BMC Psychiatry:针灸治疗脑卒中后抑郁,一项系统综述和网络荟萃分析

2023-05-05 紫菀款冬 MedSci原创 发表于上海

探讨针灸(AC)在缓解脑卒中后抑郁(PSD)症状方面的作用,并评估AC与药物疗法和各种非药物疗法联合使用的有效性差异。

背景:脑卒中后抑郁(PSD)患者通常会经历焦虑、绝望和失眠,对日常活动和脑卒中后康复有负面影响。针灸(AC)作为一种微创技术,已成为改善抑郁症症状的一种流行选择。然而,目前尚不清楚哪种疗法与PSD的最佳结果相关。

目的:该综述旨在探讨AC在缓解PSD症状方面的作用,并评估AC与药物疗法和各种非药物疗法联合使用的有效性差异。

方法:检索从研究成立到2023年3月的六个数据库和三个临床试验注册平台。纳入针刺与药物治疗以及其他非药物治疗或无效组进行比较的随机临床试验。两名独立评审员确定了符合条件的研究,并使用预先制作的表格收集数据。使用RStudio 3.6.0和“GEMTC”V.0.8.1进行了贝叶斯网络荟萃分析,以评估和比较不同的技术。

主要结果是通过测量抑郁症状的量表评估PSD的疗效。次要结果是神经功能和生活质量的有效性。所有治疗干预措施的排序概率均使用累积排序曲线下面积(SUCRA)进行。使用修订的Cochrane偏倚风险工具2评估偏倚风险。

结果:共纳入了从2003年到2022年发表的62项研究,涉及5308名参与者。结果表明,与西医(WM)(定义为PSD的药物治疗)相比,单独AC或联合重复经颅磁刺激(RTMS)、单独中医(TCM)或联合WM在缓解抑郁症状方面更为优越

与常规护理相比,单独使用AC或加上其他疗法可以显著降低汉密尔顿抑郁量表评分。根据SUCRA的结果,AC加RTMS改善抑郁症状的概率最高,为49.43%

结论:AC单独或与其他疗法联合治疗对改善中风幸存者的抑郁症状有效。此外,与WM相比,AC单独或加RTMS、TCM以及TCM联合WM在改善PSD的抑郁症状方面更有效。此外,带有RTMS的AC似乎是最有效的,概率最高。

原始出处:

Lam Ching W, Li HJ, Guo J, et al. Acupuncture for post-stroke depression: a systematic review and network meta-analysis. BMC Psychiatry. 2023;23(1):314. Published 2023 May 4. doi:10.1186/s12888-023-04749-1

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    2023-05-06 146480bem82暂无昵称 来自山东省

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    2023-05-06 1581f8c42cm 来自宁夏

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    2023-05-06 侠胆医心 来自上海
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    2023-05-05 1209e435m98(暂无昵称) 来自浙江省

    学习了,谢谢分享

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