针刺治疗肿瘤相关性抑郁疗效的Meta分析

Efficacy of acupuncture in the treatment of cancer-related depression:A meta-analysis

目的系统评价针刺治疗肿瘤相关性抑郁的疗效及安全性。方法先后检索Embase、The Cochrane Library、PubMed、维普数据库(VIP)、万方数据库(Wanfang Data)、中国知网(CNKI)和中国生物医学文献数据库(CBM)7个中、英文数据库中自建库至2023-03-04发表的有关针刺治疗肿瘤相关性抑郁的随机对照试验。结果最终纳入9篇文献,共计688例患者(试验组344例,对照组344例)。Meta分析结果显示,针刺组在改善HAMD、SDS评分,提高生活质量及临床有效率方面优于对照组(P<0.01)。亚组分析结果显示:与单独抗抑郁药物相比,针刺联合抗抑郁药能显著改善SDS、HAMD评分(P<0.05);与单独止痛药物相比,针刺联合止痛药能显著改善SDS评分(P<0.001);与抗抑郁药物相比针刺能改善SDS评分(P<0.01),但在改善HAMD评分方面差异无统计学意义(P>0.05)。结论针刺治疗肿瘤相关性抑郁是安全有效的,其中针刺联合抗抑郁药物或止痛药物的疗效优于单独的抗抑郁药物或止痛药物,但是针刺和抗抑郁药物的疗效对比尚不确定。

Objective To systematically evaluate the efficacy and safety of acupuncture in the treatment of cancer-related depression.Methods Clinical randomized controlled trials of acupuncture for cancer-related depression were retrieved from Embase Database,The Cochrane library,PubMed Database,China Scientific Journal Database(VIP),Wanfang Database,China National Knowledge Infrastructure(CNKI),and China Biology Medicine disc(CBM).The period of literature covered from the establishment of the databases to 2023-03-04.Results A total of 9 studies involving 688 patients(344 in experimental group and 344 in control group)were included.Meta-analysis showed that compared with control group,the acupuncture group could significantly improve HAMD and SDS scores,life quality and clinical effective rate(P<0.01).The results of subgroup analysis showed that compared with antidepressants alone,acupuncture combined with antidepressants group could significantly improve SDS and HAMD scores(P<0.05);compared with analgesics alone,acupuncture combined with analgesics group significantly improved SDS score(P<0.001);compared with antidepressants,acupuncture could improve SDS score(P<0.01),but there was no significant difference in HAMD scores(P>0.05).Conclusion Acupuncture is safe and effective in the treatment of cancer-related depression.The efficacy of acupuncture combined with antidepressants or analgesics is better than antidepressants or analgesics alone.However,the effectiveness of acupuncture versus antidepressants is uncertain.