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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:neuro-psychiatrie:07. depression post-avc [04 Feb 2025 18:06] Nguyen Johan [1.1. Generic Acupuncture] |
acupuncture:evaluation:neuro-psychiatrie:07. depression post-avc [17 Oct 2025 13:23] (Version actuelle) Nguyen Johan [2.1. Meng 2025] |
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| === Electro-acupuncture === | === Electro-acupuncture === | ||
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| + | == Hu 2025 == | ||
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| + | Hu X, Pan Y, Tang Y, Zhang Y, Liu Z, Zhuo Y, Zhang H, Yi X. Efficacy and safety of electroacupuncture-based comprehensive treatment for post-stroke depression: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry. 2025 Aug 15;16:1610032. https://doi.org/10.3389/fpsyt.2025.1610032 | ||
| + | ^Objective| This research aims to assess the therapeutic effects and safety of treatments for PSD by conducting a thorough systematic review and meta-analysis.| | ||
| + | ^Methods| Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wan Fang, covering all available records up to September 30, 2024. RCTs evaluating on the efficacy and safety of electroacupuncture in individuals with PSD were included. The robustness of the findings and possible contributors to heterogeneity were examined via sensitivity and subgroup analyses. Statistical analyses were conducted utilizing STATA 15.0 and Review Manager 5.4.| | ||
| + | ^Results| This study included **65 RCTs with a total of 5,362 participants**. The results showed that electroacupuncture exhibited significantly greater clinical effectiveness compared to the control group (RR = 1.16, 95% CI [1.11, 1.22], I² = 59%, p < 0.00001), effectively reducing HAMD scores (SMD = -0.56, 95% CI [-0.72, -0.40], I² = 87%, p < 0.00001), SDS scores (SMD = -0.56, 95% CI [-0.87, -0.24], I² = 90%, p = 0.006), and TCM-DS scores (SMD = -0.52, 95% CI [-0.78, -0.27], I² = 0%, p < 0.0001). The incidence of adverse reactions was lower in the electroacupuncture (EA) intervention group (RR = 0.54, 95% CI [0.35, 0.83], I² = 0%, p = 0.004).The most commonly used acupoints were primarily located along the Gallbladder, Bladder, and Du Meridian, with the five most frequently used acupoints being: Baihui (GV20, 41 times), Shenting (DU24, 28 times), Taichong (LV3, 28 times), Shenmen (HT7, 26 times), and Neiguan (PC6, 22 times).| | ||
| + | ^Conclusion| Electroacupuncture could serve as a safe and effective complementary therapy for PSD. It is recommended that multicenter, large-scale, and high-quality RCTs be conducted to further validate these findings.| | ||
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| ===== Overviews of Systematic Reviews ===== | ===== Overviews of Systematic Reviews ===== | ||
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| + | ==== Liu 2025 ==== | ||
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| + | Liu X, Zhu F, Zhang JL, He ZX, Yin S, Wu RH, He YY, Zeng F. Effectiveness and Safety of Acupuncture as an Adjunctive Therapy for Post-Stroke Depression: An Overview of Systematic Reviews. Neuropsychiatr Dis Treat. 2025 Aug 1;21:1569–1588. https://doi.org/10.2147/NDT.S526413 | ||
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| + | ^Background|Post-stroke depression (PSD) is a common and serious neuropsychiatric complication that requires effective treatment options. Acupuncture as an adjuvant therapy shows promise, though current systematic reviews exhibit significant discrepancies in effectiveness and safety evidence, with insufficient methodological rigor. The objective was to evaluate systematic reviews assessing acupuncture as an adjuvant therapy for PSD.| | ||
| + | ^Methods|Eight databases were searched from inception to March 2024 using terms such as “acupuncture and moxibustion therapy”, “post-stroke depression”, and “systematic evaluation”. All systematic reviews underwent methodological evaluation with four tools: AMSTAR 2 for methodological quality, ROBIS for risk of bias, PRISMA 2020 for reporting standards, and GRADE for evidence grading. Inter-reviewer consistency was measured using the k-index.| | ||
| + | ^Results|**Ten systematic reviews** were included. According to AMSTAR 2, 9 of 10 (90%) were rated as “very low” confidence. Based on ROBIS, only 3 reviews (30%) had a low risk of bias. Reporting quality met PRISMA 2020 standards overall, but evidence grading was insufficient in most cases (only 2/10 adequately assessed). Using GRADE, 58.8% (20/34 outcomes) were rated “very low”. Acupuncture as an adjunctive therapy combined with conventional treatments significantly improved HAMD and NIHSS scores compared with monotherapy.| | ||
| + | ^Conclusion|Acupuncture as an adjunctive therapy appears to improve depressive symptoms and functional outcomes in PSD, but the generally low methodological quality and inconsistent evidence limit the reliability of these conclusions. Further high-quality, rigorously designed systematic reviews and trials are needed.| | ||
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| + | ==== Meng 2025 ==== | ||
