针刺治疗肝郁脾虚型抑郁症疗效和安全性的Meta分析  

Meta-Analysis of Efficacy and Safety of Acupuncture in Treating Depression with Liver-Stagnation and Spleen-Deficiency

作　　者：王育纯 林景峰 常泽 张丹丹[1] 田丹枫 高强[1] 刘甘露 王振亦 胡文悦 马华萍 韩振蕴[2] WANG Yu-chun;LIN Jing-feng;CHANG Ze;ZHANG Dan-dan;TIAN Dan-feng;GAO Qiang;LIU Gan-lu;WANG Zhen-yi;HU Wen-yue;MA Hua-ping;HAN Zhen-yun(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100071,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100071

出　　处：《中医药导报》2020年第6期71-76,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京市科技新星计划项目(2009A36);北京中医药大学基本科研在读研究生项目(2018-JYB-XSCXCY07)。

摘　　要：目的:评价针刺治疗肝郁脾虚型抑郁症的疗效及安全性。方法:检索中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Embase、The Cochrane Library数据库,检索时限从建库至2019年5月,收集针刺治疗肝郁脾虚型抑郁症的随机对照试验(RCTs)。由2名研究人员分别对纳入文献进行资料提取,并采用Cochrane协作网"偏倚风险评价工具"对纳入研究进行方法学质量评价,使用RevMan5.3软件进行Meta分析。结果:纳入11项RCT,共683例患者。Meta分析显示:针刺与SSRIs药物比较,在临床有效率[OR=1.78,95%CI(0.90,3.54),P=0.10]、HAMD-24项评分[MD=1.21,95%CI(-2.19,4.61),P=0.49]方面疗效相当;针刺联合SSRIs药物在改善HAMD评分方面优于单用SSRIs药物[MD=-2.62,95%CI(-3.84,-1.41),P<0.000,1],但在有效率方面,两组差异无统计学意义;针刺联合中药在临床有效率、HAMD评分方面均优于单用中药。结论:针刺治疗肝郁脾虚型抑郁症与SSRIs西药疗效相当,未见严重不良反应,安全性好。建议临床及科研工作者开展更多高质量、大样本、多中心的随机对照试验,为针刺治疗肝郁脾虚型抑郁症提供更有力的循证医学证据。Objective:To evaluate the efficacy and safety of acupuncture in treating depression with liverstagnation and spleen-deficiency.Methods:CNKI,WanFang,VIP,SinoMed,PubMed,Embase and Cochrane library were searched by computer from establishment to May 2019,to collect randomized controlled trials(RCTs)of acupuncture treatment of depression with liver-stagnation and spleen-deficiency.The literature was extracted by two researchers,and the methodological quality of the study was evaluated by Cochrane"bias risk assessment tool",and the meta-analysis was performed by RevMan 5.3 software.Results:A total of 11 RCTs involving 683 patients were included.According to the results of meta-analysis,compared with SSRIs,acupuncture has the same efficacy in effective rate[OR=1.78,95%CI(0.90,3.54),P=0.10]and HAMD-24 score[MD=1.21,95%CI(-2.19,4.61),P=0.49];Acupuncture combined with SSRIs was superior to SSRIs alone in HAMD score[MD=-2.62,95%CI(-3.84,-1.41),P<0.000,1].But in terms of efficiency,there was no difference between the two groups;Acupuncture combined with Chinese medicinal formulae was superior to the Chinese medicinal formulae in clinical efficiency and HAMD score.Conclusion:Compared with SSRIs,acupuncture has the same curative effect in treating depression with liver-stagnation and spleen-deficiency,and there was no serious adverse reactions,with good safety.It is suggested that more high-quality,large-sample and multi-center RCTs should be carried out by researchers to provide more powerful evidence-based medicine evidence for acupuncture treatment of depression with liver-stagnation and spleen-deficiency.

关 键 词：针刺 肝郁脾虚 抑郁症 META分析 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]