Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

作     者：Ming-min Xu Pei Guo Qing-yu Ma Xuan Zhou Yu-long Wei Lu Wang Yue Chen Yu Guo Ming-min Xu;Pei Guo;Qing-yu Ma;Xuan Zhou;Yu-long Wei;Lu Wang;Yue Chen;Yu Guo

作者机构：School of Traditional Chinese MedicineJinan UniversityGuangzhou 510632Guangdong ProvinceChina Acupuncture and Tuina School/Third Teaching HospitalChengdu University of Traditional Chinese MedicineChengdu 610075Sichuan ProvinceChina School of MedicineChengdu University of Traditional Chinese MedicineChengdu 610075Sichuan ProvinceChina Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese MedicineFormula-Pattern Research CenterJinan UniversityGuangzhou 510632Guangdong ProvinceChina School of Acupuncture-Moxibustion and TuinaBeijing University of Chinese MedicineBeijing 100029China 

出 版 物：《Journal of Integrative Medicine》 (结合医学学报（英文版）)

年 卷 期：2022年第20卷第4期

页      面：305-320页

核心收录：

学科分类：1005[医学-中医学] 1002[医学-临床医学] 100512[医学-针灸推拿学] 10[医学] 

基　　金：supported by a grant from National Natural Science Foundation of China (grant number 82104983) Scientific Research Program by Traditional Chinese Medicine Bureau of Guangdong Province,China (grant number 20201103) Fundamental Research Funds for the Central Universities,China (grant number 21620362) 

主　　题：Depression Acupuncture plus antidepressants Therapeutic effectiveness Adverse drug reactions Systematic review Meta-analysis 

摘      要：Background: Some depressed patients receive acupuncture as an adjunct to their conventional ***: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with *** strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, *** criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants *** extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant *** Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included ***: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P 0.01