眼针联合治疗中风后抑郁疗效Meta分析
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摘要
目的 :系统评价眼针联合治疗中风后抑郁的临床疗效。方法 :以眼针、中风后抑郁等为检索词,在CNKI、VIP、万方数据库进行检索,收集符合要求的文献。对其进行方法学质量评价,用RevMan 5.3软件进行Meta分析。结果 :本研究共纳入文献5篇,试验组共纳入患者212例,对照组共纳入204例。均为眼针联合治疗与常规治疗比较。Meta分析结果显示,眼针联合治疗组与常规治疗组比较,总有效率OR合并=3.22,95%CI(1.87,5.53),P<0.0001,HAMD评分MD=-3.30,95%CI(-5.61,-0.99),P=0.005,说明眼针联合治疗后的总有效率明显优于常规治疗,HAMD明显低于常规治疗。结论 :眼针联合治疗中风后抑郁疗效明显优于常规治疗。但鉴于高质量、大样本的研究相对不足,仍需大样本、严谨的随机对照试验来证实。
Objective :To explore the efficiency of the the post-stroke depression(PSD)by eyes acupuncture. Methods :The randomized controlled trials(RCTs)in CNKI,VIP and WanFang database were electronically searched by using the search terms eyes acupuncture,post-stroke depression etc.Collected all the information of the selected studies and assessed the methodology quality. Meta-analysis was performed using the Cochrane Collaboration's RevMan 5.3 software. Results :5 RCTs were included in this review. In those studies,a total of 212 patients were included in the experimental group. And 204 patients were included in the control group. All of them were compared eyes acupuncture and conventional treatment with conventional treatment. The results of meta-analysis showed total effective rate :ORcombine=3.22,95%CI(1.87,5.53),P<0.0001,meant that eyes acupuncture combined with conventional treatment is more effective than only using conventional treatment. The results of meta-analysis showed the score of HAMD :MD=-3.30,95%CI(-5.61,-0.99),P=0.005,meant that the score of HAMD with eyes acupuncture combined treatment was significantly lower than that of conventional treatment. Conclusion :The eyes acupuncture combined with conventional treatment is more effective than only using conventional treatment on treatment of PSD. However,due to the relative shortage of high quality and large sample,it may larger and more rigorous randomized controlled trials to confirm.
Objective :To explore the efficiency of the the post-stroke depression(PSD)by eyes acupuncture. Methods :The randomized controlled trials(RCTs)in CNKI,VIP and WanFang database were electronically searched by using the search terms eyes acupuncture,post-stroke depression etc.Collected all the information of the selected studies and assessed the methodology quality. Meta-analysis was performed using the Cochrane Collaboration's RevMan 5.3 software. Results :5 RCTs were included in this review. In those studies,a total of 212 patients were included in the experimental group. And 204 patients were included in the control group. All of them were compared eyes acupuncture and conventional treatment with conventional treatment. The results of meta-analysis showed total effective rate :ORcombine=3.22,95%CI(1.87,5.53),P<0.0001,meant that eyes acupuncture combined with conventional treatment is more effective than only using conventional treatment. The results of meta-analysis showed the score of HAMD :MD=-3.30,95%CI(-5.61,-0.99),P=0.005,meant that the score of HAMD with eyes acupuncture combined treatment was significantly lower than that of conventional treatment. Conclusion :The eyes acupuncture combined with conventional treatment is more effective than only using conventional treatment on treatment of PSD. However,due to the relative shortage of high quality and large sample,it may larger and more rigorous randomized controlled trials to confirm.
引文
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[24]买迪尼亚提.脑卒中后3-6个月内抑郁的发生率及相关影响因素分析[J].医药前沿,2013(30):88-89.
[25]李云,郭旭,李永刚.脑卒中后抑郁大鼠额前皮质脑源性神经营养因子及酪氨酸激酶受体B表达的变化[J].中华行为医学与脑科学杂志,2013,22(1):6-8.
[26]牛海玲,马琳,王廉昌. IL-1、IL-2、IL-6、TNF-α在脑卒中后抑郁患者血清中的表达及其临床意义[J].现代医学,2016,44(1):89-91.
[27]龚琪,刘学源.老年卒中后抑郁与血清同型半胱氨酸水平的相关性研究[J].同济大学学报:医学版,2015,36(2):49-52.
[28]刘晓敏.针灸治疗卒中后抑郁研究进展[J].亚太传统医药,2017,13(10):58-60.
[29]黄广兴.针灸对照不同西药治疗中风后抑郁临床疗效的Meta分析[D].广州:广州中医药大学,2017.
[30]刘露阳,王鹏琴.眼针治疗中风偏瘫疗效Meta分析[J].辽宁中医药大学学报,2017,19(2):102-104.
[31]闵希瑞.眼针疗法治疗脑卒中后抑郁的临床研究[D].沈阳:辽宁中医药大学,2014.
[32]高鹏.眼针结合疏肝解郁颗粒治疗中风后抑郁的临床观察[D].沈阳:辽宁中医药大学,2016.
[33]刘强,黎波,王秀娟.基于累积Meta分析的针灸治疗脑卒中后抑郁症疗效评价研究[J].辽宁中医杂志,2018,45(5):897-899.
[34]张雪琳,陈新旺,高希言.针刺对脑卒中后抑郁症患者抑郁状态改善的Meta分析[J].中华中医药学刊,2018,36(12):2875-2879.
