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不同针刺方式联合抗抑郁药治疗抑郁症的 Meta 分析。

A Meta-analysis of Different Acupuncture Modalities Combined With Antidepressants to Reduce Major Depressive Disorder.

机构信息

Psychiatry and Psychology Department, Xi'an Third Hospital, Xi'an, China.

Department of Psychiatry, First Affiliated Hospital of Air Force Medical University, Xi'an, China.

出版信息

Clin Neuropharmacol. 2024;47(5):168-175. doi: 10.1097/WNF.0000000000000606. Epub 2024 Aug 12.

Abstract

OBJECTIVES

Acupuncture is an effective therapy for depression. Nevertheless, the results of clinical studies on major depressive disorder (MDD) remain controversial.

METHODS

By November 2023, English-language published randomized clinical trials involving acupuncture for treating MDD were searched. The analysis comprised 9 studies with 809 subjects who met the eligibility criteria. The quality of the included studies was evaluated using the Quality in Prognostic Studies (QUIPS) tool.

RESULTS

Acupuncture moderately alleviated the severity of MDD, independent of the method used (standardized mean difference [SMD] = -0.55; confidence interval [CI] 95%: -1.19, 0.09; P = 0.08). The severity of MDD was moderated by MA, regardless of antidepressant use (SMD = -0.49; CI95%: -1.13, 0.14, P = 0.09). Subgroup analysis revealed a nonsignificant reduction in MDD severity when using manual acupuncture alone (SMD -0.52; CI95%: -1.47, 0.44, P = 0.18). MDD severity was reduced by the use of manual acupuncture and antidepressants (SMD = -0.47; CI95%: -0.88, -0.06). Laser acupuncture and electroacupuncture (with or without antidepressants) did not significantly affect the severity of MDD.

CONCLUSIONS

Manual acupuncture with or without antidepressants may alleviate the severity of MDD, but its clinical benefit for treating MDD is inconclusive.

摘要

目的

针刺是治疗抑郁症的有效疗法。然而,针对重度抑郁症(MDD)的临床研究结果仍存在争议。

方法

截至 2023 年 11 月,检索了英文发表的针刺治疗 MDD 的随机临床试验。分析包括 9 项研究,共有 809 名符合入选标准的受试者。使用预后研究质量工具(QUIPS)评价纳入研究的质量。

结果

无论采用何种方法,针刺均能适度缓解 MDD 的严重程度(标准化均数差[SMD] = -0.55;95%置信区间[CI]:-1.19,0.09;P = 0.08)。抗抑郁药的使用与否,均会使 MA 调节 MDD 的严重程度(SMD = -0.49;95%CI:-1.13,0.14,P = 0.09)。亚组分析显示,单独使用手动针刺时,MDD 的严重程度无显著降低(SMD -0.52;95%CI:-1.47,0.44,P = 0.18)。使用手动针刺和抗抑郁药可降低 MDD 的严重程度(SMD = -0.47;95%CI:-0.88,-0.06)。激光针刺和电针(无论是否使用抗抑郁药)均未显著影响 MDD 的严重程度。

结论

手动针刺联合或不联合抗抑郁药可能会缓解 MDD 的严重程度,但针刺治疗 MDD 的临床获益尚不确定。

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