Acupuncture for post-stroke depression: a systematic review and meta-analysis
Abstract Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was...
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| Format: | Article |
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BMC
2021-04-01
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| Series: | BMC Complementary Medicine and Therapies |
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| Online Access: | https://doi.org/10.1186/s12906-021-03277-3 |
| _version_ | 1818623662027177984 |
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| author | Ran Liu Kun Zhang Qiu-yu Tong Guang-wei Cui Wen Ma Wei-dong Shen |
| author_facet | Ran Liu Kun Zhang Qiu-yu Tong Guang-wei Cui Wen Ma Wei-dong Shen |
| author_sort | Ran Liu |
| collection | DOAJ |
| description | Abstract Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I 2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I 2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I 2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I 2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I 2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I 2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I 2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. Conclusions The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed. |
| first_indexed | 2024-12-16T18:44:37Z |
| format | Article |
| id | doaj.art-b84993b0396248d0a14a037b91dfa1eb |
| institution | Directory Open Access Journal |
| issn | 2662-7671 |
| language | English |
| last_indexed | 2024-12-16T18:44:37Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Complementary Medicine and Therapies |
| spelling | doaj.art-b84993b0396248d0a14a037b91dfa1eb2022-12-21T22:20:53ZengBMCBMC Complementary Medicine and Therapies2662-76712021-04-0121111410.1186/s12906-021-03277-3Acupuncture for post-stroke depression: a systematic review and meta-analysisRan Liu0Kun Zhang1Qiu-yu Tong2Guang-wei Cui3Wen Ma4Wei-dong Shen5Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese MedicineAbstract Background Acupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs. Methods An exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system. Results A total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, − 5.08 [95% CI, − 6.48 to − 3.67], I 2 = 0%), (MD, − 9.72 [95% CI, − 14.54 to − 4.91], I 2 = 65%) and (MD, − 2.72 [95% CI, − 3.61 to − 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, − 0.43 [95% CI, − 1.61 to 0.75], I 2 = 51%), (MD, − 3.09 [95% CI, − 10.81 to 4.63], I 2 = 90%) and (MD, − 1.55 [95% CI, − 4.36 to 1.26], I 2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I 2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I 2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies. Conclusions The current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.https://doi.org/10.1186/s12906-021-03277-3AcupuncturePost-stroke depressionSystematic reviewMeta-analysisEffectivenessSafety |
| spellingShingle | Ran Liu Kun Zhang Qiu-yu Tong Guang-wei Cui Wen Ma Wei-dong Shen Acupuncture for post-stroke depression: a systematic review and meta-analysis BMC Complementary Medicine and Therapies Acupuncture Post-stroke depression Systematic review Meta-analysis Effectiveness Safety |
| title | Acupuncture for post-stroke depression: a systematic review and meta-analysis |
| title_full | Acupuncture for post-stroke depression: a systematic review and meta-analysis |
| title_fullStr | Acupuncture for post-stroke depression: a systematic review and meta-analysis |
| title_full_unstemmed | Acupuncture for post-stroke depression: a systematic review and meta-analysis |
| title_short | Acupuncture for post-stroke depression: a systematic review and meta-analysis |
| title_sort | acupuncture for post stroke depression a systematic review and meta analysis |
| topic | Acupuncture Post-stroke depression Systematic review Meta-analysis Effectiveness Safety |
| url | https://doi.org/10.1186/s12906-021-03277-3 |
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