摘要
目的评价针刺治疗产后抑郁症的临床疗效和安全性,为临床实践提供证据。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知识资源总库(CNKI)、万方数据知识服务平台(万方数据)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)建库至2021年10月1日产后抑郁症治疗随机对照试验(RCT)文献。采用Cochrane协作网偏倚风险评价工具对纳入文献进行方法学质量评价,利用RevMan5.3统计软件进行数据处理。结果纳入12篇文献,涉及患者977例。其中7项研究报告了临床有效率,2项研究报告了爱丁堡产后抑郁量表(EPDS)评分,9项研究报告了汉密顿抑郁量表(HAMD)评分,分别有5项研究和3项研究报告了雌二醇与5-羟色胺(5-HT)水平的变化,5项研究报告了不良反应发生率。Meta分析结果显示:治疗组临床有效率高于对照组(RR=1.30,95%CI[1.11,1.51],P<0.05),EPDS评分和HAMD量表评分优于对照组(P<0.05),针灸能提高患者5-HT水平(MD=0.35,95%CI[0.05,0.64],P<0.05),提升雌二醇水平(MD=28.30,95%CI[5.04,51.56],P<0.05),不良反应发生率针刺组低于对照组(RR=0.04,95%CI[0.00,0.66],P<0.05)。结论针刺治疗产后抑郁症临床疗效较好,确切结论仍有待高质量、多中心的RCT证实。
Objective To evaluate the clinical efficacy and safety of acupuncture for the treatment of postpartum depression;To provide evidence for clinical practice.Methods RCTs about the treatment of postpartum depression were retrieved from PubMed,Embase,Cochrane library,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Science and Technology Journal Database(VIP),and China Biomedical Literature Database(CBM)from the establishment of the database to October 1,2021.The Cochrane collaboration network bias risk assessment tool was used to evaluate the methodological quality of the included literature,and RevMan5.3 statistical software was used for data processing.Results Totally 12 articles involving 977 patients were included.Seven studies reported clinical effectiveness,two studies reported Edinburgh Postnatal Depression Scale(EPDS)score,nine studies reported Hamilton Depression Scale(HAMD)score,five studies and three studies reported changes in estradiol and 5-HT levels,and seven studies reported the incidence of adverse reactions.The results of Meta-analysis showed that the clinical effective rate of the experimental group was higher than that of the control group(RR=1.30,95%CI[1.11,1.51],P<0.05),and the EPDS score and HAMD scale score were better than those of the control group.Acupuncture could increase the level of 5-HT(MD=0.35,95%CI[0.05,0.64],P<0.05)and estradiol(MD=28.30,95%CI[5.04,51.56],P<0.05).Incidence of adverse reactions was lower in acupuncture group than control group(RR=0.04,95%CI[0.00,0.66],P<0.05).Conclusion Acupuncture has a good clinical efficacy in the treatment of postpartum depression.The exact conclusion still needs to be confirmed by high-quality,multi-center RCTs.
作者
李芹
陈琦
杨硕
LI Qin;CHEN Qi;YANG Shuo(Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国中医药图书情报杂志》
2023年第3期103-109,共7页
Chinese Journal of Library and Information Science for Traditional Chinese Medicine
基金
中国中医科学院科技创新工程项目(CI2021A05309)。
