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精神分裂症与抑郁症:针灸有效性及其作用机制的系统评价

Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture.

作者信息

Bosch Peggy, van den Noort Maurits, Staudte Heike, Lim Sabina

机构信息

Center for Cognition, Donders Institute for Brain, Cognition, and Behavior, Radboud University Nijmegen, Postbus 9104, Montessorilaan 3, Nijmegen 6525 HR, The Netherlands; LVR-Klinik Bedburg-Hau, Bedburg-Hau, Germany; Division of Acupuncture & Meridian, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute and School of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

Division of Acupuncture & Meridian, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute and School of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea; Free University of Brussels, Brussels, Belgium.

出版信息

Explore (NY). 2015 Jul-Aug;11(4):281-91. doi: 10.1016/j.explore.2015.04.004. Epub 2015 Apr 28.

Abstract

OBJECTIVE

This systematic review assessed clinical evidence for the use of acupuncture as an add-on treatment in patients with depression and schizophrenia and for its underlying working mechanisms.

DATA SOURCES

Four databases (Medline, Scopus, ERIC, and the Cochrane Library) were searched with a cutoff date of March 31, 2014.

STUDY SELECTION

Systematic reviews and meta-analyses of acupuncture treatment for depression and schizophrenia were considered for inclusion. The scarcity of acupuncture research involving schizophrenia led to the inclusion of randomized controlled trials and case studies.

DATA EXTRACTION

The primary and secondary aims of this study were to evaluate the effects of acupuncture in treating patients with depression or schizophrenia and the possible working mechanisms underlying acupuncture through a systematic literature review.

DATA SYNTHESIS

The overall clinical results on using acupuncture to treat depression are promising, but only limited evidence for its effectiveness in treating schizophrenia was found. Acupuncture improves the quality of life, particularly that of sleep, in psychiatric patients. Brain research has revealed that acupuncture has a modulating and normalizing effect on the limbic-paralimbic-neocortical network (LPNN), including the default mode network. Because the LPNN is related to sleep and emotions, this might explain the improved qualities of life and sleep after acupuncture.

CONCLUSIONS

From the evidence found in this study, acupuncture seems to be an effective add-on treatment in patients with depression and, to a lesser degree, in patients with schizophrenia, but large well-designed studies are needed to confirm that evidence.

摘要

目的

本系统评价评估了针刺作为抑郁症和精神分裂症患者辅助治疗方法的临床证据及其潜在作用机制。

数据来源

检索了四个数据库(Medline、Scopus、ERIC和Cochrane图书馆),截止日期为2014年3月31日。

研究选择

纳入针刺治疗抑郁症和精神分裂症的系统评价和荟萃分析。由于针刺治疗精神分裂症的研究较少,故纳入随机对照试验和病例研究。

数据提取

本研究的主要和次要目的是通过系统的文献综述,评估针刺治疗抑郁症或精神分裂症患者的效果以及针刺可能的作用机制。

数据综合

针刺治疗抑郁症的总体临床结果令人鼓舞,但在治疗精神分裂症方面仅发现有限的有效性证据。针刺可改善精神病患者的生活质量,尤其是睡眠质量。脑部研究表明,针刺对边缘 - 旁边缘 -新皮质网络(LPNN),包括默认模式网络具有调节和归一化作用。由于LPNN与睡眠和情绪有关,这可能解释了针刺后生活质量和睡眠质量的改善。

结论

从本研究发现的证据来看,针刺似乎是抑郁症患者有效的辅助治疗方法,对精神分裂症患者的有效性稍低,但需要大型精心设计的研究来证实这一证据。

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