针刺治疗肿瘤相关性抑郁：一项系统评价与Meta分析
Acupuncture for tumor-related depression: a systematic review and meta-analysis.
作者信息
Li Xiaoyi, Wang Yang, Wu Liu, Zhao Xinyu, Zhu Tianmin
机构信息
School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.
出版信息
Front Oncol. 2023 Aug 8;13:1198286. doi: 10.3389/fonc.2023.1198286. eCollection 2023.
INTRODUCTION
Tumor-related depression is a series of symptoms or states triggered by a tumor as the basic disease. It does not belong to psychiatric depression but dramatically affects individuals' quality of life. Acupuncture is extensively used to treat tumor-related depression, but the effect of body acupuncture on tumor-related depression is still unsubstantiated. This work, therefore, set out to assess the effect of acupuncture on tumor-related depression.
METHODS
Eight databases were searched from inception to October 2022 for randomized controlled trials (RCTs). Two researchers separately implemented the database search, study selection, data extraction, and quality assessment. All analyses were performed by using Review Manager 5.3.
RESULTS
A total of 10 studies, including 725 participants, were included. A majority of studies recruited patients diagnosed with various tumor types and statuses. Meta-analysis revealed that acupuncture had a beneficial effect compared with usual care on the Hamilton depression scale (HAMD) (mean difference (MD) = -2.23, 95% CI [-4.43, -0.03], = 0.05), self-rating depression scale (SDS) (MD= -6.22, 95% CI [-10.67, -1.78], = 0.006), effective rate (RR = 1.23, 95% CI [1.06, 1.43], = 0.006), and quality-of-life questionnaire (QLQ-C30) (MD = 6.08, 95% CI [3.72, 8.43], <0.0001). In the dimension of the HAMD (MD = -4.41, 95% CI [-6.77, -2.05], = 0.0002) and SDS (MD = -9.19, 95% CI [-13.14, -5.24], <0.00001), subgroup analysis also highlighted that acupuncture combined with usual care had an advantage over usual care. However, there was no superiority in acupuncture itself compared to usual care on the HAMD (MD = -1.25, 95% CI [-4.34, -1.84], = 0.43) and SDS (MD = -3.08, 95% CI [-11.14, 4.98], = 0.45). Acupuncture also reduced the incidence of adverse effects (RR=0.43, 95% CI [0.23, 0.80], = 0.008).
CONCLUSION
Acupuncture is a safe and effective complementary therapy for tumor-related depression. This technique can provide clinical references for the medical field.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022372513.
引言
肿瘤相关性抑郁是由肿瘤作为基础疾病引发的一系列症状或状态。它不属于精神性抑郁，但会显著影响个体的生活质量。针灸被广泛用于治疗肿瘤相关性抑郁，但体针治疗肿瘤相关性抑郁的效果仍未得到证实。因此，本研究旨在评估针灸对肿瘤相关性抑郁的疗效。
方法
检索了8个数据库，时间跨度从建库至2022年10月，以获取随机对照试验（RCT）。两名研究人员分别进行数据库检索、研究筛选、数据提取和质量评估。所有分析均使用Review Manager 5.3软件进行。
结果
共纳入10项研究，包括725名参与者。大多数研究招募了被诊断为各种肿瘤类型和分期的患者。荟萃分析显示，与常规护理相比，针灸在汉密尔顿抑郁量表（HAMD）（平均差（MD）=-2.23，95%可信区间[-4.43，-0.03]，P=0.05）、自评抑郁量表（SDS）（MD=-6.22，95%可信区间[-10.67，-1.78]，P=0.006）、有效率（RR=1.23，95%可信区间[1.06，1.43]，P=0.006）和生活质量问卷（QLQ-C30）（MD=6.08，95%可信区间[3.72，8.43]，P<0.0001）方面具有有益效果。在HAMD（MD=-4.41，95%可信区间[-6.77，-2.05]，P=0.0002）和SDS（MD=-9.19，95%可信区间[-13.14，-5.24]，P<0.00001）维度上，亚组分析也突出显示针灸联合常规护理优于常规护理。然而，与常规护理相比，单纯针灸在HAMD（MD=-1.25，95%可信区间[-4.34，-1.84]，P=0.43）和SDS（MD=-3.08，95%可信区间[-11.14，4.98]，P=0.45）方面并无优势。针灸还降低了不良反应的发生率（RR=0.43，95%可信区间[0.23，0.80]，P=0.008）。
结论
针灸是治疗肿瘤相关性抑郁的一种安全有效的辅助疗法。该技术可为医学领域提供临床参考。
系统评价注册
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