A Systematic Review Of Acupuncture Treatment Of Depression After Stroke

Objective:To evaluate the efficiency and security of acupuncture for post-stroke depression by means of system evaluation.Methods:The inclusion and exclusion criteria were formulated on the basis of the purpose of the study.Search CNKI,Wan Fang database,VIP,Pubmed,Cochrane library comprehensively（before February 2017）.The literatures were screened progressively to eliminate those discrepant studies and bring into studies meeting the inclusion and exclusion cr-itia.Finally,analysis of relavent data was conducted through Revman5.3 software,which leaded to the conclusion.Results:19 studies were included in this systematic review in total,and 1488 patients were included in the study.The analysis results are as follows.Total effective rate:Simple acupuncture therapy is better than antidepressants（RR=1.23,95%CI[1.14,1.33]）;Combination of acupuncture and medicine is better than antidepressants（RR=1.22,95%CI[1.15,1.30]）.Curative ratio:Simple acupuncture therapy is better than antide-pressants（RR=1.63,95%CI[1.21,2.20]）;Combination of acupuncture and medicine is better than antidepressants（RR=1.78,95%CI[1.29,2.45]）.HAMD score:Acupuncture therapy is better than antidepressants in improving HAMD scores(4^thweek:WMD=-3.53,95%CI[-4.16,-2.90]),6^thweek:WMD=-4.00,95%CI[-4.79,-3.22]),8^thweeks:WMD=-4.00,95%CI[-4.79,-3.22]).MESSS score:Acupuncture therapy is better than antidepressants in improving the MESSS score（WMD=-3.32,95%CI[-4.38,-2.26]）.CSS score:Acupuncture combined with medicine is better than antid-epressants in improving the CSS score（WMD=-5.70,95%CI[-6.98,-4.41]）.BI score:Acupuncture therapy is better than antidepressants in im-proving BI score(4^thweek:WMD=10.37,95%CI[5.75,15.00]).TCM Syndrome Scale score:Acupuncture combined with Deanxit andDeanxit have equivalent efficacy in improving symptom score（WMD=-2.49,95%CI[-5.05,0.06]）.Security:7 studies reported the security.A total of 60 cases of adverse events were reported,13 cases in the treatment group,47 cases in the control group.So,acupuncture treatment of post-stroke depression is perceived as safer than antidepressants preliminarily.However,only a few literatures reported the safety,so the definite conclusion can not be drawn.Some outcomes were single or couldn’t be combined,containing the BI score(8^thweek),NIHSS score,TESS score,so those outcomes were quali tatively analyzed.Conclusion:Based on the evaluation results,the acupuncture treatment of post-stroke depression in improving the total efficiency,curative ratio,HAMD score,MESSS score and BI score are better than antidepress-ant,while having equivalent efficacy in improving TCM syndrome score.However,because the studies included are limited,foreign literatures and gray literatures are lacked,and the quality of methodological as well as evidence are both low,which may lead tochange of outcomes by future researchs,so the current results should be treated discreetly.More clinical studies are needed to confirm these results.In terms of security,it’s believed that acupuncture is safer than antidepressant drugs,which needs to be confirmed by further clinical studies.