摘要
目的系统评价针刺治疗肝气郁结型抑郁障碍患者的有效性和安全性。方法搜索数据库建库起至2023年4月15日发表的相关文献。筛选符合入组标准的随机对照试验研究,评价文献质量并归类后进行Meta分析与系统评价。结果共纳入15篇随机对照研究,共计患者1077例。结果显示针刺治疗与单用抗抑郁药相比,在肝气郁结型抑郁障碍患者的汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分[MD=-0.73,95%CI(-1.22,-0.24),P<0.05]、中医证候量表评分[MD=-1.89,95%CI(-2.35,-1.44),P<0.001]、有效率[RR=1.09,95%CI(1.03,1.153),P=0.001]及治疗副反应量表(Treatment Emergent Symptom Scale,TESS)评分[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]均有统计学意义。针刺治疗与盐酸氟西汀相比,HAMD量表评分有效率的统计结果[RR=1.07,95%CI(1.01,1.14),P<0.05]有统计学意义。结论针刺疗法与单用抗抑郁药相比,对肝气郁结型抑郁障碍患者HAMD评分及中医症状的改善有优势,不良反应明显少于对照组。本研究认为针刺对肝气郁结型抑郁障碍患者来说可以作为一种安全有效的治疗方式。由于纳入的相关文献的质量和数量的限制,仍需要进一步的高质量的随机对照研究验证上述结论。
Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.
作者
厉汪涛
涂明琦
郭励园
胡奕颖
孙颢珉
郦沛祺
刘兰英
Li Wangtao;Tu Mingqi;Guo Liyuan;Hu Yiyin;Sun Haomin;Li Peiqi;Liu Lanying(The Second Clinical School of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053,China;Shanghai Institute of Mental Diseases of Traditional Chinese Medicine,Shanghai 201109,China;Shanghai Mental Health Center,Shanghai 201109,China;The Third Clinical School of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2024年第1期76-87,共12页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
浙江省卫生和计划生育委员会中医药防治重大疾病攻关计划项目(2018ZY001):病证结合治疗重性抑郁障碍诊疗新技术研究,负责人:刘兰英
上海市卫生健康委员会中医药科研项目计划(2022CX004):中医药防治伴有童年创伤的郁病作用机制研究,负责人:刘兰英
关键词
抑郁障碍
针刺
肝气郁结
系统评价
Major depressive disorders
Acupuncture
Stagnation of liver qi
System evaluation
作者简介
通讯作者:刘兰英,主任医师,主要研究方向:精神疾病的中西医结合治疗研究。
