电针治疗抑郁症相关失眠：一项系统评价与Meta分析
Electroacupuncture for treating depression-related insomnia: a systematic review and meta-analysis.
作者信息
Gao Yu, Li Tie, Lu Qi, Wang Jiaxin, Wang Ying, Wang Long
机构信息
Department of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun, Jilin, China.
Department of acupuncture and moxibustion, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China.
出版信息
Front Psychiatry. 2025 Jul 8;16:1610107. doi: 10.3389/fpsyt.2025.1610107. eCollection 2025.
BACKGROUND
Depression is a major mental disorder worldwide, affecting over 264 million people. Approximately 50% of individuals with depression also experience insomnia. The treatment of depression may be complicated by comorbid insomnia. Electroacupuncture (EA) has been widely used in clinical practice, with substantial empirical evidence accumulated for its role in treating both depression and related insomnia. However, a systematic evaluation of its efficacy is lacking. This study seeks to assess the efficacy and safety of EA for treating insomnia related to depression.
METHODS
Web of Science, Sinomed, Cochrane Library, CNKI, Wanfang, Embase, and PubMed were searched up to November 2024 to select randomized controlled trials (RCTs) investigating EA for treating depression-related insomnia. The literature was selected and the data were extracted separately by two reviewers. The methodological quality of eligible RCTs was evaluated via the risk of bias 2 tool. Meta-analysis was carried out via Stata SE V.15.0 software.
RESULTS
14 studies involving 1342 individuals with depression-related insomnia were included. The results unraveled that EA was more effective in reducing PSQI scores in comparison to the interventions used in the controls (WMD = -2.757, 95% CI: -3.759 to -1.755). Moreover, EA demonstrated superior efficacy in lowering HAMD scores in contrast to the interventions used in the controls (WMD = -3.587, 95% CI: -4.992 to -2.182). Regarding lowering PSQI scores, the subgroup analysis revealed that EA was more effective than Western medication (WMD =-3.598, 95%CI:-4.771 to -2.426), sham acupuncture (SA) (WMD = -3.623, 95% CI: -4.500 to -2.746). For reducing HAMD scores, the subgroup analysis demonstrated that EA had superior efficacy in comparison to Western medication (WMD =-4.903, 95%CI:-6.974 to -2.831), SA (WMD = -4.641, 95% CI: -6.913 to -2.369).
CONCLUSION
Our findings suggested that EA may be effective in treating depression-related insomnia. However, further large-scale, rigorously designed studies are required to validate its efficacy and safety.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023421281, identifier CRD42023421281.
背景
抑郁症是一种全球性的主要精神障碍，影响着超过2.64亿人。约50%的抑郁症患者还伴有失眠。抑郁症的治疗可能因合并失眠而变得复杂。电针（EA）已在临床实践中广泛应用，有大量实证证据表明其在治疗抑郁症及相关失眠方面的作用。然而，目前缺乏对其疗效的系统评价。本研究旨在评估电针治疗抑郁症相关失眠的疗效和安全性。
方法
检索截至2024年11月的Web of Science、中国生物医学文献数据库、Cochrane图书馆、中国知网、万方数据库、Embase和PubMed，以选择研究电针治疗抑郁症相关失眠的随机对照试验（RCT）。由两名 reviewers 分别进行文献筛选和数据提取。通过偏倚风险2工具评估符合条件的RCT的方法学质量。使用Stata SE V.15.0软件进行荟萃分析。
结果
纳入了14项研究，共1342例抑郁症相关失眠患者。结果显示，与对照组的干预措施相比，电针在降低PSQI评分方面更有效（加权均数差[WMD]=-2.757，95%置信区间[CI]：-3.759至-1.755）。此外，与对照组的干预措施相比，电针在降低汉密尔顿抑郁量表（HAMD）评分方面显示出更好的疗效（WMD=-3.587，95%CI：-4.992至-2.182）。在降低PSQI评分方面，亚组分析显示电针比西药更有效（WMD=-3.598，95%CI：-4.771至-2.426），比假针灸（SA）更有效（WMD=-3.623，95%CI：-4.500至-2.746）。在降低HAMD评分方面，亚组分析表明电针比西药更有效（WMD=-4.903，95%CI：-6.974至-2.831），比SA更有效（WMD=-4.641，95%CI：-6.913至-2.369）。
结论
我们的研究结果表明，电针可能对治疗抑郁症相关失眠有效。然而，需要进一步开展大规模、设计严谨的研究来验证其疗效和安全性。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023421281，标识符CRD42023
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