Early filiform needle acupuncture for poststroke depression: a meta-analysis of 17 randomized controlled clinical trials

OBJECTIVE： To evaluate the effectiveness and safety of filiform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efficacy of antidepressant drugs. DATA RETRIEVAL： We retrieved data from the Chinese National Knowledge Infrastructure （1979-2012）, Wanfang （1980-2012）, VIP （1989-2012）, Chinese Biomedical Literature （1975- 2012）, PubMed （1966-2012）, Ovid Lww （-2012）, and Cochrane Library （-2012） Database using the internet. SELECTION CRITERIA： Randomized controlled trials on filiform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in- cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria： other acupuncture therapies as treatment group, not stroke-induced depression patients, score 〈 4 points, non-ran- domized controlled trials, or animal trials. MAIN OUTCOME MEASURES： These were the Hamilton Depression Scale scores, clinical ef- fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events. RESULTS： A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with fill- form needle acupuncture than those treated with simple antidepressant drugs [relative risk = 1.11, 95% confidence interval （C/）： 1.03-1.21, P = 0.01]. At 6 weeks, clinical effective rate was similar between filiform needle acupuncture and antidepressant drug groups. At 2 weeks after filiform needle acupuncture, Hamilton Depression Scale （17 items） scores were lower than in the antide- pressant drug group （mean difference = -2.34, 95%CI： -3.46 to -1.22, P 〈 0.000,1）. At 4 weeks, Hamilton Depression Scale （24 items） scores were similar between filiform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti- cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the filiform needle acupuncture group. CONCLUSION： Early filiform needle acupuncture for poststroke depression can perfectly con- trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of filiform needle acupuncture were better than those of antidepressant drugs.

Filiform needle acupuncture for poststroke depression

To the editor, I read with interest the recent report on ＂filiform needle acupuncture for poststroke depression＂ （Zhang et al., 2014）. Zhang et al. （2014） performed a meta-analysis and conclud- ed that ＂early filiform needle acupuncture for poststroke depression can perfectly control depression：＇ In fact, the in- cluded meta-analysis might support the clinical effectiveness of filariform needle acupuncture for poststroke depression. However, there are several concerns. First, the hospital infection due to acupuncture manipulation with filiform is a big topic to be addressed. As Gang et al. （2012） noted, ＂aseptic technic principles aren＇t strictly followed; disinfection and isolation systems are unsound;

Filiform needle acupuncture for allergic rhinitis:A systematic review and meta-analysis

Background:Filiform needle acupuncture(FNA),the most classical and widely applied acupuncture method based on traditional Chinese medicine theory,has shown a promising effect in the treatment of allergic rhinitis(AR).Objective:To evaluate the efficacy,safety,cost-effectiveness,and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture,no treatment,and conventional medication.Search strategy:Eight electronic databases were systematically searched from inception to October 14,2021.Additional studies were acquired from clinical trial registration platforms and reference lists.Inclusion criteria:Randomized controlled trials were included if they compared FNA with either sham acupuncture,no treatment or conventional medication for AR.Data extraction and analysis:Two researchers extracted data independently of each other using a predesigned data acquisition form,and results were cross-checked after completion.The primary outcome was symptom score(Total Nasal Symptom Score or Visual Analogue Scale),and the secondary outcomes were the AR control questionnaire,quality of life(QoL)score(Different versions of Rhinoconjunctivitis Quality of Life Questionnaire),medication score(use of rescue medication),mental health score,total IgE,adverse event rate,clinical economic indicators,and patient satisfaction score.Standardized mean difference(SMD)or mean difference(MD)with 95% confidence interval was used to calculate the effect size for continuous data,while risk ratio with 95%CI was used for dichotomous data.Results:Thirty studies were included in this review.Compared with sham acupuncture,FNA significantly reduced the symptom score(SMD:-0.29[-0.43,-0.15]),AR’s impact on QoL(SMD:-0.23[-0.37,-0.08])and medication score(SMD:-0.3[-0.49,-0.11]).Compared with no treatment,FNA dramatically reduced the symptom score(SMD:-0.8[-1.2,-0.39])and AR’s impact on QoL(SMD:-0.82[-1.13,-0.52]).There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment.FNA increased patient satisfaction and may be cost-effective.Most pieces of evidence from the above two comparisons were of high confidence.Moreover,FNA significantly outperformed conventional medication in reducing the symptom score(SMD:-0.48[-0.85,-0.1])and displayed a lower rate of adverse events,but the quality of evidence was very low.Conclusion:FNA is an effective and safe intervention for AR and can help with symptom relief,QoL improvement,reducing medication usage,and increasing patient satisfaction.Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.