基于有序数据Meta分析模型评价针灸疗效及干预层次的研究:原发性抑郁症

目的]基于针灸治疗原发性抑郁症(MD-D)的高质量临床证据与有序数据Meta分析模型,评价针灸治疗MD-D疗效及干预层次。方法]计算机检索国内外医学文献数据库,全面收集针灸治疗MD-D的高质量临床证据。按照Jadad评分法评价证据质量,采用最大似然法来拟合累积比数模型,运用STATA12.0软件进行有序数据Meta分析及效应量统计评价。结果]共纳入13项研究,有序数据Meta分析结果显示针灸相对于选择性5-羟色胺再摄取抑制剂类药物(SSRIs)疗效提高一个及一个以上的等级的可能性增加了55%,针刺配合SSRIs疗效提高一个及一个以上的等级的可能性增加了183%(202%)。结论]基于现阶段高质量临床证据,针灸干预轻中度MD-D应以针灸治疗为主,配合抗抑郁药可显著提高整体疗效。

Study to evaluate effficacy, intervention-level of acupuncture therapy based on Meta-analysis of ordinal data: major depressive disorder

Objective] Based on high quality data clinical evidence and Meta-analysis of ordinal data model to evaluate the efficacy, intervention-level of acupuncture treatment of major depressive disorder(MD-D). Methods] The published papers on clinical trails for acupuncture treatment of MD-D were widely retrieved from Chinese and abroad Database. Quality of clinical evidence was evaluated by Jadad scale. Using the maximum likelihood method to fit the cumulative odds model, STATA12.0 software was used for data analyses. Results] The 13 studies accord with the inclusive criterion were retrieved. Meta-analyses of ordinal data showed acupuncture compare with SSRIs increase the possibility of efficacy an increase of more than one level of 55%; acupuncture with SSRIs increase the possibility of efficacy an increase of more than one level of 183%. Conclusion] According to the present stage clinical evidences, treatment mild and moderate MD-D acupuncture can be used as the main treatment method, with antidepressants can significantly improve the overall efficacy.