醒脑开窍针法治疗卒中后抑郁疗效与安全性的Meta分析

Efficacy and Safety of Xingnao Kaiqiao Acupuncture Therapy for Post-stroke Depression:A Meta-analysis

【目的】系统评价醒脑开窍针法治疗卒中后抑郁(PSD)的疗效及安全性。【方法】计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、美国医学在线(PubMed)、荷兰医学文献数据库(EMbase)、中国生物医学文献数据库(SinoMed)及国际循证医学图书馆(Cochrane Library)等数据库中关于醒脑开窍针刺法治疗PSD的随机对照试验。检索时间为各数据库自建库以来至2021年4月。采用Review Manager 5.3软件对相关数据进行Meta分析,采用Stata16.0进行发表偏倚检测。【结果】共纳入16篇文献进行Meta分析,共纳入研究对象1618例。Meta分析结果显示:与单纯西药组相比,醒脑开窍针法组治疗卒中后抑郁可明显改善情绪健康,汉密尔顿抑郁量表(HAMD)评分优于对照组[WMD=-4.46,95%CI(-6.26,-2.67),Z=4.88,P<0.00001];改善抑郁自评量表(SDS)评分[WMD=-7.19,95%CI(-9.73,-5.26),Z=6.58,P<0.00001];改善美国国立卫生院神经功能缺损评分量表(NIHSS)评分[WMD=-1.74,95%CI(-2.33,-1.15),Z=5.81,P<0.00001];提高总有效率[RR=1.16,95%CI(1.08,1.26),Z=3.86,P=0.0001];安全性评价提示:醒脑开窍针法未见明显不良反应。【结论】醒脑开窍针法可明显改善卒中后抑郁患者的情绪健康及神经功能,由于纳入研究样本量较小、质量较低,未来仍需开展更多高质量、大样本、多中心的临床研究进一步验证。

Objective To systematically evaluate the efficacy and safety of Xingnao Kaiqiao(inducing resuscitation)acupuncture in the treatment of post-stroke depression(PSD).Methods Computer retrieval of CNKI,Wanfang,VIP,PubMed,EMbase,SinoMed and the Cochrane Library,databases on randomized controlled trials on the treatment of PSD by Xingnao Kaiqiao Acupuncture therapy.The retrieval period was from the establishment of each database to April 2021.Meta-analysis of relevant data was performed using Review Manager 5.3 software,and publication bias was detected using Stata 16.0.Results A total of 16 literatures were included for meta-analysis,including 1618 subjects.The results of the Meta-analysis showed that compared with the western medicine alone group,the treatment of PSD in the Xingnao Kaiqiao acupuncture group significantly improved emotional well-being,and the Hamilton Depression Scale(HAMD)scores[WMD=-4.46,95%CI(-6.26,-2.67),Z=4.88,P<0.00001]was superior to that of the control group;Depression SelfRating Scale(SDS)score being[WMD=-7.19,95%CI(-9.73,-5.26),Z=6.58,P<0.00001];National Institutes of Health Neurological Impairment Scale(NIHSS)score being[WMD=-1.74,95%CI(-2.33,-1.15),Z=5.81,P<0.00001];overall effective rate being[RR=1.16,95%CI(1.08,1.26),Z=3.86,P=0.0001];safety evaluation suggested that no significant adverse effects were found with the inducing resuscitation acupuncture therapy.Conclusion The Xingnao Kaiqiao acupuncture therapy can significantly improve emotional well-being and neurological function in PSD patients.Due to the small sample size and low quality of the included studies,more high-quality,large-sample,multi-centre clinical studies are still needed for further validation in the future.