A systematic review on effect and safety of acupuncture for perimenopausal depression

Objective:To assess the effect and safety of acupuncture in the treatment for perimenopausal depression.Methods:Randomized controlled trials(RCTs) involving acupuncture for perimenopausal depression were identified from CBM(1979 to 2010),VIP(1979 to 2010),WANFANG Database(1998 to 2010),CNKI(1979 to 2010),PubMed(1966 to 2009),EMbase(1980 to 2010),and The Cochrane Library(Issue 4,2010).We also hand searched relevant journals from library of Guangzhou University of Chinese Medicine.Then assessed the quality according to Cochrane Handbook 5.0.The Cochrane Collaboration's RevMan 5.0.24 software was used for data analyses.'GRADE profiler' software was making the evidence classification of this system review's evaluation results.Results:A total of 13 trials involving 1057 patients were included.Meta-analyses showed that the effective rate in the acupuncture combined with western medicine group was higher when compared with western medicine[OR=1.01,95%CI(1.38,5.51)]and also the cure rate[OR=2.91,95%CI(1.82,4.65)].As for acupuncture compared with western medicine,no significant difference was noted in effective rate[OR=1.08,95%CI(0.64,1.83)],cure rate[OR=1.04,95%CI(0.70,1.56)] and the HAMD score at week 2 [WMD=-0.35,95%CI(-3.43,2.72)];at week 4[WMD=0.01,95%CI-1.96,1.98)];at week 6[WMD=-0.19,95%CI(-2.57,2.18)].GRADE evidence classification is very low.The incidence of adverse events of acupuncture(1.5%) was lower than western medicine group(12.5%)which showed acupuncture relatively safer than western medicine therapy.Conclusion:Acupuncture was a relative safe method with few adverse reactions.In combination with western medicine,acupuncture in the treatment of perimenopausal depression reducing HAMD rate shown potentially valid tendency,while acupuncture compared to western medicine therapy showed no statistical difference.Further researches were required to define the role of acupuncture in the treatment of perimenopausal depression neurosis.