基于电针的综合治疗对脑卒中后抑郁的疗效与安全性：一项随机对照试验的系统评价与Meta分析
Efficacy and safety of electroacupuncture-based comprehensive treatment for post-stroke depression: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Hu Xiaomei, Pan Yanying, Tang Yasi, Zhang You, Liu Zhaoping, Zhuo Yue, Zhang Hong, Yi Xiqin
机构信息
College of Acupuncture, Massage, and Rehabilitation, Hunan University of Chinese Medicine, Changsha, Hunan, China.
College of Medical Imaging Laboratory and Rehabilitation, Xiangnan University, Chenzhou, Hunan, China.
出版信息
Front Psychiatry. 2025 Aug 15;16:1610032. doi: 10.3389/fpsyt.2025.1610032. eCollection 2025.
OBJECTIVE
This research aims to assess the therapeutic effects and safety of treatments for PSD by conducting a thorough systematic review and meta-analysis.
METHODS
Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wan Fang, covering all available records up to September 30, 2024. RCTs evaluating on the efficacy and safety of electroacupuncture in individuals with PSD were included. The robustness of the findings and possible contributors to heterogeneity were examined via sensitivity and subgroup analyses. Statistical analyses were conducted utilizing STATA 15.0 and Review Manager 5.4.
RESULTS
This study included 65 RCTs with a total of 5,362 participants. The results showed that electroacupuncture exhibited significantly greater clinical effectiveness compared to the control group (RR = 1.16, 95% CI [1.11, 1.22], ² = 59%, < 0.00001), effectively reducing HAMD scores (SMD = -0.56, 95% CI [-0.72, -0.40], ² = 87%, < 0.00001), SDS scores (SMD = -0.56, 95% CI [-0.87, -0.24], ² = 90%, = 0.006), and TCM-DS scores (SMD = -0.52, 95% CI [-0.78, -0.27], ² = 0%, < 0.0001). The incidence of adverse reactions was lower in the electroacupuncture (EA) intervention group (RR = 0.54, 95% CI [0.35, 0.83], I² = 0%, p = 0.004).The most commonly used acupoints were primarily located along the Gallbladder, Bladder, and Du Meridian, with the five most frequently used acupoints being: Baihui (GV20, 41 times), Shenting (DU24, 28 times), Taichong (LV3, 28 times), Shenmen (HT7, 26 times), and Neiguan (PC6, 22 times).
CONCLUSION
Electroacupuncture could serve as a safe and effective complementary therapy for PSD. It is recommended that multicenter, large-scale, and high-quality RCTs be conducted to further validate these findings.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618618, identifier CRD42024618618.
目的
本研究旨在通过全面的系统评价和荟萃分析，评估 PSD 治疗方法的疗效和安全性。
方法
从 PubMed、Embase、Web of Science、Cochrane 图书馆、中国知网（CNKI）和万方数据库中检索随机对照试验（RCT），涵盖截至 2024 年 9 月 30 日的所有可用记录。纳入评估电针治疗 PSD 疗效和安全性的 RCT。通过敏感性分析和亚组分析检验研究结果的稳健性以及异质性的可能影响因素。使用 STATA 15.0 和 Review Manager 5.4 进行统计分析。
结果
本研究纳入 65 项 RCT，共 5362 名参与者。结果显示，与对照组相比，电针具有显著更高的临床疗效（RR = 1.16，95%CI [1.11, 1.22]，I² = 59%，P < 0.00001），有效降低汉密尔顿抑郁量表（HAMD）评分（SMD = -0.56，95%CI [-0.72, -0.40]，I² = 87%，P < 0.00001）、抑郁自评量表（SDS）评分（SMD = -0.56，95%CI [-0.87, -0.24]，I² = 90%，P = 0.006）和中医证候量表（TCM-DS）评分（SMD = -0.52，95%CI [-0.78, -0.27]，I² = 0%，P < 0.0001）。电针（EA）干预组的不良反应发生率较低（RR = 0.54，95%CI [0.35, 0.83]，I² = 0%，P = 0.004）。最常用的穴位主要分布在胆经、膀胱经和督脉上，最常使用的五个穴位分别是：百会（GV20，41 次）、神庭（DU24，28 次）、太冲（LV3，28 次）、神门（HT7，26 次）和内关（PC6，22 次）。
结论
电针可作为 PSD 的一种安全有效的辅助治疗方法。建议开展多中心、大规模、高质量的 RCT 以进一步验证这些结果。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618618，标识符 CRD42024618618。
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