| Background:Depression [1](Depression) also known as depressive disorder, depression as the main clinical features of mental disorders in the clinical significant and lasting depressed mood. Each episode lasts at least 2 weeks, or even years old, most of the cases had the tendency of repeated attack, most of each attack can be alleviated, some may have residual symptoms or become chronic. Modern therapeutic methods mainly include drug therapy,psychological treatment, electroconvulsive therapy and daily physical exercise[2].Auricular therapy(Auricular therapy AT) is also called auriculotherapy, is a way of treatment and health care of pathological state by stimulating ear outer surface and the ear part to ease the various parts of the body[3]. In China, usually with auriculotherapy meridians and acupoints of the ear is formed by the combination of auricular therapy(auricular acupoints therapy), auricular therapy combines traditional Chinese medicine theory, known as the "auriculotherapy" father of the famous American auriculotherapy physician Paul Nogier understanding for ear therapy[4]. Auriculotherapy now as one of the main clinical treatment methods, especially for the treatment of depression. In the system of modern medicine in the treatment of ear the ear, reflect the distribution range of the shape is similar to an inverted fetus[5]. The clinical treatment of middle ear therapy is often combined with other treatment methods, including the formation of the ear acupuncture, ear acupuncture massage,moxibustion, acupoint Injection, vagus nerve stimulation therapy and so on. By stimulating the outer or represents a particular body parts or organs of special point can treat various related diseases[6]. The World Health Organization is aware of the ear therapy in clinical treatment has been widely recognized in patients with is a function on the human body produce positive influence of complementary therapies. around the world within the scope of doctors and scholars also on the ear therapy clinical efficacy gave extensive attention and carried out a large number of experimental studies[7].Although the ear therapy has been widely used in clinical treatment of depression, clinical workers also published a large number of clinical studies in the literature, but system evaluation of the related literature on the efficacy of auricular points but does not see more,the clinical curative effect of auricular therapy also did not get effective confirmed. This study aims at application system evaluation method, on the auricular points therapy combined with other methods in the treatment of depression clinical efficacy evaluation system and for future auricular therapy in the clinical application of depression and mental illness, providing more powerful evidence.Purpose:The purpose of this study is through the application of system evaluation method and the efficacy and safety of the combination of auricular therapy and other methods of treatment of depression of evaluation system.Material and method:All the original researches included about the Auricular therapy for depression were searched from The Cochrane Central Register of Controlled Trials,Pub Med, MEDLINE, OVID, SCI, Springer, CNKI, VIP, CBM, Wang Fang Database. Our primary outcomes were HAMD, BDI, SDS, HAMA, SAS, BI, PAC-QOL, the adverse event.Data extraction was based on filling independently the data collection form by reviewers,discussion or consulting a third party was used to resolve disagreement. The Cochrane collaboration’s tool for assessing risk of bias was performed to assessment of methodological quality of all the inclusive trials, The Review Manager 5.0 for the Meta-analysis.Results:Retrieved a total of 168 articles, and finally into a 12 randomized controlled study of auricular therapy in the treatment of depression or semi randomized controlled study. The 2 articles in English literature, 10 pieces of Chinese literature.1. Compared with sham treatment of auricular therapyHamilton Depression table(HAMD): included 2 study, a total of 71 patients. Between Auricular therapy and false treatment does not exist significant difference [MD=-2.84, 95%CI(-9.50,3.82) I2=84% random].Beck Depression self rating scale(BDI) included 2 study, a total of 37 patients. Between Auricular therapy and false treatment exist significant difference [MD=-10.26, 95% CI(-18.00,-2.51), I2=0% Fixed].SDS self rating depression scale, were included in the study. A total of 34 patients. Between Auricular therapy and false treatment exist significant difference [MD =-10.63, 95% CI(-18.05-3.21)].Hamilton anxiety rating table(HAMA) were included in the study, a total of 34 patients.Between Auricular therapy and false treatment does not exist significant difference [MD =-1.77, 95% CI-5.50,1.96].SAS self rating depression scale, were included in the study. A total of 34 patients. Between Auricular therapy and false treatment exist significant difference [MD =-11.61, 95% CI CHG,-6.26](in Chinese).2. Auricular therapy compared with placeboRemission status contrast were included in this study, a total of 70 patients. Between Auricular therapy and placebo treatment exist significant difference [Risk difference = 3.57,95% CI-1.89,6.74](in Chinese).3. Auricular therapy combined with other therapies compare it with other therapiesHamilton Depression Scale(HAMD): included 4 study, 297 patients, auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD =-2.95, 95% CI(-4.94,-0.97), I2=83% Random].SDS self rating Depression Scale: four studies were included, a total of 264 patients.Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD =-8.66, 95% CI(-9.96,-7.37), I2=21% Fixed].SAS self rating Depression Scale: 1 study included, a total of 60 patients. Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD =-6.20, 95% CI,(-11.22,-1.18)].Remission status contrast: included 4 study. A total of 180 patients. Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD = 3.87, 95% CI(2.10,7.13) and I2=0% Fixed].BI were included in this study, 60 patients. Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD = 3.34, 95%CI-1.05,7.73](in Chinese).PAC-QOL were included in the study, 60 patients. Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD =-6.46,95% CI,(-10.78,-2.15), I2=95% Random]. constipation patients survival quality scaleAdverse reactions were included in this study, 72 patients. Auricular therapy in combination with other therapies and the simple use of other therapies exist significant difference [MD =-4.80, 95% CI(-7.25-2.35)].Conclusion:Auricular therapy in the treatment of depression in the overall efficiency is better than that of the sham treatment and the placebo treatment. The Beck Depression self rating scale(BDI),SDS(self rating depression self rating scale, Hamilton anxiety rating table(HAMA and SAS depression self rating table to improve the situation has obvious potential advantages. The adverse reactions of auricular therapy in the treatment of depression occur rate is lower than that of sham treatment and placebo treatment.Auricular point therapy combined with other therapy in the treatment of depression in general is more efficient than treated with other therapy. For the Hamilton Depression Rating Scale(HAMD), SDS(self rating depression self rating scale, SAS and depression self rating scale,alleviate the situation, and quality of life in patients with constipation table(PAC-QOL)related to the index improvement has more obvious advantage. |
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