Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression
Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression
复制标题
DOI：
10.1016/j.jad.2012.04.008
复制
发表时间：
2012-12-15
影响因子：
6.6
通讯作者：
Wong, Vivian Taam
中科院分区：
文献类型：
--
作者：
Chung, Ka-Fai;Yeung, Wing-Fai;Wong, Vivian Taam
背景：产后抑郁症影响10%-15%的母亲。尽管针灸对妊娠期和围产期外的女性抑郁症有效，但目前还没有关于针刺治疗产后抑郁症的可行性、耐受性和有效性的随机对照研究。方法：这是一项随机、受试者和评估者盲法、平行分组、假对照试验。20例产后6个月内经DSM-IV诊断为轻度抑郁症的产妇，汉密尔顿抑郁量表(HDRS17)17项评分为12~19分，随机分为电针组和非侵入性假针刺组，每周2次，共4周。结果：两组产后4周HDRS17评分均较治疗前显著降低，其中电针组和假针刺组的有效值分别为1.4和1.8。早在开始针灸后两周就观察到改善。治疗4周后，电针组有效率和缓解率分别为33%和44%，假针刺组分别为60%和50%。在所有结果指标上，包括HDRS17、爱丁堡产后抑郁量表、医院焦虑和抑郁量表、临床总体印象和希恩残疾量表，两组之间没有显著差异。两组间的治疗可信度、致盲成功率和不良事件相似。限制：样本量小，流失率高。结论：电针和无创假针刺治疗产后抑郁症均有效。利用更大的样本量、更好的招募策略和家庭针灸治疗进行进一步的研究是有必要的。
Background: Postpartum depression affects 10-15% of mothers. Although acupuncture was efficacious for major depressive disorder in pregnancy and in women outside the perinatal period, there has been no randomized controlled study on the feasibility, tolerability, and efficacy of acupuncture for postpartum depression.Methods: This was a randomized, subject- and assessor-blind, parallel-group, sham-controlled trial. Twenty women within six months postpartum with DSM-IV-diagnosed major depressive disorder of mild severity, defined as a 17-item Hamilton Depression Rating Scale (HDRS17) score of 12 to 19, were randomly assigned to either electroacupuncture or non-invasive sham acupuncture two sessions weekly for four weeks.Results: There was significant reduction in HDRS17 score from baseline to 4-week posttreatment in both groups, with an effect size 1.4 and 1.8 for electroacupuncture and sham acupuncture, respectively. Improvement was observed as early as two weeks after commencing acupuncture. The response and remission rate in the electroacupuncture group at 4-week posttreatment was 33% and 44%, respectively; for the sham acupuncture group, it was 60% and 50%, respectively. There was no significant between-group difference in all outcome measures, including the HDRS17, Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale, Clinical Global Impression, and Sheehan Disability Scale. Treatment credibility, success of blinding, and adverse events were similar between groups.Limitation: Small sample size and high attrition rate. No waiting list observation group.Conclusion: Both electroacupuncture and non-invasive sham acupuncture were effective for postpartum depression. Further studies utilizing larger sample size, better recruitment strategies, and home-based acupuncture treatment are warranted.