Xiao Xiao, Zhang Jiayuan, Jin Yuxia, Wang Yunxia, Zhang Qi
Chengdu University of Traditional Chinese Medicine, No. 37 Shierqiao Road, Jinniu District, Chengdu, Sichuan 610075, China.
Evid Based Complement Alternat Med. 2020 Jan 19;2020:5865697. doi: 10.1155/2020/5865697. eCollection 2020.
To determine the effectiveness and safety of acupuncture for perimenopausal depression.
We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, CNKI, VIP Citation Databases, Wan Fang, and online trial registries such as ClinicalTrials.gov for randomized controlled trials (RCTs) assessing the efficacy and safety of acupuncture for perimenopausal depression. Literature screening, data extraction, and determination of the risk of bias were performed by two researchers independently. The extracted data were pooled and meta-analyzed using RevMan5.3 software.
In total, 16 RCTs covering 1311 patients were enrolled. Overall, the results showed that acupuncture was more effective in the treatment of perimenopausal depression than antidepressants (OR = 2.68, 95% CI (1.84, 3.90), < 0.00001). Furthermore, HAMD scores in the manual acupuncture group and electroacupuncture group were lower than those of antidepressants (manual acupuncture vs. antidepressants (MD = -2.35, 95% CI (-2.93, -1.77), < 0.00001) and electroacupuncture vs. antidepressants (MD = -1.2, 95% CI (-1.92, -0.48), =0.001)). Data analysis revealed that the treatment effect of acupuncture was more stable than that of antidepressants (MD = -2.4, 95% CI (-3.37, -1.43), < 0.00001). Moreover, acupuncture was safer than antidepressants based on the incidence of adverse events (OR = 0.23, 95% CI (0.1, 0.52), =0.0004). But acupuncture has no effect on estrogen levels ( ≥ 0.05).
Acupuncture for perimenopausal depression is safe and effective. Moreover, it has more stable long-term effects than antidepressants and hormone replacement therapy (HRT). We recommend acupuncture as a clinical treatment of perimenopausal depression.
确定针刺治疗围绝经期抑郁症的有效性和安全性。
我们检索了Cochrane对照试验中央注册库、PubMed、EMBASE、中国知网、维普资讯数据库、万方数据库以及ClinicalTrials.gov等在线试验注册库，以查找评估针刺治疗围绝经期抑郁症疗效和安全性的随机对照试验（RCT）。由两名研究人员独立进行文献筛选、数据提取和偏倚风险判定。提取的数据进行汇总，并使用RevMan5.3软件进行荟萃分析。
共纳入16项RCT，涉及1311例患者。总体而言，结果显示针刺治疗围绝经期抑郁症比抗抑郁药更有效（OR = 2.68，95%CI（1.84，3.90），P < 0.00001）。此外，手针组和电针组的汉密尔顿抑郁量表（HAMD）评分低于抗抑郁药组（手针组与抗抑郁药组比较（MD = -2.35，95%CI（-2.93，-1.77），P < 0.00001），电针组与抗抑郁药组比较（MD = -1.2，95%CI（-1.92，-0.48），P = 0.001））。数据分析显示针刺的治疗效果比抗抑郁药更稳定（MD = -2.4，95%CI（-3.37，-1.43），P < 0.00001）。此外，基于不良事件发生率，针刺比抗抑郁药更安全（OR = 0.23，95%CI（0.1，0.52），P = 0.0004）。但针刺对雌激素水平无影响（P≥0.05）。
针刺治疗围绝经期抑郁症安全有效。此外，与抗抑郁药和激素替代疗法（HRT）相比，其长期效果更稳定。我们推荐针刺作为围绝经期抑郁症的临床治疗方法。
