Efficacy and safety of acupuncture for postpartum depression: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

CAO Yue ¹ , CAO Wei ¹ , YUAN Jie ² , LI Meixuan ^3,5 , LI Xiuxia ^4,5 , YANG Kehu ^3,4,5 ,  WEN Chuanbiao ⁶

1. Department of Acupuncture and Moxibustion, Chengdu University of TCM, Chengdu 610075, P.R.China;
2. Department of Encephalopathy, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi’an 710003, P.R.China;
3. The Evidence-based Medicine Center of Lanzhou University, The School of Basic Medical Science of Lanzhou University, Lanzhou 730000, P.R.China;
4. Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P.R.China;
5. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, P.R.China;
6. School of Medical Information Engineering, Chengdu University of TCM, Chengdu 610075, P.R.China;

Corresponding author：

WEN Chuanbiao, Email: 228237222@qq.com

Keywords：

Acupuncture; Postpartum depression; Efficacy; Safety; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.202103078

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy and safety of acupuncture on postpartum depression (PPD).Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of acupuncture in treatment of PPD from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata16.0 software.Results A total of 13 RCTs involving 899 patients were included. The results of meta-analysis showed that there was no significant difference between hand acupuncture and fluoxetine hydrochloride in HAMD score (MD=0.45, 95%CI −0.52 to 1.41, P=0.36), clinical effective rate (RR=0.93, 95%CI 0.70 to 1.23, P=0.59), and clinical cure rate (RR=0.88, 95%CI 0.44 to 1.76, P=0.73). However, hand acupuncture was superior in safety to fluoxetine hydrochloride (RR=0.04, 95%CI 0.01 to 0.28, P<0.05). There was no significant difference in clinical effective rate (RR=1.08, 95%CI 0.87 to 1.36, P=0.49) and cure rate (RR=1.31, 95%CI 0.84 to 2.04, P=0.24) between both groups.Conclusions The current evidence shows that there are no differences between hand acupuncture and non-acupuncture in reducing HAMD score, improving the clinical effective rate and clinical cure rate. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.

Citation： CAO Yue, CAO Wei, YUAN Jie, LI Meixuan, LI Xiuxia, YANG Kehu, WEN Chuanbiao. Efficacy and safety of acupuncture for postpartum depression: a systematic review. Chinese Journal of Evidence-Based Medicine, 2021, 21(8): 922-928. doi: 10.7507/1672-2531.202103078 Copy

