摘要
目的:系统评价针刺联合中药治疗卒中后抑郁症的疗效。方法:计算机检索中国知网(CNKI)、万方(Wan Fang)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、The Cochrane Library、Embase数据库建库至2019年8月公开发表的关于针刺联合中药治疗脑卒中后抑郁的随机对照试验。在筛选文献、提取资料和评价质量后,应用RevMan 5.3软件进行Meta分析。结果:共纳入13篇文献,累计989例卒中后抑郁患者。Meta分析结果显示,针刺结合中药治疗在降低卒中后抑郁患者HAMD评分(MD=-1.76,95%CI:-2.60~-0.92,Z=4.12,P<0.01)、NIHSS评分(MD=-3.74,95%CI:-4.99~-2.48,Z=5.83,P<0.01)和提高Barthel指数(MD=8.42,95%CI:3.28~13.57,Z=3.21,P<0.01)以及临床有效率(RR=1.16,95%CI:1.06~1.26,Z=3.45,P<0.01)方面优于单纯西药治疗。结论:针刺联合中药治疗卒中后抑郁的效果优于单纯西药治疗,能改善卒中后抑郁患者的抑郁状态、修复神经功能的缺损、提高日常生活能力,且不良反应少,值得临床推广应用。
Objective:To evaluate the efficacy of acupuncture combined with traditional Chinese medicine in the treatment of post-stroke depression by a meta-analysis.Methods:The randomized controlled trials of acupunc⁃ture combined with traditional Chinese medicine in the treatment of post-stroke depression published up to August 2019 were collected by a computerized search of CNKI,WanFang Data,VIP,China Biology Medicine disc,PubMed,Cochrane Library,and EMBASE.After literature screening,data extraction,and quality evaluation,the articles were analyzed by RevMan 5.3 software.Results:A total of 13 articles involving 989 patients were included in this study.According to the result of meta-analysis,compared with Western medicine alone,acupuncture com⁃bined with traditional Chinese medicine significantly reduced HAMD score(mean difference[MD]=-1.76,95%confidence interval[CI]:-2.60 to-0.92,Z=4.12,P<0.01)and NIHSS score(MD=-3.74,95%CI:-4.99 to-2.48,Z=5.83,P<0.01),and significantly increased the Barthel Index(MD=8.42,95%CI:3.28-13.57,Z=3.21,P<0.01)and clinical response rate(risk ratio=1.16,95%CI:1.06-1.26,Z=3.45,P<0.01)in pa⁃tients with post-stroke depression.Conclusion:Acupuncture combined with traditional Chinese medicine is superi⁃or to Western medicine alone in the treatment of post-stroke depression.The combination therapy can improve the depression state,repair nerve dysfunction,and improve activities of daily living with few adverse reactions.It holds promise for clinical application.
作者
罗珊
李玉
谭琳
陈丽
LUO Shan;LI Yu;TAN Lin;CHEN Li(School of Nursing,Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《西南医科大学学报》
2021年第1期8-15,共8页
Journal of Southwest Medical University
基金
四川医院管理和发展研究中心课题(SCYG2019-44)。
关键词
卒中后抑郁
针刺治疗
中药
随机对照试验
系统评价
Post-stroke depression
Acupuncture
Traditional Chinese medicine
Randomized controlled trial
Meta-analysis
