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Acupuncture for post-stroke depression: a systematic review and meta-analysis

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 conduct...

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Autores principales: Liu, Ran, Zhang, Kun, Tong, Qiu-yu, Cui, Guang-wei, Ma, Wen, Shen, Wei-dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017746/
https://www.ncbi.nlm.nih.gov/pubmed/33794857
http://dx.doi.org/10.1186/s12906-021-03277-3
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author Liu, Ran
Zhang, Kun
Tong, Qiu-yu
Cui, Guang-wei
Ma, Wen
Shen, Wei-dong
author_facet Liu, Ran
Zhang, Kun
Tong, Qiu-yu
Cui, Guang-wei
Ma, Wen
Shen, Wei-dong
author_sort Liu, Ran
collection PubMed
description 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-D(17), HAM-D(24) 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-021-03277-3.
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spelling pubmed-80177462021-04-02 Acupuncture for post-stroke depression: a systematic review and meta-analysis Liu, Ran Zhang, Kun Tong, Qiu-yu Cui, Guang-wei Ma, Wen Shen, Wei-dong BMC Complement Med Ther Research Article 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-D(17), HAM-D(24) 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-021-03277-3. BioMed Central 2021-04-01 /pmc/articles/PMC8017746/ /pubmed/33794857 http://dx.doi.org/10.1186/s12906-021-03277-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Liu, Ran
Zhang, Kun
Tong, Qiu-yu
Cui, Guang-wei
Ma, Wen
Shen, Wei-dong
Acupuncture for post-stroke depression: a systematic review and meta-analysis
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 Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8017746/
https://www.ncbi.nlm.nih.gov/pubmed/33794857
http://dx.doi.org/10.1186/s12906-021-03277-3
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