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针刺治疗围绝经期女性情绪障碍:一项随机对照试验的荟萃分析。

Acupuncture for mood disorders in perimenopausal women: A meta-analysis of randomized controlled trials.

作者信息

Li Yixuan, Xu Yujie, Yang Lu, Wu Han, Ma Xian

机构信息

Gynecology of Traditional Chinese Medicine, Hangzhou Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2025 Aug 22;104(34):e43568. doi: 10.1097/MD.0000000000043568.

Abstract

BACKGROUND

Acupuncture reportedly improves mood disorders in perimenopausal women, but the effect is controversial. The aim of this study is to evaluate the effect of acupuncture in the treatment of mood disorders in perimenopausal women.

METHODS

Through the electronic retrieval from English and Chinese databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, the China National Knowledge Infrastructure databases, Wangfang databases, VIP databases, and the Chinese Biomedical Literature databases), randomized controlled trial literature regarding acupuncture treatment of mood disorders in perimenopausal women till June 2024 was collected. All of the studies were available in English. Risk ratio, standardized mean differences (SMDs), 95% confidence intervals (CIs), and heterogeneity were calculated.

RESULTS

A total of 49 randomized controlled trials were included. Acupuncture was effective for mood disorders in perimenopausal women (risk ratio = 0.13; 95% CI = 0.09-0.16; P = .00; I2 = 34.42%). In pooled analysis, the acupuncture group could significantly improve Hamilton Depression Scale score (SMD = -0.57; 95% CI = -0.70 to -0.44; P = .00; I2 = 64.20%). In anxiety analysis with Hamilton Anxiety Scale and Self-Rating Anxiety Scale scores, there was significant improvement after treatment in Hamilton Anxiety Scale (SMD = -1.11; 95% CI = -0.79 to -0.44; P = .00; I2 = 91.52%) and Self-Rating Anxiety Scale (SMD = -1.05; 95% CI = -1.87 to -0.23; P = .01; I2 = 90.87%). Compared with drugs, acupuncture significantly improved the Kupperman Index score (SMD = -0.84; 95% CI = -1.23 to -0.46; P = .00; I2 = 91.87%) and follicle-stimulating hormone level (SMD = -0.45; 95% CI = -0.84 to -0.05; P = .03; I2 = 84.98%). There was no significant difference in luteinizing hormone level (SMD = -0.14; 95% CI = -0.32 to 0.04; P = .12; I2 = 0.00%) and estradiol level (SMD = 0.14; 95% CI = -0.46 to 0.74; P = .64; I2 = 92.69%).

CONCLUSIONS

This meta-analysis demonstrates that acupuncture is effective in the treatment of mood disorders in perimenopausal women. However, due to some shortcomings in the methodology and quality of the included studies, more rigorously designed, large sample size and multicenter randomized controlled trials are needed to further support the above conclusions.

摘要

背景

据报道,针灸可改善围绝经期女性的情绪障碍,但效果存在争议。本研究旨在评估针灸治疗围绝经期女性情绪障碍的效果。

方法

通过对英文和中文数据库(PubMed、Embase、Cochrane对照试验中心注册库、科学网、中国知网数据库、万方数据库、维普数据库和中国生物医学文献数据库)进行电子检索,收集截至2024年6月关于针灸治疗围绝经期女性情绪障碍的随机对照试验文献。所有研究均为英文。计算风险比、标准化均数差(SMD)、95%置信区间(CI)和异质性。

结果

共纳入49项随机对照试验。针灸对围绝经期女性的情绪障碍有效(风险比=0.13;95%CI=0.09-0.16;P=0.00;I2=34.42%)。在汇总分析中,针灸组可显著改善汉密尔顿抑郁量表评分(SMD=-0.57;95%CI=-0.70至-0.44;P=0.00;I2=64.20%)。在使用汉密尔顿焦虑量表和自评焦虑量表评分进行的焦虑分析中,治疗后汉密尔顿焦虑量表(SMD=-1.11;95%CI=-0.79至-0.44;P=0.00;I2=91.52%)和自评焦虑量表(SMD=-1.05;95%CI=-1.87至-0.23;P=0.01;I2=90.87%)均有显著改善。与药物相比,针灸显著改善了库珀曼指数评分(SMD=-0.84;95%CI=-1.23至-0.46;P=0.00;I2=91.87%)和促卵泡生成素水平(SMD=-0.45;95%CI=-0.84至-0.05;P=0.03;I2=84.98%)。促黄体生成素水平(SMD=-0.14;95%CI=-0.32至0.04;P=0.12;I2=0.00%)和雌二醇水平(SMD=0.14;95%CI=-0.46至0.74;P=0.64;I2=92.69%)无显著差异。

结论

本荟萃分析表明,针灸治疗围绝经期女性情绪障碍有效。然而,由于纳入研究的方法学和质量存在一些缺陷,需要更严格设计、大样本量和多中心的随机对照试验来进一步支持上述结论。

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