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[针灸治疗肠易激综合征焦虑抑郁的Meta分析]

[Meta analysis of acupuncture and moxibustion for anxiety and depression in irritable bowel syndrome].

作者信息

Li Huai-Yu, Chen Yun, Hu Zi-Yi, Chen Wei, Tang Hai-Yi, Yu Zhi-Ying, Ye Jing

机构信息

Graduate School, Jiangxi University of Chinese Medicine, Nanchang 330004, China.

Department of Gastroenterology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341002, Jiangxi Province.

出版信息

Zhen Ci Yan Jiu. 2022 Sep 25;47(9):821-9. doi: 10.13702/j.1000-0607.20210808.

Abstract

OBJECTIVE

To evaluate the effectiveness of acupuncture and moxibustion in the treatment of anxiety and depression in irritable bowel syndrome (IBS) by meta-analysis.

METHODS

China National Knowledge Infrastructure (CNKI), Wanfang Data, China Scientific Journal Database (VIP), China Biomedical Literature Service System (SinoMed), PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) on acupuncture and moxibustion in the treatment of IBS anxiety and depression from database inception to June 30, 2021. RevMan5.3 and Stata16.0 were used to conduct Meta-analysis of relevant outcome indicators.

RESULTS

A total of 11 RCTs were included in this study, involving 774 IBS patients (431 in the intervention group and 343 in the control group). Eight of them used manual acupuncture (MA) intervention, and the other three used electroacupuncture (EA) intervention. Meta-analysis showed that compared with the western medicine, MA improved the sedation-agitation scale (SAS) scores (=5.24, 95%=[3.49, 7.00], <0.000 01) and self-rating depression scale (SDS) scores (=8.50, 95%=[4.68, 12.32], <0.000 1) in IBS patients, and there was no significant difference between MA or EA and western medicine in the improvement of Hamilton anxiety rating scale (HAMA) scores (=1.10, 95%=[0.36, 2.56], =0.14) and Hamilton depression rating scale (HAMD) scores (=0.53, 95%=[0.89, 1.94], =0.47). In terms of total effective rates (=1.21, 95%=[1.12, 1.31], <0.000 01) and the irritable bowel syndrome severity scoring system (IBS-SSS) scores (=42.16, 95%=[27.40, 56.91], <0.000 01), both MA and EA therapy was superior to western medicine in alleviating gastrointestinal symptoms of IBS patients.

CONCLUSION

MA and EA can improve the anxiety and depression of IBS patients, while the influence of other acupuncture and moxibustion interventions needs to be deeply explored with more high-quality RCTs.

摘要

目的

通过Meta分析评价针灸治疗肠易激综合征(IBS)伴焦虑抑郁的有效性。

方法

检索中国知网(CNKI)、万方数据、维普中文科技期刊数据库(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase和Cochrane图书馆,收集自建库至2021年6月30日关于针灸治疗IBS伴焦虑抑郁的随机对照试验(RCT)。采用RevMan5.3和Stata16.0软件对相关结局指标进行Meta分析。

结果

本研究共纳入11项RCT,涉及774例IBS患者(干预组431例,对照组343例)。其中8项采用手针(MA)干预,3项采用电针(EA)干预。Meta分析结果显示,与西药相比,MA可改善IBS患者的躁动镇静评分(SAS)(=5.24,95%=[3.49,7.00],<0.000 01)和自评抑郁量表(SDS)评分(=8.50,95%=[4.68,12.32],<0.000 1);在改善汉密尔顿焦虑量表(HAMA)评分(=1.1, 95%=[0.36, 2.56], =0.14)和汉密尔顿抑郁量表(HAMD)评分(=0.53, 95%=[0.89, 1.94], =0.47)方面,MA或EA与西药相比差异无统计学意义。在总有效率(=1.21,95%=[1.12,1.31],<0.000 01)和肠易激综合征严重程度评分系统(IBS-SSS)评分(=42.16,95%=[27.40,56.91],<0.000 01)方面,MA和EA治疗在缓解IBS患者胃肠道症状方面均优于西药。

结论

MA和EA可改善IBS患者的焦虑抑郁状态,其他针灸干预措施的影响有待更多高质量RCT深入探索。

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