Acupuncture for Chronic Pain-Related Depression: A Systematic Review and Meta-Analysis.

Jianyu You,Rixin Chen,Mingren Chen,Haiyan Li,Dingyi Xie,César Fernández-De-Las-Peñas

doi:10.1155/2021/6617075

Abstract

Objective The aim of this systematic review was to summarize and evaluate the existing evidence on the effectiveness and safety of acupuncture in relieving chronic pain-related depression (CPRD). Methods We searched seven online databases to identify eligible randomized controlled trials (RCTs) of acupuncture for CPRD published before September 2020. We included studies that used acupuncture as the intervention group, with or without a control group, and the control group was treated with conventional drugs. Meta-analysis was performed using RevMan 5.3 software. For outcomes, assessments were performed using the Hamilton Depression Scale (HAMD), Visual Analogue Scale (VAS), and adverse events. Results Eight studies involving 636 participants were identified and included in the meta-analysis. The results showed that single acupuncture treatment and drug treatment have the same effect in improving the HAMD score (MD = −0.14, 95% CI = [−0.88, 0.59], P = 0.71) and alleviating the VAS score (MD = −0.42, 95% CI = [−1.10, −0.27], P = 0.23), but acupuncture treatment is safer (OR = 0.03, 95% CI = [0.01, 0.21], P = 0.0003). In addition, acupuncture combined with drugs (control group) is more beneficial than single-drug treatment in improving the HAMD score (MD = −2.95, 95% CI = [−3.55, −2.36], P < 0.00001) and alleviating the VAS score (MD = −1.06, 95% CI = [−1.65, −0.47], P = 0.0004). Conclusion Acupuncture is an effective and safe treatment for CPRD, and acupuncture combined with drug therapy is more effective than single-drug therapy. Nevertheless, the conclusions were limited due to the low quality and a small number of included studies.

Highlights

Chronic pain (CP) is defined as pain that continues beyond 3 months
We included a total of 8 randomized controlled trials (RCTs), involving 636 participants, including 316 in the experimental group and 320 in the control group
The brain structures involved in pain and depression shared neural circuits, and neurochemicals play an important role in the formation of pain and depression [6, 37, 38]

Summary

Introduction

Chronic pain (CP) is defined as pain that continues beyond 3 months. Internationally, no less than 20% of adults (18–65 years) and more than 33% of older adults (>65 years) suffer from CP [1]. RCTs were published in English or Chinese; (2) types of participants: Participants met the diagnosis of depression and chronic pain at the same time; (3) type of intervention: e only experimental treatments allowed are manual acupuncture or electroacupuncture alone, or either of these combined with the control group (drugs); (4) types of control groups: e control group should be conventional drug therapy, and the method, dosage, and course of treatment were reported in detail. Among all the included 8 RCTs, five studies [29,30,31, 33, 34] used a random number table to generate random sequences for grouping and were assessed as low ROB.

Results

Conclusion