OBJECTIVE:To evaluate the effectiveness and safety of ifliform needle acupuncture for poststroke depression, and to compare acupuncture with the therapeutic efifcacy of antidepressant drugs.
DATA RETRIEVAL:We retrieved data from the Chinese National Knowledge Infrastructure (1979-2012), Wanfang (1980-2012), VIP (1989-2012), Chinese Biomedical Literature (1975-2012), PubMed (1966-2012), Ovid Lww (-2012), and Cochrane Library (-2012) Database using the internet.
SELECTION CRITERIA:Randomized controlled trials on ifliform needle acupuncture versus antidepressant drugs for treatment of poststroke depression were included. Moreover, the in-cluded articles scored at least 4 points on the Jadad scale. Exclusion criteria:other acupuncture therapies as treatment group, not stroke-induced depression patients, score<4 points, non-ran-domized controlled trials, or animal trials.
MAIN OUTCOME MEASURES:These were the Hamilton Depression Scale scores, clinical ef-fective rate, Self-Rating Depression Scale scores, Side Effect Rating Scale scores, and incidence of adverse reaction and events.
RESULTS:A total of 17 randomized controlled clinical trials were included. Meta-analysis results displayed that after 4 weeks of treatment, clinical effective rate was better in patients treated with ifli-form needle acupuncture than those treated with simple antidepressant drugs [relative risk =1.11, 95%conifdence interval (CI):1.03-1.21, P=0.01]. At 6 weeks, clinical effective rate was similar between ifliform needle acupuncture and antidepressant drug groups. At 2 weeks after ifliform needle acupuncture, Hamilton Depression Scale (17 items) scores were lower than in the antide-pressant drug group (mean difference=-2.34, 95%CI:-3.46 to-1.22, P<0.000,1). At 4 weeks, Hamilton Depression Scale (24 items) scores were similar between ifliform needle acupuncture and antidepressant drug groups. Self-Rating Depression Scale scores were lower in filiform needle acupuncture group than in the antidepressant drug group. Side Effect Rating Scale was used in only two articles, and no meta-analysis was conducted. Safety evaluation of the 17 arti-cles showed that gastrointestinal tract reactions such as nausea and vomiting were very common in the antidepressant drug group. Incidence of adverse reaction and events was very low in the ifliform needle acupuncture group.
CONCLUSION:Early ifliform needle acupuncture for poststroke depression can perfectly con-trol depression. Filiform needle acupuncture is safe and reliable. Therapeutic effects of ifliform needle acupuncture were better than those of antidepressant drugs.