Yang Xiang-Yun, Yang Ning-Bo, Huang Fang-Fang, Ren Shuai, Li Zhan-Jiang
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong Deshengmen Wai, Xicheng District, Beijing, 100088, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Ann Gen Psychiatry. 2021 Jan 30;20(1):9. doi: 10.1186/s12991-021-00327-5.
A number of studies have shown the positive effects of acupuncture on state anxiety. However, the efficacy of acupuncture in treating anxiety disorder remains unclear. This review and meta-analysis aimed to explore whether acupuncture has a positive effect on anxiety disorder.
Randomised controlled trials (RCTs) published in English and Chinese were found through various electronic databases, including PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Embase, and the Chinese databases WanFang data, VIP Chinese Sci tech periodical database, and China National Knowledge Infrastructure. The primary outcome variable was extent of anxiety symptoms. The secondary outcomes included side effects and dropout rate. Effect sizes were pooled by random-effects modelling using Rev Man 5.3.
Twenty RCTs were included in this systematic review and meta-analysis. All included studies were designed for patients with generalised anxiety disorder (GAD), and 18 studies were published in Chinese. Egger's test showed that the asymmetry of the funnel plot in all studies was not significant (t = - 0.34, p = 0.74). The meta-analysis of anxiety symptoms showed that acupuncture was more effective than the control condition, with a standard mean effect size of - 0.41 (95% CI - 0.50 to - 0.31; p < 0.001), and that acupuncture intervention showed good tolerance and safety in the treatment of anxiety disorder.
Our findings suggest that acupuncture therapy aimed at reducing anxiety in patients with GAD has certain beneficial effects compared to controls. More RCTs with high quality should be conducted to fully understand the role of acupuncture in the treatment of various types of anxiety disorder. The protocol of this review was registered at the Prospero International Prospective Register of Systematic Reviews (Registration ID: PROSPERO 2020CRD42020148536).
多项研究表明针刺对状态焦虑有积极作用。然而，针刺治疗焦虑症的疗效仍不明确。本综述和荟萃分析旨在探讨针刺对焦虑症是否有积极作用。
通过各种电子数据库检索中英文发表的随机对照试验（RCT），包括PubMed、Scopus、Cochrane对照试验中心注册库、Embase以及中国数据库万方数据、维普中文科技期刊数据库和中国知网。主要结局变量为焦虑症状程度。次要结局包括副作用和脱落率。使用Rev Man 5.3通过随机效应模型汇总效应量。
本系统评价和荟萃分析纳入了20项RCT。所有纳入研究均针对广泛性焦虑症（GAD）患者设计，18项研究以中文发表。Egger检验显示所有研究中漏斗图的不对称性均不显著（t = -0.34，p = 0.74）。焦虑症状的荟萃分析表明，针刺比对照更有效，标准平均效应量为-0.41（95%CI -0.50至-0.31；p < 0.001），且针刺干预在焦虑症治疗中显示出良好的耐受性和安全性。
我们的研究结果表明，与对照组相比，针对GAD患者减轻焦虑的针刺疗法有一定的有益效果。应开展更多高质量的RCT以充分了解针刺在各种类型焦虑症治疗中的作用。本综述方案已在国际前瞻性系统评价注册库Prospero注册（注册号：PROSPERO 2020CRD42020148536）。
