针药结合治疗中风后抑郁临床疗效的Meta分析

目的:系统评价针药结合治疗中风后抑郁的安全性和有效性。方法:检索中国知网、维普、万方、PubMed、Embase、Medline数据库,由3名研究者对检索文献按照纳入标准进行筛选,对纳入文献进行数据提取、质量评价并记录其基本特征,用Cochrane手册5.1.0版本推荐的"偏倚风险评估"工具评估其偏倚风险,用RevMan 5.3进行Meta分析。结果:纳入26篇文献,共2103例病例,文献的质量评价多为中等。Meta分析结果显示,试验组总有效率高于对照组OR=3.38,95%CI(2.61,4.37),P<0.00001,I2=0%];试验组HAMD评分低于对照组MD=-6.00,95%CI(-8.98,-3.03),P<0.0001,I2=99%];试验组NIHSS评分低于对照组MD=-4.65,95%CI(-6.33,-2.98),P<0.00001,I2=96%];试验组Barthel评分高于对照组MD=15.92,95%CI(9.79,22.06),P<0.00001,I2=93%]。结论:针药并用治疗中风后抑郁具有显著的疗效,但纳入文献的质量不高,仍需要更多高质量的多中心、大样本的临床研究来证明。

Clinical Curative Effect of Combination of Acupuncture with Medicine on Depression after Stroke:A Meta-Analysis

Objective:To systematically evaluate the safety and effect of combination of acupuncture with medicine on depression after stroke.Methods:CNKI,VIP,Wanfang,PubMed,Embase and MEDLINE database were retrieved.The three researchers screened the retrieved articles according to the inclusion criteria,extracted the data,evaluated the quality of the included articles,and recorded their basic characteristics.The risk of bias was assessed with the"bias risk assessment"tool recommended by Cochrane Handbook version 5.1.0,and metaanalysis was performed with RevMan 5.3.Results:A total of 26 articles were included,including 2103 cases.The quality of literature evaluation was medium.According to meta analysis,the treatment group showed higher total effective rate than control groupOR=3.38,95%CI(2.61,4.37),P<0.00001,I2=0%].The treatment group showed lower HAMD scores than control groupMD=-6.00,95%CI(-8.98,-3.03),P<0.0001,I2=99%].The treatment group showed lower NIHSS scores than control groupMD=-4.65,95%CI(-6.33,-2.98),P<0.00001,I2=96%].The treatment group showed higher Barthel scores than control groupMD=15.92,95%CI(9.79,22.06),P<0.00001,I2=93%].Conclusion:Combination of acupuncture with medicine showed significant curative effect on post-stroke depression.But the quality is not high in literature,and more high-quality multi center and large sample clinical studies are needed to prove it.