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| + | Meng L, Xu CL, He XX, Tan XC. Acupuncture and Moxibustion for Poststroke Depression: Systematic Review. Interact J Med Res. 2025 Oct 16;14:e76577. https://doi.org/10.2196/76577 | ||
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| + | ^Background|Poststroke depression (PSD) is a common complication following stroke. In recent years, several systematic reviews have evaluated the effects of moxibustion and acupuncture on PSD; however, their findings have been inconsistent.| | ||
| + | ^Objective|To assess the methodological quality, reporting quality, and strength of evidence of existing systematic reviews on acupuncture and moxibustion for PSD, and to analyze their limitations to guide future research.| | ||
| + | ^Methods|Systematic reviews and meta-analyses of randomized controlled trials comparing moxibustion and acupuncture for the treatment of PSD were searched in eight databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM) up to August 10, 2024. Methodological, reporting, and evidence quality were assessed using AMSTAR 2, PRISMA 2020, and GRADE, respectively. Overlap among primary studies was measured using the corrected covered area.| | ||
| + | ^Results|Twenty-four reviews were included. All were rated as having low or critically low methodological quality (AMSTAR 2). Reporting quality was inadequate or partially inadequate in 22 of 24 studies (PRISMA 2020). The quality of evidence ranged from very low to moderate (GRADE). Most primary outcomes showed mild to moderate overlap among studies.| | ||
| + | ^Conclusion|Acupuncture may be beneficial for PSD, but the methodological and reporting quality of current reviews remains poor. Future evidence should come from large, multicenter, rigorously designed RCTs and high-quality systematic reviews.| | ||
| + | ==== Miao 2025 ==== | ||
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| + | Miao RQ, Zhu FY, Wang TY, Yin S, Shuai C, Li T, Li Z, Luo L, Yang B. The effectiveness and safety of acupuncture for post-stroke depression: an overview of systematic reviews. Complement Ther Med. 2025 Apr 19:103178. https://doi.org/10.1016/j.ctim.2025.103178. | ||
| + | ^Backgound| In recent years, research on acupuncture for post-stroke depression (PSD) has grown significantly, yet findings remain inconsistent. Few researchers have conducted comprehensive assessments of systematic reviews (SRs) in this area. Consequently, there is a need for a thorough and objective synthesis of clinical evidence regarding acupuncture's effectiveness in treating PSD.| | ||
| + | ^Objective| To evaluate and synthesize evidence on the efficacy and safety of acupuncture for PSD through systematic reviews, offering valuable insights for clinical practice and guiding future research directions.| | ||
| + | ^Methods| We searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang, VIP and Google Scholar databases for relevant literature. The search covered publications from database inception to September 10, 2024. Literature selection and data extraction were independently performed by two reviewers. The methodological quality, bias risk, and evidence level of included SRs were assessed using AMSTAR 2, ROBIS, and GRADE tools. The corrected covered area (CCA) was calculated to assess overlap in original studies. Data from included SRs were subjected to quantitative or descriptive analysis.| | ||
| + | ^Results| A total of **38 SRs **on acupuncture for PSD were included. After assessment using AMSTAR 2, one SR was rated as moderate quality, two as low quality, and 35 as very low quality. According to ROBIS, 21 SRs were classified as high risk of overall bias, and 17 as low risk. Acupuncture showed potential to improve depressive symptoms, stroke-related symptoms, and activities of daily living in PSD patients, though the quality of evidence is limited. Some studies suggested possible effects on cognitive function, biomarkers, sleep quality, and Traditional Chinese Medicine syndromes, but these findings require further validation with higher-quality research. While no serious adverse effects were reported in the reviewed studies, more rigorous safety evaluations are needed before definitive conclusions about acupuncture's safety for PSD can be made.| | ||
| + | ^Conclusion| Acupuncture shows potential as a treatment for PSD, though more high-quality research is needed to establish its effectiveness and safety. Currently, the majority of systematic reviews exhibit deficiencies in protocol pre-registration, documentation of excluded studies, and disclosure of funding sources, resulting in systematic reviews of suboptimal quality. Current evidence suggests possible benefits for depressive symptoms, stroke-related symptoms, activities of daily living, cognitive function, biomarkers, sleep quality, and TCM syndromes, but these findings should be interpreted cautiously given the limitations in study quality. Further high-quality studies are needed to confirm the efficacy and safety of acupuncture for PSD.| | ||
| ==== Xie 2022 ==== | ==== Xie 2022 ==== | ||