1.	Shorey S, Chee CYI, Ng ED, et al. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res, 2018, 104: 235-248.
2.	Lewis BA, Gjerdingen D, Schuver K, et al. The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health, 2018, 18(1): 12.
3.	Josefsson A, Larsson C, Sydsjö G, et al. Temperament and character in women with postpartum depression. Arch Womens Ment Health, 2007, 10(1): 3-7.
4.	de Paula Eduardo JAF, de Rezende MG, Menezes PR, et al. Preterm birth as a risk factor for postpartum depression: a systematic review and meta-analysis. J Affect Disord, 2019, 259: 392-403.
5.	Xu H, Ding Y, Ma Y, et al. Cesarean section and risk of postpartum depression: a meta-analysis. J Psychosom Res, 2017, 97: 118-126.
6.	Figueiredo B, Dias CC, Brandão S, et al. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J), 2013, 89(4): 332-338.
7.	Maimburg RD, Vaeth M. Postpartum depression among first-time mothers - results from a parallel randomised trial. Sex Reprod Healthc, 2015, 6(2): 95-100.
8.	Hantsoo L, Ward-O'Brien D, Czarkowski KA, et al. A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression. Psychopharmacology (Berl), 2014, 231(5): 939-948.
9.	Sheikh M, Hantoushzadeh S, Shariat M, et al. The efficacy of early iron supplementation on postpartum depression, a randomized double-blind placebo-controlled trial. Eur J Nutr, 2017, 56(2): 901-908.
10.	Mokhber N, Namjoo M, Tara F, et al. Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial. J Matern Fetal Neonatal Med, 2011, 24(1): 104-108.
11.	Simavli S, Kaygusuz I, Gumus I, et al. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. J Affect Disord, 2014, 156: 194-199.
12.	Buttner MM, Brock RL, O'Hara MW, et al. Efficacy of yoga for depressed postpartum women: a randomized controlled trial. Complement Ther Clin Pract, 2015, 21(2): 94-100.
13.	Jiang L, Wang ZZ, Qiu LR, et al. Psychological intervention for postpartum depression. J Huazhong Univ Sci Technolog Med Sci, 2014, 34(3): 437-442.
14.	Milgrom J, Danaher BG, Gemmill AW, et al. Internet cognitive behavioral therapy for women with postnatal depression: a randomized controlled trial of mummoodbooster. J Med Internet Res, 2016, 18(3): e54.
15.	Tsai SS, Wang HH, Chou FH. The effects of aromatherapy on postpartum women: a systematic review. J Nurs Res, 2020, 28(3): e96.
16.	王斐繁. 中药治疗产后抑郁障碍的系统评价. 哈尔滨: 黑龙江中医药大学, 2019.
17.	王金凤, 谭凌菁. 针刺治疗产后抑郁症的 Meta 分析. 世界针灸杂志(英文版), 2017, 27(1): 28-34.
18.	Peng L, Fu C, Xiong F, et al. Effects of repetitive transcranial magnetic stimulation on depression symptoms and cognitive function in treating patients with postpartum depression: a systematic review and meta-analysis of randomized controlled trials. Psychiatry Res, 2020, 290: 113124.
19.	石学敏. 针灸临床适应病证与未来展望. 中国针灸, 2011, 31(11): 961-964.
20.	官宏, 王健. 产后抑郁的现代病因病机研究及针灸治疗进展. 中医药学报, 2020, 48(12): 74-78.
21.	郑雅峰, 魏超, 王健, 等. 针灸治疗抑郁症研究进展. 中医学报, 2019, 34(4): 732-736.
22.	Li S, Zhong W, Peng W, et al. Effectiveness of acupuncture in postpartum depression: a systematic review and meta-analysis. Acupunct Med, 2018, 36(5): 295-301.
23.	Li W, Yin P, Lao L, et al. Effectiveness of acupuncture used for the management of postpartum depression: a systematic review and meta-analysis. Biomed Res Int, 2019, 2019: 6597503.
24.	Tong P, Dong LP, Yang Y, et al. Traditional Chinese acupuncture and postpartum depression: a systematic review and meta-analysis. J Chin Med Assoc, 2019, 82(9): 719-726.
25.	Higgins JP, Green S. Cochrane handbook for systematic review of intervention (Version 5.1. 0). Available at: http://handbook.cochrane.org.
26.	苏苇, 刘思聪, 海英, 等. “调任通督法”针刺对轻中度产后抑郁障碍患者的疗效分析. 时珍国医国药, 2019, 30(12): 2932-2934.
27.	陈杰, 张捷, 裴音. 针刺治疗产后抑郁症的疗效评价. 中国中医药信息杂志, 2010, 17(7): 77-78.
28.	于树静, 李雪青, 冯小明, 等. 针刺十三鬼穴对产后抑郁患者疗效及生活质量的影响. 四川中医, 2015, 33(3): 163-165.
29.	张凯宇. 针刺治疗产后抑郁临床疗效观察. 哈尔滨: 黑龙江中医药大学, 2017.
30.	习永霞, 王莹. 针刺配合心理干预对产后抑郁患者 5-HT, OFQ 和 E_2 的影响. 上海针灸杂志, 2015, 34(10): 947-950.
31.	Chung KF, Yeung WF, Zhang ZJ, et al. Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression. J Affect Disord, 2012, 142(1-3): 115-121.
32.	许淑娟. 头皮针对产后抑郁症的影响. 广州: 广州中医药大学, 2010.
33.	陈洪琳. 俞募通经法治疗产后抑郁症的临床研究. 哈尔滨: 黑龙江中医药大学, 2007.
34.	许芳, 唐启盛, 李小黎. 益肾调气法治疗产后抑郁症的随机对照临床研究. 北京中医药, 2013, 32(3): 200-203.
35.	Manber R, Schnyer RN, Allen JJ, et al. Acupuncture: a promising treatment for depression during pregnancy. J Affect Disord, 2004, 83(1): 89-95.
36.	张伟范, 孙沫, 吕大鸣, 等. 耳穴电针治疗产后抑郁症 43 例. 中国针灸, 2012, 32(12): 1075-1076.
37.	赵蓉. 针灸治疗产后抑郁症 50 例. 河南中医, 2011, 31(4): 405-406.
38.	董建萍, 高岩. 头部透穴结合普通针刺治疗产后抑郁症 30 例. 黑龙江中医药, 2014, 43(5): 54-55.
39.	苏谨程, 张佳蓉, 伍亚男. 针刺治疗产后抑郁症的选穴规律研究. 贵州中医药大学学报, 2021, 02: 88-93.
40.	刘思聪, 裴莹, 汤聪, 等. 针灸治疗产后抑郁的理论探析. 中华中医药学刊, 2019, 11: 2621-2624.
41.	马莉, 程为平, 梅晨健, 等. 加强扬刺百会穴对抑郁症患者体内单胺类神经递质代谢影响的研究. 中西医结合心脑管病杂志, 2012, 05: 562-563.

