School of Graduate, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China.
School of Basic Medical, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China.
Medicine (Baltimore). 2023 Aug 4;102(31):e34561. doi: 10.1097/MD.0000000000034561.
Poststroke depression (PSD) is a common clinical poststroke complication that adversely affects cognitive and physical function rehabilitation. Scalp acupuncture (SA) can significantly improve somatic dysfunction and emotional disorder in stroke patients. This meta-analysis aims to evaluate the effectiveness and safety of SA in the treatment of PSD.
We conducted a comprehensive search of multiple electronic databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Internet, China Science and Technology Journal Database, Wan Fang Data Knowledge Service Platform, and China Biology Medicine databases until December 20, 2022, to identify randomized controlled trials investigating the efficacy of SA in the treatment of PSD. Two independent researchers screened the literature, extracted data, and assessed the risk of bias in the included studies based on the inclusion and exclusion criteria. We performed a meta-analysis of the eligible literature using RevMan 5.4.1 and Stata 15.0 software.
This study comprised a total of 14 randomized controlled trials, 10 of which used SA and 4 of which used SA in combination with electroacupuncture therapy. The results of the meta-analysis revealed that the effective rate of the SA group was significantly higher than that of the Western medicine group (relative risk = 1.09, 95% confidence interval (CI) [1.02, 1.16], P = .008). Moreover, compared to the Western medicine group, the SA group demonstrated significant improvements in Hamilton depression scale scores (mean difference = -2.29, 95% CI [-3.88, -0.70], P = .005) and neurological function deficit scores (mean difference = -3.06, 95% CI [-5.91, -0.21], P = .04). Additionally, the SA group has a lower incidence of adverse events than the western medicine group (relative risk = 0.12, 95% CI [0.05, 0.29], P < .00001).
SA has superior efficacy and safety compared to Western medicine for PSD. These findings suggest that SA could be a promising alternative treatment for the assessed condition. Due to the limited number and quality of the included literature, the above conclusions must be confirmed by additional high-quality research.
脑卒中后抑郁（PSD）是一种常见的临床脑卒中后并发症，它会对认知和身体功能康复产生不利影响。头皮针刺（SA）可以显著改善脑卒中患者的躯体功能障碍和情绪障碍。本荟萃分析旨在评估 SA 在 PSD 治疗中的有效性和安全性。
我们对多个电子数据库进行了全面检索，包括 PubMed、Cochrane 图书馆、Embase、Web of Science、中国国家知识基础设施、中国科技期刊数据库、万方数据知识服务平台和中国生物医学文献数据库，检索时间截至 2022 年 12 月 20 日，以确定关于 SA 治疗 PSD 疗效的随机对照试验。两名独立的研究人员根据纳入和排除标准筛选文献、提取数据，并评估纳入研究的偏倚风险。我们使用 RevMan 5.4.1 和 Stata 15.0 软件对合格文献进行荟萃分析。
本研究共纳入 14 项随机对照试验，其中 10 项使用 SA，4 项使用 SA 联合电针治疗。荟萃分析结果显示，SA 组的有效率明显高于西药组（相对风险=1.09，95%置信区间[1.02，1.16]，P=0.008）。此外，与西药组相比，SA 组汉密尔顿抑郁量表评分（均差=-2.29，95%置信区间[-3.88，-0.70]，P=0.005）和神经功能缺损评分（均差=-3.06，95%置信区间[-5.91，-0.21]，P=0.04）均有显著改善。此外，SA 组的不良反应发生率低于西药组（相对风险=0.12，95%置信区间[0.05，0.29]，P<0.00001）。
SA 治疗 PSD 的疗效优于西药，安全性更高。这些发现表明，SA 可能是一种有前途的治疗选择。由于纳入文献的数量和质量有限，上述结论还需要更多高质量的研究来证实。
