有随访。
激光针刺在客观测量指标上显示出对减少抑郁症状具有临床和统计学意义的益处。