1. Shorey S, Chee CYI, Ng ED, et al. Prevalence and incidence of postpartum depression among healthy mothers: a systematic review and meta-analysis. J Psychiatr Res, 2018, 104: 235-248.
2. Lewis BA, Gjerdingen D, Schuver K, et al. The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health, 2018, 18(1): 12.
3. Josefsson A, Larsson C, Sydsjö G, et al. Temperament and character in women with postpartum depression. Arch Womens Ment Health, 2007, 10(1): 3-7.
4. de Paula Eduardo JAF, de Rezende MG, Menezes PR, et al. Preterm birth as a risk factor for postpartum depression: a systematic review and meta-analysis. J Affect Disord, 2019, 259: 392-403.
5. Xu H, Ding Y, Ma Y, et al. Cesarean section and risk of postpartum depression: a meta-analysis. J Psychosom Res, 2017, 97: 118-126.
6. Figueiredo B, Dias CC, Brandão S, et al. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J), 2013, 89(4): 332-338.
7. Maimburg RD, Vaeth M. Postpartum depression among first-time mothers - results from a parallel randomised trial. Sex Reprod Healthc, 2015, 6(2): 95-100.
8. Hantsoo L, Ward-O'Brien D, Czarkowski KA, et al. A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression. Psychopharmacology (Berl), 2014, 231(5): 939-948.
9. Sheikh M, Hantoushzadeh S, Shariat M, et al. The efficacy of early iron supplementation on postpartum depression, a randomized double-blind placebo-controlled trial. Eur J Nutr, 2017, 56(2): 901-908.
10. Mokhber N, Namjoo M, Tara F, et al. Effect of supplementation with selenium on postpartum depression: a randomized double-blind placebo-controlled trial. J Matern Fetal Neonatal Med, 2011, 24(1): 104-108.
11. Simavli S, Kaygusuz I, Gumus I, et al. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. J Affect Disord, 2014, 156: 194-199.
12. Buttner MM, Brock RL, O'Hara MW, et al. Efficacy of yoga for depressed postpartum women: a randomized controlled trial. Complement Ther Clin Pract, 2015, 21(2): 94-100.
13. Jiang L, Wang ZZ, Qiu LR, et al. Psychological intervention for postpartum depression. J Huazhong Univ Sci Technolog Med Sci, 2014, 34(3): 437-442.
14. Milgrom J, Danaher BG, Gemmill AW, et al. Internet cognitive behavioral therapy for women with postnatal depression: a randomized controlled trial of mummoodbooster. J Med Internet Res, 2016, 18(3): e54.
15. Tsai SS, Wang HH, Chou FH. The effects of aromatherapy on postpartum women: a systematic review. J Nurs Res, 2020, 28(3): e96.
16. 王斐繁. 中药治疗产后抑郁障碍的系统评价. 哈尔滨: 黑龙江中医药大学, 2019.
17. 王金凤, 谭凌菁. 针刺治疗产后抑郁症的 Meta 分析. 世界针灸杂志(英文版), 2017, 27(1): 28-34.
