School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China; .
Evidence-Based Medicine Center, Beijing, China; Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Ann Palliat Med. 2022 Jan;11(1):85-97. doi: 10.21037/apm-21-3421.
To assess the effectiveness and safety of moxibustion for post-stroke depression (PSD).
A search was conducted in the following English and Chinese databases: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), VIP and Wanfang. The outcomes included Hamilton Depression Rating Scale (HAMD), effective rate, and Modified Edinburgh-Scandinavian Stroke Scale (MESSS) scale. The formulation of search strategy, data extraction, and quality evaluation of involved studies was performed according to Cochrane handbook guidelines. The software RevMan 5.4 and Stata 16 were used for data analysis. The evidence quality of each outcome was evaluated by GRADEpro guideline development tool (GDT).
A total of 14 trials with 863 participants were included. A certain risk of bias of unclear or high was detected in the included studies. Compared with the control group, adding moxibustion could change the value of HAMD [standardized mean difference (SMD) =-1.17; 95% confidence interval (CI): -1.55 to -0.79; I2=85.5%; P<0.01] and the effective rate [risk ratio (RR) =1.22; 95% CI: 1.13 to 1.32; I2=0.0%; P=0.56], and the differences in the MESSS scale (SMD =-0.72; 95% CI: -1.06 to -0.38; I2=0.0%; P=0.80) had statistical differences. The certainty was low in effective rate, and very low in HAMD and MESSS. Besides, moxibustion was shown to be generally safe.
This review found that moxibustion may be an effective intervention for PSD. However, the results of this study have a certain limitation. The benefits of moxibustion for PSD need to be confirmed in the future by more high-quality randomized controlled trials (RCTs).
评估艾灸治疗脑卒中后抑郁（PSD）的有效性和安全性。
在以下英文和中文数据库中进行检索：Medline、Embase、Cochrane 中央对照试验注册库（CENTRAL）、中国知网（CNKI）、中国生物医学文献数据库（CBM）、维普及万方。结局指标包括汉密尔顿抑郁量表（HAMD）、有效率和改良爱丁堡-斯堪的纳维亚卒中量表（MESSS）评分。根据 Cochrane 手册指南制定检索策略、提取数据和评价纳入研究的质量。采用 RevMan 5.4 和 Stata 16 软件进行数据分析。使用 GRADEpro 指南制定工具（GDT）评价每个结局的证据质量。
共纳入 14 项研究，涉及 863 名参与者。纳入研究存在一定程度的偏倚风险不确定或高。与对照组相比，加用艾灸可改变 HAMD 的评分[标准化均数差（SMD）=-1.17；95%置信区间（CI）：-1.55 至-0.79；I²=85.5%；P<0.01]和有效率[风险比（RR）=1.22；95% CI：1.13 至 1.32；I²=0.0%；P=0.56]，而 MESSS 评分的差异（SMD=-0.72；95% CI：-1.06 至-0.38；I²=0.0%；P=0.80）则无统计学差异。有效率的证据质量为低，HAMD 和 MESSS 的证据质量为极低。此外，艾灸一般安全。
本综述发现艾灸可能是 PSD 的一种有效干预措施。但是，本研究结果存在一定的局限性。艾灸治疗 PSD 的益处需要更多高质量的随机对照试验（RCT）来进一步证实。
