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针刺治疗产后抑郁有效性和安全性的系统评价 被引量:8

Efficacy and safety of acupuncture for postpartum depression:a systematic review
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摘要 目的系统评价针刺治疗产后抑郁的有效性和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集针刺治疗产后抑郁的随机对照试验(RCT),检索时限均从建库至2021年2月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件进行Meta分析。结果共纳入13个RCT,包括899例患者。Meta分析结果显示:手针治疗与盐酸氟西汀在患者汉密尔顿抑郁量表(HAMD)评分[MD=0.45,95%CI(−0.52,1.41),P=0.36]、临床有效率[RR=0.93,95%CI(0.70,1.23),P=0.59]、临床痊愈率[RR=0.88,95%CI(0.44,1.76),P=0.73]等方面的差异均无统计学意义,不良反应发生率更低[RR=0.04,95%CI(0.01,0.28),P<0.05]。手针与心理治疗在患者临床有效率[RR=1.08,95%CI(0.87,1.36),P=0.49]和痊愈率[RR=1.31,95%CI(0.84,2.04),P=0.24]方面的差异也无统计学意义。结论当前有限证据表明,手针在降低产后抑郁患者HAMD评分、提高患者临床有效率、临床痊愈率方面与非针刺治疗无明显差异。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。 Objective To systematically review the efficacy and safety of acupuncture on postpartum depression(PPD). Methods Pub Med, EMbase, The Cochrane Library, Web of Science, CNKI, Wan Fang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs) on the efficacy and safety of acupuncture in treatment of PPD from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata16.0 software. Results A total of13 RCTs involving 899 patients were included. The results of meta-analysis showed that there was no significant difference between hand acupuncture and fluoxetine hydrochloride in HAMD score(MD=0.45, 95%CI-0.52 to 1.41, P=0.36),clinical effective rate(RR=0.93, 95%CI 0.70 to 1.23, P=0.59), and clinical cure rate(RR=0.88, 95%CI 0.44 to 1.76, P=0.73).However, hand acupuncture was superior in safety to fluoxetine hydrochloride(RR=0.04, 95%CI 0.01 to 0.28, P<0.05).There was no significant difference in clinical effective rate(RR=1.08, 95%CI 0.87 to 1.36, P=0.49) and cure rate(RR=1.31,95%CI 0.84 to 2.04, P=0.24) between both groups. Conclusions The current evidence shows that there are no differences between hand acupuncture and non-acupuncture in reducing HAMD score, improving the clinical effective rate and clinical cure rate. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
作者 曹悦 曹炜 袁捷 李美萱 李秀霞 杨克虎 温川飙 CAO Yue;CAO Wei;YUAN Jie;LI Meixuan;LI Xiuxia;YANG Kehu;WEN Chuanbiao(Department of Acupuncture and Moxibustion,Chengdu University of TCM,Chengdu 610075,P.R.China;Department of Encephalopathy,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an 710003,P.R.China;The Evidence-based Medicine Center of Lanzhou University,The School of Basic Medical Science of Lanzhou University,Lanzhou 730000,P.R.China;Evidence Based Social Science Research Center,School of Public Health,Lanzhou University,Lanzhou 730000,P.R.China;Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province,Lanzhou 730000,P.R.China;School of Medical Information Engineering,Chengdu University of TCM,Chengdu 610075,P.R.China)
出处 《中国循证医学杂志》 CSCD 北大核心 2021年第8期922-928,共7页 Chinese Journal of Evidence-based Medicine
基金 四川省科技厅项目(编号:18ZDYF3289) 四川省卫生信息学会研发项目(编号:2019036)。
关键词 针刺 产后抑郁 有效性 安全性 META分析 系统评价 随机对照试验 Acupuncture Postpartum depression Efficacy Safety Meta-analysis Systematic review Randomized controlled trial
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