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Clinical effects and safety of electroacupuncture for the treatment of post-stroke depression: a systematic review and meta-analysis of randomised controlled trials
  1. Xue-bin Li1,2,
  2. Jie Wang3,
  3. An-ding Xu1,
  4. Jian-min Huang2,
  5. Lan-Qing Meng2,
  6. Rui-Ya Huang2,
  7. Jing Xu4
  1. 1 Stroke Center & Neurology Division, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China
  2. 2 Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
  3. 3 Department of Nephrology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
  4. 4 Department of Traditional Chinese Medicine, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi Zhuang Autonomous Region 533000, China
  1. Correspondence to Professor An-ding Xu, Stroke Center & Neurology Division, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province 510630, China; tlil{at}jnu.edu.cn

Abstract

Objective The aim of this systematic review was to assess the efficacy/effectiveness and safety of electroacupuncture (EA) in the treatment of post-stroke depression (PSD).

Methods A comprehensive literature search in the Pubmed, Embase, CENTRAL, ISI Web of Science, CNKI and Wanfang databases was conducted, and all relevant randomised controlled trials (RCTs) were screened for eligibility by two independent reviewers. The Cochrane Collaboration’s tool and Jadad score were used to assess the risk of bias of included studies, and only RCTs scoring ≥3 were included in a meta-analysis.

Results 18 RCTs involving a total of 813 participants (mean age 61.6 years) in the EA groups and 723 participants (mean age 61.9 years) in the control groups were included. The included studies had an average 3 point Jadad score. PSD was diagnosed according to the Chinese Classification of Cerebrovascular Disease (CCCD) and the Chinese Classification of Mental Disease (CCMD) criteria. There was no significant difference between EA and antidepressants (fluoxetine 10–40 mg/day, citalopram 20 mg/day, sertraline 50 mg/day) in terms of the Hamilton Depression Rating Scale (HAMD) scores at week 4 after treatment (standardised mean difference (SMD) −0.11, 95% CI −0.31 to 0.10), at week 6 after treatment (SMD 0.04, 95% CI −0.43 to 0.51) or at week 8 after treatment (SMD −0.01, 95% CI −0.23 to 0.22). However, the combined incidence of adverse events in the EA groups was significantly lower than in the antidepressant groups (RR 0.21, 95% CI 0.14 to 0.33).

Conclusion There was no significant difference between EA and antidepressants in the severity of depression, however EA caused fewer adverse events than antidepressants. Additional larger scale RCTs with rigorous study design are required.

  • electroacupuncture
  • stroke medicine
  • systematic reviews

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Footnotes

  • Contributors AdX had full access to all of the data in the study and takes responsibility for its integrity and the accuracy of its analysis. XbL developed the idea, performed the literature search, analysed the data, and drafted and revised the paper. JW, JmH and LQM designed the data collection tool, analysed the data and revised the manuscript. RYH and JX were responsible the for statistical analysis and acquisition of data and revised the final manuscript. All authors read and approved the final version of the manuscript accepted for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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