18. Peng L, Fu C, Xiong F, et al. Effects of repetitive transcranial magnetic stimulation on depression symptoms and cognitive function in treating patients with postpartum depression: a systematic review and meta-analysis of randomized controlled trials. Psychiatry Res, 2020, 290: 113124.
19. 石学敏. 针灸临床适应病证与未来展望. 中国针灸, 2011, 31(11): 961-964.
20. 官宏, 王健. 产后抑郁的现代病因病机研究及针灸治疗进展. 中医药学报, 2020, 48(12): 74-78.
21. 郑雅峰, 魏超, 王健, 等. 针灸治疗抑郁症研究进展. 中医学报, 2019, 34(4): 732-736.
22. Li S, Zhong W, Peng W, et al. Effectiveness of acupuncture in postpartum depression: a systematic review and meta-analysis. Acupunct Med, 2018, 36(5): 295-301.
23. Li W, Yin P, Lao L, et al. Effectiveness of acupuncture used for the management of postpartum depression: a systematic review and meta-analysis. Biomed Res Int, 2019, 2019: 6597503.
24. Tong P, Dong LP, Yang Y, et al. Traditional Chinese acupuncture and postpartum depression: a systematic review and meta-analysis. J Chin Med Assoc, 2019, 82(9): 719-726.
25. Higgins JP, Green S. Cochrane handbook for systematic review of intervention (Version 5.1. 0). Available at: http://handbook.cochrane.org.
26. 苏苇, 刘思聪, 海英, 等. “调任通督法”针刺对轻中度产后抑郁障碍患者的疗效分析. 时珍国医国药, 2019, 30(12): 2932-2934.
27. 陈杰, 张捷, 裴音. 针刺治疗产后抑郁症的疗效评价. 中国中医药信息杂志, 2010, 17(7): 77-78.
28. 于树静, 李雪青, 冯小明, 等. 针刺十三鬼穴对产后抑郁患者疗效及生活质量的影响. 四川中医, 2015, 33(3): 163-165.
29. 张凯宇. 针刺治疗产后抑郁临床疗效观察. 哈尔滨: 黑龙江中医药大学, 2017.
30. 习永霞, 王莹. 针刺配合心理干预对产后抑郁患者 5-HT, OFQ 和 E_2 的影响. 上海针灸杂志, 2015, 34(10): 947-950.
31. Chung KF, Yeung WF, Zhang ZJ, et al. Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression. J Affect Disord, 2012, 142(1-3): 115-121.
32. 许淑娟. 头皮针对产后抑郁症的影响. 广州: 广州中医药大学, 2010.
33. 陈洪琳. 俞募通经法治疗产后抑郁症的临床研究. 哈尔滨: 黑龙江中医药大学, 2007.
34. 许芳, 唐启盛, 李小黎. 益肾调气法治疗产后抑郁症的随机对照临床研究. 北京中医药, 2013, 32(3): 200-203.
35. Manber R, Schnyer RN, Allen JJ, et al. Acupuncture: a promising treatment for depression during pregnancy. J Affect Disord, 2004, 83(1): 89-95.
36. 张伟范, 孙沫, 吕大鸣, 等. 耳穴电针治疗产后抑郁症 43 例. 中国针灸, 2012, 32(12): 1075-1076.
37. 赵蓉. 针灸治疗产后抑郁症 50 例. 河南中医, 2011, 31(4): 405-406.
38. 董建萍, 高岩. 头部透穴结合普通针刺治疗产后抑郁症 30 例. 黑龙江中医药, 2014, 43(5): 54-55.
39. 苏谨程, 张佳蓉, 伍亚男. 针刺治疗产后抑郁症的选穴规律研究. 贵州中医药大学学报, 2021, 02: 88-93.
40. 刘思聪, 裴莹, 汤聪, 等. 针灸治疗产后抑郁的理论探析. 中华中医药学刊, 2019, 11: 2621-2624.
41. 马莉, 程为平, 梅晨健, 等. 加强扬刺百会穴对抑郁症患者体内单胺类神经递质代谢影响的研究. 中西医结合心脑管病杂志, 2012, 05: 562-563.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of acupuncture for postpartum depression: a systematic review

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