针刺治疗中风后抑郁症的Meta分析

目的:评价针刺疗法治疗中风后抑郁症的疗效和安全性.方法:检索10年来针灸治疗中风后抑郁症的临床研究文献,对纳入Meta分析的临床随机对照试验(RCT)文献进行同质性检验及合并效应量,并进一步对治疗后针刺组与药物组的汉密尔顿抑郁量表(HAMD)评分进行Meta分析.结果:被纳入研究的17个RCT异质性检验结果显示χ~2=21.98,P=0.14,证明其具有同质性,故采用固定效应模型进行分析,合并后OR=2.54,95%可信区间(CI)为(1.91,3.38),经Z检验,Z=6.41,P<0.00001,菱形位于竖线的右侧,提示针刺组和药物组疗效比较差异有统计学意义.同时针刺对HAMD影响的评价表明,针刺组与药物组相比有统计学差异.结论:针刺治疗中风后抑郁症疗效优于其他常用药物,且具有安全性,但仍需更多的大样本RCT进行验证.

Meta-analysis on acupuncture for treatment of depression in patients of poststroke

Objective To assess therapeutic effect and the safety of acupuncture for treatment of the depression in patients of poststroke. Methods The clinical research documents in recent 10 years of acupuncture for treatment of depression in patients of poststroke were retrieved, the homogeneity test was used and the effect amount was complicated in the clinical randomized controlled trials (RCT) documents which had been adopted in the Meta-analysis, and furthermore the Meta-analysis was used in the Hamilton Depression Scale (HAMD) score of both acupuncture group and medication group after treatment. Results Seventeen RCT heterogeneity test results which were adopted in the study indicated that χ~2=21.98, P=0.14, proved that they had homogeneity, and fixed effect model was a-dopted to analyse, after combination, OR=2.54, 95% confidence interval was (1.91, 3.38), according to Z test, Z=6.41, P<0.000 01, the diamond was in the right side of the vertical line, indicated that there was a significant difference in the therapeutic effect between the acupuncture group and the medication group. The evaluation of the influnce of acupuncture on HAMD indicated that there was a significant difference between the acupuncture group and the medication group. Conclusion The therapeutic effect of acupuncture for treatment of the depression in patients of poststroke is superior to other common medicine with safety, but it still needs more large sample RCTs to verify.