摘要
目的系统评价针刺对照常规医药治疗抑郁症睡眠障碍的疗效和安全性。方法计算机检索Pubmed、Embase、Cochrane Library、中国生物医学文献数据库、中国知网和万方数据库,由2名评价员分别独立检索针刺治疗抑郁症睡眠障碍的临床随机对照试验,检索时限为建库至2018年3月。由2名评价者独立检索、提取资料和评估方法学质量后,采用RevMan 5.3软件进行Meta分析。结果最终纳入15个研究,共1 081例受试者,Meta分析结果显示:(1)针刺组疗效与常规西药对照组无明显差异:①有效率:OR=1.55,95%CI(0.87,2.78);②汉密尔顿抑郁量表评分:OR=-1.47,95%CI(-3.44,0.50);③匹兹堡睡眠质量指数评定量表评分:OR=-2.07,95%CI(-4.26,0.13);④抑郁症测试表(SDS)抑郁严重度指数评分:OR=-3.31,95%CI(-5.22,-1.40),SDS评分:OR=-0.04,95%CI(-0.10,0.02)。(2)治疗后复发率针刺组与常规西药对照组无明显差异:①治疗后1个月随访:OR=0.43,95%CI(0.16,1.16);②治疗后3个月随访:OR=0.49,95%CI(-3.51,-2.71)。(3)不良反应发生率针刺组优于西药对照组:不良反应量表评分:OR=-3.38,95%CI(-4.84,-1.92)。结论本Meta分析结果显示,针刺治疗抑郁症睡眠障碍具有较好的临床疗效,不良反应发生率较常规西药低。
Objective To systematically evaluate the efficacy and safety of acupuncture in treating depression with insomnia. Methods Databases, including Pubmed, Embase, Cochrane Library, CBM, CNKI and WanFang Data were retrieved by two assessors independently, so as to retrieve randomized controlled trials(RCTs) on acupuncture combined with TCM in treating depression. Meanwhile, grey literature and the references in the published literature were retrieved manually from construction of database to March 2018. The trials were screened, data were extracted and the methodological quality was evaluated by two assessors independently. Afterwards, the RevMan 5.3 software was employed for Meta-analysis. Results The following findings could be obtained from meta-analysis.(1) There was no marked difference in the efficacy between acupuncture group and conventional western medicine control group:① response rate: OR=1.55, 95%CI(0.87, 2.78);②HAMD scale score:OR=-1.47, 95%CI(-3.44, 0.50);③PSQI scale score:OR=-2.07, 95%CI(-4.26, 0.13);and ④SDS index score:OR=-3.31, 95%CI(-5.22,-1.40), SDS scale score:OR=-0.04, 95%CI(-0.10, 0.02).(2) Difference in the recurrence rate after treatment between acupuncture group and conventional western medicine control group was not statistically significant: follow-up 1 month after treatment:OR=0.43, 95%CI(0.16, 1.16);and ② follow-up 3 months after treatment:OR=0.49, 95%CI(-3.51,-2.71).(3) The incidence rate of adverse reaction was superior in acupuncture group to that in western medicine control group:Asberg scale score:OR=-3.38,95% CI(-4.84,-1.92). Conclusions Our study suggests that acupuncture displays favorable clinical efficacy in treating depression, along with lower incidence rate of adverse reaction than conventional western medicine.
作者
臧颖颖
王朝阳
陈昕力
刘玥婷
邱灵慧
Zang Yingying;Wang Zhaoyang;Chen Xinli;Liu Yueting;Qiu Linghui(School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029)
出处
《现代中医临床》
2019年第2期18-24,29,共8页
Modern Chinese Clinical Medicine
基金
国家自然科学基金项目(No.81574069)
北京市自然科学基金项目(No.7162121)
