| Objectives To evaluate the efficacy of five different non-drug treatment interventions:high frequency repetitive transcranial magnetic stimulation(rTMS),low frequency rTMS,hyperbaric oxygen therapy(HBO),cognitive behavioral therapy(CBT)and music therapy combined with SSRIs antidepressants on post-stroke depression(PSD).Methods Search china’s biomedical literature database(CBM),China journal full-text database(CNKI),Wanfang database,VIP,the Cochrane Library,Pub Med,EMBASE,and web of science databases.The retrieval time limit is from establishing the database to February 2021.Literature involves five different interventions of high-frequency rTMS,low-frequency rTMS,HBO,CBT,and music therapy combined with SSRI antidepressant therapy(PSD).Use gemtc14.0 software for network meta-analysis.Results A total of 53 RCT studies were included,including 20 high-frequency rTMS,10low-frequency rTMS,9 HBO,10 CBT,and six music therapy.At four weeks of treatment,a total of 32 kinds of literature reported the decline in the HAMD score of PSD patients treated with various intervention measures after four weeks of treatment because there was only one piece of literature related to music therapy.To reduce the impact on the results,only the differences in the efficacy of high-frequency rTMS,low-frequency rTMS,HBO,and CBT were compared.Compared with the control group,the four non-drug treatment interventions reduced HAMD scores,and the differences were statistically significant,including low-frequency rTMS(MD=3.45,95%CI: 1.52-5.37),high-frequency rTMS(MD=4.35,95%CI: 3.02-5.71),HBO(MD=4.27,95%CI: 2.49-6.02),CBT(MD=2.72,95%CI: 1.24-4.20).There was no significant difference between the four non-drug treatment interventions.The order of probability ranking results of the network metaanalysis is high-frequency rTMS,HBO,low-frequency rTMS,CBT;After four weeks of fluoxetine treatment,there were significant differences in the efficacy of the four interventions.Compared with the control group,the four non-drug treatment interventions of low-frequency rTMS(MD=3.87,95%CI: 1.55-6.15),high-frequency rTMS(MD=4.92,95%CI: 3.20-6.95),HBO(MD=3.65,95%CI: 0.89-6.63)and CBT(MD=2.45,95%CI:0.49-4.39)decreased HAMD scores,and the differences were statistically significant;There was no significant difference between the four non-drug treatment interventions.The probability ranking results of the network meta-analysis were as follows:high frequency rTMS,low frequency rTMS,HBO,CBT.At eight weeks of treatment,a total of 33 kinds of literature reported the decline in the HAMD score of PSD patients treated with various intervention measures after eight weeks of treatment.Compared with the control group,low-frequency rTMS(MD=5.42,95%CI: 2.47-8.40),high-frequency rTMS(MD=3.21,95%CI: 1.50-4.88),HBO(MD=4.93,95%CI: 2.39-7.49),CBT(MD=4.71,95%CI: 2.61-6.91)Music therapy(MD=6.40,95%CI: 4.04-8.78)five non-drug treatment interventions reduced HAMD scores,and the differences were statistically significant;Compared with high-frequency rTMS,music therapy(MD=3.20,95%CI: 0.24-6.05)had statistically significant difference in reducing HAMD score,and there was no significant difference between other non-drug treatment interventions.The probability ranking results of the network meta-analysis were as follows: Music Therapy,lowfrequency rTMS,CBT,HBO,high-frequency rTMS;All patients were treated with fluoxetine for eight weeks because there is no literature on the treatment of fluoxetine combined with HBO in the literature of this study,only the differences in the efficacy of high-frequency rTMS,low-frequency rTMS,CBT and music therapy in the treatment of PSD are compared.Compared with the control group,low-frequency rTMS(MD=7.98,95%CI: 2.48-13.74)and music therapy(MD=8.22,95%CI: 3.90-12.66)decreased HAMD score,and there was no significant difference between the control group and other nondrug therapy interventions;There was no significant difference between the four non-drug treatment interventions.The probability ranking results of the network meta-analysis were as follows: Music Therapy,low frequency rTMS,high frequency rTMS,CBT.Conclusions After four weeks of treatment,high-frequency rTMS,HBO,low-frequency rTMS,and CBT were effective in the treatment of PSD,and high-frequency rTMS was the best;After eight weeks of treatment,high-frequency rTMS,HBO,low-frequency rTMS,CBT and music therapy were effective in the treatment of PSD,among which music therapy was relatively the best.Figure15;Table9;Reference 184... |
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