电针治疗抑郁障碍:与药物治疗的效果比较

目的介绍国内近20年来电针治疗抑郁障碍的临床研究概况,以期进一步了解电针治疗抑郁障碍的有效性和安全性.资料来源应用计算机检索中国生物医学文献数据库PubMed数据库1984/2004期间的相关文章,限定文章语言种类为中文,检索词为"电针,抑郁症". 资料选择对资料进行初审,选择临床试验研究文献查找全文.纳入标准①有明确诊断标准.②随机对照实验或对照试验.③治疗组干预措施为电针或电针合并抗抑郁药物或电针合并安慰剂;对照组干预措施为抗抑郁药物、抗抑郁药合并模拟电针、单纯电针或不采用抗抑郁措施.排除标准①非对照研究.②治疗组或对照组的干预措施不符合纳入标准.③机制研究.④重复研究.资料提炼共收集到相关文献99篇,按上述标准纳入15篇,其余文献均被排除.资料综合15篇文章中12篇为随机对照研究,3篇为对照研究,各研究的试验期为1～1.5个月,试验地点都在中国.各研究所纳入的病例数量为30～241例.其中6个研究对比了电针与传统抗抑郁药治疗抑郁症的疗效及安全性,2个研究进行了电针与新型抗抑郁药疗效的比较,4个研究观察了针药结合与单纯药物或单纯电针对抑郁症的疗效,1个研究比较了电针与西药治疗抑郁性神经症的疗效,2个研究观察了电针对脑卒中后抑郁的治疗作用.结论电针治疗抑郁障碍可以取得与西药抗抑郁剂相似的疗效,且具有副作用少,安全性高,易被患者接受等优势.但由于大样本的严格执行随机对照盲法原则的临床研究数量较少,今后还需要有高质量的临床研究来提供更加有力的证据.

General situation of electro-acupuncture in treating depressive disorders: Comparing the effect with that of drug therapy

OBJECTIVE: To introduce the general situation of the internal clinical studies about electro-acupuncture in treating depressive disorders during the recent 20 years so as to investigate further the effectiveness and safety of electro-acupuncture in treating depressive disorders.DATA SOURCES: A computer-based online search of Pubmed database and Chinese biomedical literature database (CBM) was undertaken to identify relevant articles published in Chinese between 1984 and 2004 with the keywords of "electro-acupuncture, depression".STUDY SELECTION: The data were checked firstly, and the full-texts of clinical trials were searched. Inclusion criteria: ① having definite diagnostic criteria; ② randomized control study or control trial; ③ the interventions in the treatment group should be electro-acupuncture or electroacupuncture combined with antidepressant drugs or electro-acupuncture combined with placebo, and those in the control group should be antidepressant drugs, antidepressant drugs combined with modeling electroacupuncture and only electro-acupuncture or without antidepressant measures. Exclusion criteria: ① non-control study; ② the interventions in the treatment group or control group did not accord with the inclusive criteria;③ mechanism study; ④ repetitive study.DATA EXTRACTION: In total 99 relevant articles were collected and 15 were selected according to the in clusive criteria and the others were excluded.DATA SYNTHESIS: Of the 15 articles, 12 were randomized control studies and 3 were control studies. The studies all lasted 1-1.5 months, all were completed in China, and the number of patients was 30-241. Six studies compared the effect and safety in treating depression between electro-acupuncture and traditional antidepressant drug therapy, 2 studies compared the effect of electro-acupuncture and new antidepressant drug, 4studies observed the effect of electro-acupuncture combined with drug and drug 9r electro-acupuncture only on depression, 1 study compared the effect of electro-acupuncture with that of western medicine in the treatment of depression, and 2 studies observed the role of electro-acupuncture in treating post-stroke depression.CONCLUSION: Electro-acupuncture has the similar effect of western antidepressant drug in treating depressive disorders; moreover, it has the advantages of fewer side effects, higher safety and easier acceptance of the patients, etc. There are fewer clinical studies of large samples and strictly following the randomized control and blinded principle, so clinical studies of high quality are still needed to provide more powerful evidences.