光生物调节改善抑郁症状：一项随机对照试验的系统评价和荟萃分析

Photobiomodulation improves depression symptoms: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Ji Qipei, Yan Shichang, Ding Jilin, Zeng Xin, Liu Zhixiang, Zhou Tianqi, Wu Zhuorao, Wei Wei, Li Huaqiang, Liu Shuangyue, Ai Shuangchun

机构信息

School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.

Department of Rehabilitation, Mianyang Hospital of Traditional Chinese Medicine, Mianyang, China.

出版信息

Front Psychiatry. 2024 Jan 31;14:1267415. doi: 10.3389/fpsyt.2023.1267415. eCollection 2023.

DOI:10.3389/fpsyt.2023.1267415

PMID:38356614

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10866010/

Abstract

BACKGROUND

Depression is a common mental illness that is widely recognized by its lack of pleasure, fatigue, low mood, and, in severe cases, even suicidal tendencies. Photobiomodulation (PBM) is a non-invasive neuromodulation technique that could treat patients with mood disorders such as depression.

METHODS

A systematic search of ten databases, including randomized controlled trials (RCTs) for depression, was conducted from the time of library construction to September 25, 2023. The primary outcome was depression. The secondary outcome was sleep. Meta-analysis was performed using RevMan (version 5.4) and Stata (version 14.0). Subgroup analyses were performed to identify sources of heterogeneity. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

Three thousand two hundred and sixty-five studies were retrieved from the database and screened for inclusion in eleven trials. The forest plot results demonstrated that PBM alleviated depression (SMD = -0.55, 95% CI [-0.75, -0.35], = 46%). But it is not statistically significant for patients' sleep outcomes (SMD = -0.82, 95% CI [-2.41, 0.77], = 0%, > 0.05). Subgroup analysis showed that s-PBM was superior to t-PBM in relieving symptoms of depression. The best improvement for t-PBM was achieved using a wavelength of 823 nm, fluence of 10-100 J/cm, irradiance of 50-100 mW/cm, irradiance time of 30 min, treatment frequency < 3/week, and number of treatments >15 times. The best improvement for s-PBM was achieved using a wavelength of 808 nm, fluence ≤1 J/cm, irradiance of 50-100 mW/cm, irradiance time ≤ 5 min, treatment frequency ≥ 3/week, number of treatments >15 times. All results had evidence quality that was either moderate or very low, and there was no bias in publication.

CONCLUSION

We conclude that PBM is effective in reducing depression symptoms in patients. However, the current number of studies is small, and further studies are needed to extend the current analysis results.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, CRD42023444677.

摘要

背景

抑郁症是一种常见的精神疾病，其特征为缺乏愉悦感、疲劳、情绪低落，严重时甚至有自杀倾向，这已得到广泛认可。光生物调节（PBM）是一种非侵入性神经调节技术，可用于治疗抑郁症等情绪障碍患者。

方法

从数据库建立至2023年9月25日，对包括抑郁症随机对照试验（RCT）在内的十个数据库进行系统检索。主要结局指标为抑郁。次要结局指标为睡眠。使用RevMan（5.4版）和Stata（14.0版）进行荟萃分析。进行亚组分析以确定异质性来源。采用推荐分级的评估、制定与评价（GRADE）方法评估证据的确定性。

结果

从数据库中检索到3265项研究，并筛选纳入11项试验。森林图结果表明，PBM可缓解抑郁（标准化均数差[SMD]= -0.55，95%置信区间[-0.75, -0.35]，P = 46%）。但对患者的睡眠结局无统计学意义（SMD = -0.82，95%置信区间[-2.41, 0.77]，P = 0%，P>0.05）。亚组分析显示，在缓解抑郁症状方面，表面PBM优于经皮PBM。经皮PBM在波长823 nm、能量密度10 - 100 J/cm、辐照度50 - 100 mW/cm、辐照时间30分钟、治疗频率<3次/周且治疗次数>15次时改善效果最佳；表面PBM在波长808 nm、能量密度≤1 J/cm、辐照度50 - 100 mW/cm、辐照时间≤5分钟、治疗频率≥3次/周且治疗次数>15次时改善效果最佳。所有结果的证据质量均为中等或极低，且无发表偏倚。