电针治疗产后抑郁症患者的疗效与安全性：一项荟萃分析
Efficacy and safety of electroacupuncture in patients with postpartum depression: a meta-analysis.
作者信息
Fang Xue, Wang Xiaoyan, Zheng Wenjun, Han Jing, Ge Xiaobin
机构信息
Department of Acupuncture and Moxibustion, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
出版信息
Front Psychiatry. 2024 Jul 11;15:1393531. doi: 10.3389/fpsyt.2024.1393531. eCollection 2024.
OBJECTIVE
This study aimed to assess the clinical effectiveness and safety of electroacupuncture (EA) for the treatment of postpartum depression (PPD).
METHODS
We systematically retrieved relevant randomized controlled trials (RCTs) from electronic databases, including PubMed, Cochrane Library, China National Knowledge Infrastructure, EMBASE, China Science and Technology Journal Database, Chinese Biological Medical Database, and the Wanfang database from their inception to November 2023. The outcomes measured were the Hamilton Depression Rating Scale (HAMD) scores, Edinburgh Postnatal Depression Scale (EPDS) scores, adverse events (AEs), and the total response rate. The study aimed to estimate heterogeneity, publication bias, mean difference (MD), and risk ratios (RR) with 95% confidence intervals (CIs).
RESULTS
This study included 12 RCTs with a total of 1364 participants (571 in the treatment group and 793 in the control group) for analysis. The results of the meta-analysis indicated that EA did not significantly reduce HAMD (MD = 1.49, 95% CI = [-0.30, 3.27], P = 0.1, = 0%) and EPDS (MD = 1.12, 95% CI = [-1.62, 3.85], P = 0.42, = 32%) scores compared to sham EA among patients with PPD, resulting in low heterogeneity. In terms of the total response rate, the EA group exhibited superior results compared to the placebo group (RR = 1.77, 95% CI = [1.15, 2.74], P = 0.01, = 0%) and the sham EA group (RR = 1.2, 95% CI = [1.02, 4.4], P = 0.02, = 0%), with statistical significance and low heterogeneity. The incidence of AEs was lower, also with low heterogeneity (RR = 0.9, 95% CI = [0.57, 1.43], P = 0.66, = 12%).
CONCLUSION
The current evidence indicates that the effectiveness and safety of EA in the treatment of PPD warrant affirmation. However, EA does not demonstrate superiority over sham EA in reducing HAMD and EPDS scores in patients with PPD. Due to the limited quantity and quality of curent research, the above conclusion should be further validated through high-quality studies to confirm the efectiveness of EA in PPD management.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=318917, identifier CRD42023318917.
目的
本研究旨在评估电针（EA）治疗产后抑郁症（PPD）的临床有效性和安全性。
方法
我们从电子数据库中系统检索了相关随机对照试验（RCT），包括PubMed、Cochrane图书馆、中国知网、EMBASE、中国科技期刊数据库、中国生物医学数据库和万方数据库，检索时间从建库至2023年11月。测量的结局指标为汉密尔顿抑郁量表（HAMD）评分、爱丁堡产后抑郁量表（EPDS）评分、不良事件（AE）和总有效率。本研究旨在估计异质性、发表偏倚、平均差（MD）和风险比（RR）及其95%置信区间（CI）。
结果
本研究纳入12项RCT，共1364名参与者（治疗组571名，对照组793名）进行分析。荟萃分析结果表明，与假电针相比，电针在PPD患者中并未显著降低HAMD（MD = 1.49，95%CI = [-0.30, 3.27]，P = 0.1，I² = 0%）和EPDS（MD = 1.12，95%CI = [-1.62, 3.85]，P = 0.42，I² = 32%）评分，异质性较低。在总有效率方面，电针组与安慰剂组（RR = 1.77，95%CI = [1.15, 2.74]，P = 0.01，I² = 0%）和假电针组（RR = 1.2，95%CI = [1.02, 4.4]，P = 0.02，I² = 0%）相比效果更佳，具有统计学意义且异质性较低。不良事件发生率较低，异质性也较低（RR = 0.9，95%CI = [0.57, 1.43]，P = 0.66，I² = 12%）。
结论
目前证据表明电针治疗PPD的有效性和安全性值得肯定。然而，在降低PPD患者的HAMD和EPDS评分方面，电针并未显示出优于假电针的效果。由于当前研究的数量和质量有限，上述结论应通过高质量研究进一步验证，以确认电针在PPD管理中的有效性。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=318917，标识符CRD42023318917。
Zotero 插件