■本研究旨在系统地评估针刺结合重复经颅磁刺激(rTMS)治疗中风后抑郁症(PSD)的疗效。
■我们对国内外八大数据库进行了全面检索,包括中国知网,从成立到2023年12月。包括研究针刺联合rTMS治疗PSD的随机对照试验。筛选过程遵循预定的纳入和排除标准,使用Cochrane手册5.1指南评估研究质量。采用RevMan5.4软件进行Meta分析。
■分析中纳入了12项研究,涉及800名患者。meta分析显示,针刺联合rTMS明显提高了临床有效率(RR=1.19,95%CI:1.12至1.27,p<0.00001),并降低了多个量表的得分:汉密尔顿抑郁量表(HAMD)(MD=-3.35,95%CI:-3.79至-2.90,p<0.00001),自我抑郁量表(SDS)(MD=-9.57,95%CI:-12.26至-6.89,p<0.00001),中医症状评分(MD=-3.34,95%CI:-3.76至-2.91,p<0.00001),匹兹堡睡眠质量量表(MD=-3.91,95%CI:-4.58至-3.25,p<0.00001),和美国国立卫生研究院卒中量表(NIHSS)(MD=-2.77,95%CI:-3.21至-2.32,p<0.00001)。此外,针刺结合rTMS治疗改善认知功能(MMSE,MoCA评分)(p<0.00001)和进行日常生活活动的能力评分(MD=10.40,95%CI:9.53至11.28,p<0.00001)。此外,它被发现减少白细胞介素6,肿瘤坏死因子α,白细胞介素1β,并增加5-羟色胺和脑源性神经营养因子水平(p<0.001)。
■推荐针刺结合rTMS治疗PSD,因为它有效地改善了临床结果,缓解抑郁症状,增强认知功能,和日常生活能力,并调节炎症反应和神经递质水平。然而,值得注意的是,纳入研究的样本量和质量有限,因此需要更多高质量的研究来验证这些结论.
■插入,标识符INPLASY202430085。
UNASSIGNED: This
study aimed to systematically assess the efficacy of combining acupuncture with repetitive transcranial magnetic stimulation (rTMS) in treating post-stroke depression (PSD).
UNASSIGNED: We conducted a comprehensive search of eight major domestic and international databases, including the China Knowledge Network, from inception until December 2023. Included were randomized controlled trials that investigated acupuncture combined with rTMS for PSD. The screening process adhered to predetermined inclusion and exclusion criteria, and
study quality was assessed using Cochrane Handbook 5.1 guidelines. Meta-analysis was conducted using RevMan 5.4 software.
UNASSIGNED: Twelve studies involving 800 patients were included in the analysis. The meta-analysis showed that acupuncture combined with rTMS significantly improved the clinical effectiveness rate (RR = 1.19, 95% CI: 1.12 to 1.27, p < 0.00001) and reduced scores on several scales: Hamilton Depression Scale (HAMD) (MD = -3.35, 95% CI: -3.79 to -2.90, p < 0.00001), Self-Depression Scale (SDS) (MD = -9.57, 95% CI: -12.26 to -6.89, p < 0.00001), Chinese Medicine Symptom Score (MD = -3.34, 95% CI: -3.76 to -2.91, p < 0.00001), Pittsburgh Sleep Quality Scale (MD = -3.91, 95% CI: -4.58 to -3.25, p < 0.00001), and National Institutes of Health Stroke Scale (NIHSS) (MD = -2.77, 95% CI: -3.21 to -2.32, p < 0.00001). Furthermore, acupuncture combined with rTMS treatment improved cognitive functioning (MMSE, MoCA scores) (p < 0.00001) and ability to perform activities of daily living scores (MD = 10.40, 95% CI: 9.53 to 11.28, p < 0.00001). Additionally, it was found to reduce interleukin 6, tumor necrosis factor alpha, interleukin 1β, and increase 5-hydroxytryptamine and brain-derived neurotrophic factor levels (p < 0.001).
UNASSIGNED: Acupuncture combined with rTMS therapy is recommended for treating PSD, as it effectively improves clinical outcomes, alleviates depressive symptoms, enhances cognitive function, and daily living capabilities, and modulates inflammatory responses and neurotransmitter levels. However, it is important to note that the limitations of the sample size and quality of the included studies warrant the need for more high-quality research to validate these conclusions.
UNASSIGNED: INPLASY, Identifier INPLASY202430085.