| Obj ective:To evaluate the clinical efficacy and safety of different acupuncture and moxibustion therapies for depression by Network meta-analysis.Methods:Authors searched PubMed,Embase,Cochrane Library,CNKI,Wanfang Date,VIP retrieval time from the January 2011 to December 31th,2020.The languages are limited to English and Chinese.We identified randomized controlled trials(RCTs)related to acupuncture therapy for depression according to the predefined inclusion and exclusion criteria.After quality assessment,relevant data were extracted,and then head to head meta-analysis and Network meta-analysis were performed using STATA1 5.0 and R 3.6.0 software respectively.Results:A total of 483 8 related literatures were retrieved and 53 RCTs were included,including 4095 patients.And this study involved acupuncture,electroacupuncture,acupuncture+Chinese medicine,acupuncture+western medicine,electroacupuncture+western medicine,acupuncture+Chinese medicine+western medicine,acupuncture+Chinese medicine+western medicine.Head to head meta-analysis:① In improving the total effective rate,acupuncture+western medicine is better than western medicine,acupuncture is better than western medicine,acupuncture+Chinese medicine+western medicine is better than western medicine,electroacupuncture is better than western medicine,electroacupuncture+western medicine is better than western medicine,acupuncture+Chinese medicine is better than western medicine,electroacupuncture+western medicine is better than acupuncture+western medicine;②In terms of reducing the adverse reaction rate,only acupuncture+western medicine had a lower adverse reaction rate than western medicine.Network meta-analysis:① In terms of improving the total effective rate,compared with western medicine,the efficacy of 6 kinds of acupuncture and moxibustion therapy is better than that of western medicine,electroacupuncture is better than acupuncture,acupuncture+western medicine is better than acupuncture,acupuncture+Chinese medicine+western medicine is better than acupuncture;②In terms of reducing the adverse reaction rate,the adverse reaction rate of acupuncture+Chinese medicine and acupuncture+western medicine was lower than that of western medicine,and the adverse reaction rate of acupuncture+Chinese medicine was lower than that of electroacupuncture+western medicine.Efficacy ranking:①In terms of improving the total effective rate,acupuncture+traditional Chinese medicine+western medicine was the best treatment method with the highest probability;②In terms of reducing the rate of adverse reactions,acupuncture and traditional Chinese medicine may be the lowest intervention measures Conclusions:Acupuncture+traditional Chinese medicine+western medicine is the best treatment for depression.But each acupuncture therapy has its own dominant syndromes,so it is necessary to select acupuncture therapy based on the actual situation and syndrome differentiation in clinical practice.The number of RCTs directly comparing different acupuncture and moxibustion methods in pairs is small,and more direct comparison RCTs are still needed to verify the results of indirect comparison in this study. |
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