针药并用治疗老年抑郁症的系统评价及Meta分析  

Meta-analysis of the Clinical Efficacy of Combined Acupuncture and Medicine for Senile Depression

作　　者：彭红叶 马孟园 龚晓红 王蜜源 刘佳[3] 王军[3] 赵振海[3] PENG Hongye;MA Mengyuan;GONG Xiaohong;WANG Miyuan;LIU Jia;WANG Jun;ZHAO Zhenhai(Beijing University of Traditional Chinese Medicine,Beijing 100029,China;Yichang Zigui County People’s Hospital,Yichang 443600,China;Beijing University of Traditional Chinese Medicine Dongzhimen Hospital,Beijing 100700,China)

机构地区：[1]北京中医药大学,北京100029 [2]宜昌市秭归县人民医院,宜昌443600 [3]北京中医药大学东直门医院,北京100700

出　　处：《上海针灸杂志》2022年第3期297-308,共12页Shanghai Journal of Acupuncture and Moxibustion

基　　金：北京市卫健委首都卫生发展科研专项研究项目(首发2020-1-2121)。

摘　　要：目的系统评价针药并用治疗老年抑郁症的有效性和安全性。方法利用计算机全面检索中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方学术期刊全文数据库(WF)、PubMed、荷兰医学文献数据库(EMbase)和Cochrane图书馆(Cochrane Library),自建库至2020年12月的有关针药并用治疗老年抑郁症的相关文献。筛选随机对照试验(RCT试验),采用Cochrane偏倚风险评估工具RoB2进行证据质量评价,采用RevMan5.3.0进行Meta分析。结果共纳入16篇文献,病例数1238例,针药组620例,单纯药物组618例。Meta分析结果显示针药组有效率明显高于单纯药物组[RR=1.12,95%CI(1.07,1.17),P<0.01],汉密尔顿抑郁(HAMD)量表评分明显低于单纯药物组[SMD=﹣1.20,95%CI(﹣1.64,﹣0.77),P<0.01],简易精神状态检查表(MMSE)评分明显高于单纯药物组[SMD=1.90,95%CI(1.60,2.20),P<0.01],匹兹堡睡眠质量指数(PSQI)评分明显低于单纯药物组[SMD=﹣1.43,95%CI(﹣1.77,﹣1.10),P<0.01]。而针药组不良反应显著低于单纯药物组[SMD=﹣0.60,95%CI(﹣0.85,﹣0.36),P<0.01]。结论针药并用治疗老年抑郁症可以显著改善患者抑郁程度、认知水平和睡眠状态,并减少不良反应的发生。Objective To systematically assess the efficacy and safety of acupuncture medication combined for senile depression.Method A computer search of China National Knowledge Infrastructure(CNKI),VIP Chinese Sci-Tech Journal Database(VIP),Wanfang Academic Journal Full-text Database(WF),PubMed,The Excerpta Medica Database(EMBASE)and Cochrane Library was made for literature on acupuncture medication combined for senile depression from database construction to Dec.,2020.Randomized controlled trials(RCT)were sifted out.The quality of evidence was evaluated using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.3.0.Result A total of 16 pieces of literature were included,including 1238 cases,620 cases in the acupuncture and medicine group and 618 cases in the medicine alone group.Meta-analysis Result showed that the efficacy rate was significantly higher[RR=1.12,95%CI(1.07,1.17),P<0.01],the Hamilton depression scale(HAMD)score was significantly lower[SMD=﹣1.20,95%CI(﹣1.64,﹣0.77),P<0.01],the mini-mental state examination(MMSE)score was significantly higher[SMD=1.90,95%CI(1.60,2.20),P<0.01]and the Pittsburgh sleep quality index(PSQI)score was significantly lower[SMD=﹣1.43,95%CI(﹣1.77,﹣1.10),P<0.01]in the acupuncture and medicine group than in the medicine alone group.Adverse reactions were significantly less in the acupuncture and drug group[SMD=﹣0.60,95%CI(﹣0.85,﹣0.36),P<0.01]than in the medicine alone group.Conclusion Acupuncture medication combined can significantly reduce depression severity,improve cognitive levels and sleep state and decrease the occurrence of adverse reactions in treating senile depression.

关 键 词：针药并用 抑郁症 汉密尔顿抑郁量表 匹兹堡睡眠质量指数 简易精神状态检查表 META分析 系统评价 

分 类 号：R246.6[医药卫生—针灸推拿学]