[2]丁贤慧,万梅,杨倩.卒中后抑郁与卒中部位的相关性研究[J].皖南医学院学报,2015,34(2):125-128.
[3]张卫红,陈长香,王云龙,等.脑卒中患者发生抑郁的影响因素[J].职业与健康,2015,31(17):2422-2424.
[4]田云霞,王尚臣,孟庆春.脑卒中后抑郁与损伤部位的关系研究[J].河北医药,2014,36(21):3292-9294.
[5]Wu C,Zhang,Chen Y. Study on the behavioral changes of a post stroke depression rat model[J]. Exp Ther Med,2015,10(1):159.
[6]Hackett M L,Pickles K. Part I:frequency of depression after stroke:an updated systematic review and Meta-analysis of observational studies[J]. International Journal of Stroke Official Journal of the International Stroke Society,2014,9(8):1017.
[7]Lukk J,Delbari A. Management of depression in elderly stroke patients[J]. Neuropsychiatr Dis Treat,2010,46(6):539-549.
[8]黄盛,赵红.针刺治疗中风后抑郁的临床概况[J].中华针灸电子杂志,2014,3(1):16-19.
[9]Schulte-Altedorneburg M,Bereczki D. Post-stroke depression[J].Orv Hetil,2014,155(34):1335.
[10]秦菁菁,王海荣,赵红.卒中后情感障碍的中医诊疗新进展[J].中国中医急症,2016,25(11):2108-2111.
[11]王少石,周新雨,朱春燕.卒中后抑郁临床实践的中国专家共识[J].中国卒中杂志,2016,11(8):685-693.
[12]Xiao W,Zhang X B,Hu H X,et al. Acupuncture and drug or subcortical ischemic vascular disease complicated with depression:a randomized controlled trial[J]. Chinese Acupuncture&Moxibustion,2014,34(11):1051.
[13]刘铭.系统评价、Meta-分析设计与实施方法[M].北京:人民卫生出版社,2013:69-71.
[14]Higgins J P T,Green S. Cochrane Handbook for Systematic R eviews of Interventions Version 5.1.0[J]. The Cochrane Collaboration,2011,2(2):126-130.
[15]黄春元.眼针治疗脑梗死后抑郁状态临床分析[J].辽宁中医药大学学报,2013,15(8):236-238.
[16]王婷婷.眼针疗法联合西药百忧解治疗中风后抑郁临床疗效观察[D].沈阳:辽宁中医药大学,2013.
[17]李辰瑶.眼针治疗脑卒中后抑郁的临床疗效观察[D].沈阳:辽宁中医药大学,2013.
[18]徐锦平,王健,周鸿飞.眼针疗法加百忧解治疗脑卒中后抑郁疗效观察[J].辽宁中医杂志,2008(1):119-120.
[19]佟阳.眼针结合心理干预疗法治疗中风后抑郁的临床观察[D].沈阳:辽宁中医药大学,2017.
[20]国家中医药管理局脑病急症科研协作组.中风病诊断和疗效评定标准[J].北京中医药大学学报,1996,19(1):55-56.
[21]中华神经科学会.各类脑血管病诊断要点[S].中华神经科杂志,1996,29(6):379.
[22]国家中医药管理局.中华人民共和国中医药行业标准-中医病证诊断疗效标准[S].南京:南京大学出版社,1994:20.
[23]中华医学会精神科分会.中国精神障碍分类与诊断标准[S].3版.济南:山东科学技术出版社,2001:87-88.
[24]买迪尼亚提.脑卒中后3-6个月内抑郁的发生率及相关影响因素分析[J].医药前沿,2013(30):88-89.
[25]李云,郭旭,李永刚.脑卒中后抑郁大鼠额前皮质脑源性神经营养因子及酪氨酸激酶受体B表达的变化[J].中华行为医学与脑科学杂志,2013,22(1):6-8.
[26]牛海玲,马琳,王廉昌. IL-1、IL-2、IL-6、TNF-α在脑卒中后抑郁患者血清中的表达及其临床意义[J].现代医学,2016,44(1):89-91.
[27]龚琪,刘学源.老年卒中后抑郁与血清同型半胱氨酸水平的相关性研究[J].同济大学学报:医学版,2015,36(2):49-52.
[28]刘晓敏.针灸治疗卒中后抑郁研究进展[J].亚太传统医药,2017,13(10):58-60.
[29]黄广兴.针灸对照不同西药治疗中风后抑郁临床疗效的Meta分析[D].广州:广州中医药大学,2017.
[30]刘露阳,王鹏琴.眼针治疗中风偏瘫疗效Meta分析[J].辽宁中医药大学学报,2017,19(2):102-104.
[31]闵希瑞.眼针疗法治疗脑卒中后抑郁的临床研究[D].沈阳:辽宁中医药大学,2014.
[32]高鹏.眼针结合疏肝解郁颗粒治疗中风后抑郁的临床观察[D].沈阳:辽宁中医药大学,2016.
[33]刘强,黎波,王秀娟.基于累积Meta分析的针灸治疗脑卒中后抑郁症疗效评价研究[J].辽宁中医杂志,2018,45(5):897-899.
[34]张雪琳,陈新旺,高希言.针刺对脑卒中后抑郁症患者抑郁状态改善的Meta分析[J].中华中医药学刊,2018,36(12):2875-2879.