Huang Cheng, Zhang Peiming, Dong Yu, Chang Ruchun, Lao Jinxiong, Li Ziyong, Lan Danchun
Acupuncture and Rehabilitation Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
Department of Acupuncture and Moxibustion, Foshan Hospital of Traditional Chinese Medicine, Foshan, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Nov 7;19:2381-2400. doi: 10.2147/NDT.S428518. eCollection 2023.
To systematically evaluate the efficacy of acupuncture in the treatment of schizophrenia.
We searched China National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP Chinese Science and Technology Periodical Database (VIP), China Biology Medicine Database (CBM), PubMed, Embase, Web of Science, Cochrane Library for relevant literature on the acupuncture treatment of schizophrenia published from database inception to May 17, 2023. The evaluation criteria included total effective rate, incidence of adverse reactions, TESS scale, PANSS scale, BPRS scale, SANA scale, SAPS scale. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The RevMan 5.4 software was used for meta-analysis, risk of bias (ROB) evaluation tool was used to evaluate the risk of bias of the studies, and the GRADE evaluation tool was used to evaluate the quality of evidence. The study was registered on PROSPERO, CRD42023416438.
A total of 38 RCTs involving 3143 patients were included in the meta-analysis. The results showed that acupuncture can improve the total effective rate [OR=3.43 (95% CI: 2.71, 4.35), moderate credibility], reduce the incidence of adverse reactions [OR=0.45 (95% CI: 0.32, 0.63), moderate credibility], reduce the TESS score (side effect scale) [MD=-1.83 (95% CI: -2.94, -0.71), very low credibility]. Acupuncture also reduced the PANSS total score [MD=-5.75 (95% CI: -8.08, -3.42), very low credibility], SANA score [MD=-2.66 (95% CI: -6.84, 1.51), very low credibility], SAPS score [MD=-1.26 (95% CI: -2.55, -0.02), very low credibility], and BPRS score [MD=-7.02 (95% CI: -10.59, -3.46), very low credibility].
Existing evidence indicates that acupuncture as an adjunctive therapy can improve the total effective rate of SZ patients, reduce the incidence of adverse reactions, improve clinical symptoms, and alleviate depression and anxiety in SZ patients. However, more high-quality clinical research evidence is still needed to support these findings.
系统评价针刺治疗精神分裂症的疗效。
检索中国知网（CNKI）、万方数据库、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、PubMed、Embase、Web of Science、Cochrane图书馆，收集自建库至2023年5月17日发表的关于针刺治疗精神分裂症的相关文献。评价指标包括总有效率、不良反应发生率、TESS量表、PANSS量表、BPRS量表、SANA量表、SAPS量表。由两名研究人员独立筛选文献、提取数据并评估纳入研究的偏倚风险。采用RevMan 5.4软件进行Meta分析，使用偏倚风险（ROB）评估工具评估研究的偏倚风险，使用GRADE评估工具评估证据质量。本研究已在PROSPERO注册，注册号为CRD42023416438。
Meta分析共纳入38项随机对照试验，涉及3143例患者。结果显示，针刺可提高总有效率[比值比（OR）=3.43（95%置信区间：2.71，4.35），可信度中等]，降低不良反应发生率[OR=0.45（95%置信区间：0.32，0.63），可信度中等]，降低TESS评分（副作用量表）[平均差（MD）=-1.83（95%置信区间：-2.94，-0.71），可信度极低]。针刺还可降低PANSS总分[MD=-5.75（95%置信区间：-8.08，-3.42），可信度极低]、SANA评分[MD=-2.66（95%置信区间：-6.84，1.51），可信度极低]、SAPS评分[MD=-1.26（95%置信区间：-2.55，-0.02），可信度极低]和BPRS评分[MD=-7.02（95%置信区间：-10.59，-3.46），可信度极低]。
现有证据表明，针刺作为辅助治疗可提高精神分裂症患者的总有效率，降低不良反应发生率，改善临床症状，缓解精神分裂症患者的抑郁和焦虑情绪。然而，仍需要更多高质量的临床研究证据来支持这些发现。
